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Several tests suggest Wilson’s disease:
❑ Serum ceruloplasmin: less than 20 mg/dl
❑ Serum copper: less than 80 mcg/dl
❑ Urine copper: more than 100 mcg/24 hours (may be as high as 1,000 mcg)
❑ Liver biopsy: excessive copper deposits (250 mcg/g dry weight), tissue changes indicative of chronic active hepatitis, fatty liver, or cirrhosis.
Source: Professional Guide to Diseases (Eighth Edition), 2005
If erythema isn’t associated with anaphylaxis, obtain a detailed health history. (See Differential diagnosis: Erythema, pages 310 and 311.) Find out how long the patient has had the erythema and where it first began. Has he had any associated pain or itching? Has he recently had a fever, an upper respiratory tract infection, or joint pain? Does he have a history of skin disease or other illness? Does he or anyone in his family have allergies, asthma, or eczema? Find out if he has been exposed to someone who has had a similar rash or who is now ill. Did he have a recent fall or injury in the erythematous area?
Obtain a complete drug history, including recent immunizations. Ask about food intake and exposure to chemicals.
Begin the physical examination by assessing the extent, distribution, and intensity of erythema. Look for edema and other skin lesions, such as urticaria, scales, papules, and purpura. Examine the affected area for warmth, and gently palpate it to check for tenderness or crepitus.
Cultural Cue: Dark-skinned patients may have difficulty recognizing erythema; as a result, they may present with associated diseases in a more advanced state.
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
If erythema isn't associated with anaphylaxis, obtain a detailed health history. Find out how long the patient has had the erythema and where it first began. Has he had associated pain or itching? Has he recently had a fever, upper respiratory tract infection, or joint pain? Does he have a history of skin disease or other illness? Does he or anyone in his family have allergies, asthma, or eczema? Find out if he has been exposed to someone who has had a similar rash or who's now ill. Did he have a recent fall or injury in the area of erythema? Obtain a complete drug history, including recent immunizations. Ask about food intake and exposure to chemicals. Begin the physical examination by assessing the extent, distribution, and intensity of erythema. Look for edema and other skin lesions, such as hives, scales, papules, and purpura. Examine the affected area for warmth, and gently palpate it to check for tenderness or crepitus.
Source: Nursing: Interpreting Signs and Symptoms, 2007
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Erythema [Erythroderma]:
History and physical examination
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History and physical examination
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