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“I have an itchy rash on my forearm. It started as one and now there are three. I used hydrocortisone before when I have rashes, so I apply it every hour and it seems to be making it worse. My roommate told me Benadryl might help so I’ve been taking that too and it just makes me sleepy. The lesions look scaly with red rings around them.”
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History of Present Illness
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Don Williams is a 34-year-old man presenting to clinic today complaining of an itchy red rash that appears scaly with a red border on his forearm. There are a total of 3 lesions. He has been applying hydrocortisone cream every hour and it seems to be making it worse. He also tried oral Benadryl which has not helped and only made him tired. He was diagnosed with rheumatoid arthritis 4 years ago and currently stable while taking 40mg of adalimumab every other week subcutaneously.
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What signs and symptoms of tinea corporis does the patient have?
Hint: See Mycotic Infections of the Skin, Hair, and Nails in PPP
What treatment options are available for tinea corporis and would you use the same treatment options for other forms of tinea?
Hint: See Mycotic Infections of the Skin, Hair, and Nails in PPP
What risk factor(s) does the patient have for mycotic infections?
Hint: See Mycotic Infections of the Skin, Hair, and Nails in PPP
If the patient is uninsured, what would be the recommended option for over-the-counter treatment?
Hint: See Mycotic Infections of the Skin, Hair, and Nails and Table 85-6 in PPP
What, if any, are the non-pharmacological treatment options for this condition?
Hint: See Mycotic Infections of the Skin, Hair, and Nails in PPP
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What types of counseling points would you let the patient know to prevent ring worm in the future?
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Ringworm occurring on the scalp (Tinea Capitis) was historically treated worldwide with radiation therapy. It was discovered in the 1970s that radiation treatment may be associated with a higher risk of cancerous tumors in the head and neck area. In 1995, Israel enacted a law to compensate these patients who were treated with radiation therapy between 1946 and 1960. The target population of these radiation therapies was limited to children of North African immigrants with over 100,000 children affected by radiation treatment. Radiation for ...