Diagnostic Tests for Heat rash
Heat rash Tests: Book Excerpts
Heat rash Diagnosis: Book Excerpts
Diagnostic Tests for Heat rash: Online Medical Books
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PRURITUS ANI:
DIAGNOSTIC WORKUP
(Algorithmic Diagnosis of Symptoms and Signs)
If the physical examination is normal, examination with an anoscope is essential. Sigmoidoscopy should also be done but is not adequate to detect hemorrhoids, anal fissures, and fistulas. If these are negative, a trial of antifungal creams (Lotrimin®, etc.) should be given before other expensive diagnostic tests are ordered. A Scotch tape test and stool for ovum and parasites are useful, especially in children.
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Source: Algorithmic Diagnosis of Symptoms and Signs, 2003
PRURITUS, GENERALIZED:
DIAGNOSTIC WORKUP
(Algorithmic Diagnosis of Symptoms and Signs)
If there is an associated skin rash, microscopic examination of a potassium hydroxide preparation of curetted burrows will be helpful. Additional examinations include Wood's lamp evaluation, a patch test, and skin biopsies. Therapeutic trials for scabies, fungal disease, or other disorders, however, are justified if testing is not economically feasible. Routine laboratory tests for the various systemic diseases that may cause pruritus include a CBC, sedimentation rate, urinalysis, chemistry panel, ANA assay, thyroid profile, and serum protein electrophoresis. A bone marrow examination and lymph node biopsy may be useful. A dermatologist, hematologist, or endocrinologist may help solve the diagnostic dilemma. Further workup may include plain films of the chest and abdomen and CT scans of the abdomen and pelvis. A bone scan may be useful in diagnosing metastatic carcinoma. HIV testing may be indicated if the patient has a history of high-risk sexual behavior.
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Source: Algorithmic Diagnosis of Symptoms and Signs, 2003
PRURITUS, VULVAE:
DIAGNOSTIC WORKUP
(Algorithmic Diagnosis of Symptoms and Signs)
If there is a discharge, microscopic examination of a potassium hydroxide preparation and saline preparation is necessary. A smear and culture of the discharge should be done for bacteria and fungi. Scrapings of the burrows for scabies may be useful. Skin biopsy may help diagnose the cause of a rash. Lesions should be biopsied also. If senile vaginitis is suspected, serum FSH and estradiol and a Pap smear may help determine if there is estrogen deficiency. A gynecologist should be consulted in all difficult diagnostic problems.
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Source: Algorithmic Diagnosis of Symptoms and Signs, 2003
Pruritus:
History and physical examination
(Handbook of Signs & Symptoms (Third Edition))
If the patient reports pruritus, have him describe its onset, frequency, and intensity. If pruritus occurs at night, ask whether it prevents him from falling asleep or awakens him after he falls asleep. (Generally, pruritus related to dermatoses prevents — but doesn’t disturb — sleep.) Is the itching localized or generalized? When is it most severe? How long does it last? Is there a relationship to activities (physical exertion, bathing, applying makeup, or the use of perfumes)?
Ask the patient how he cleans his skin. In particular, look for excessive bathing, harsh soaps, contact allergy, and excessively hot water. Does he have occupational exposure to known skin irritants, such as glass fiber insulation or chemicals? Ask about the patient’s general health and the medications he takes (new medications are suspect). Has he recently traveled abroad? Does he have pets? Does anyone else in the house report itching? Does exercise, stress, fear, depression, or illness seem to aggravate the itching? Ask about contact with skin irritants, previous skin disorders, and related symptoms. Then obtain a complete drug history.
Examine the patient for signs of scratching, such as excoriation, purpura, scabs, scars, or lichenification. Look for primary lesions to help confirm dermatoses.
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Source: Handbook of Signs & Symptoms (Third Edition), 2006
Heat intolerance:
History and physical examination
(Handbook of Signs & Symptoms (Third Edition))
Ask the patient when he first noticed his heat intolerance. Did he gradually use fewer blankets at night? Does he have to turn up the air conditioning to keep cool? Is it hard for him to adjust to warm weather? Does he sweat in a hot environment? Find out if his appetite or weight has changed. Also, ask about unusual nervousness or other personality changes. Then take a drug history, especially noting the use of amphetamines or amphetamine-like drugs. Ask the patient if he takes a thyroid drug. If so, what’s the daily dose? When did he last take it?
As you begin the examination, notice how much clothing the patient is wearing. After taking his vital signs, inspect his skin for flushing and diaphoresis. Also, note tremors and lid lag.
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Source: Handbook of Signs & Symptoms (Third Edition), 2006
Pruritus:
History and physical examination
(Professional Guide to Signs & Symptoms (Fifth Edition))
If the patient reports pruritus, have him describe its onset, frequency, and intensity. If pruritus occurs at night, ask whether it prevents him from falling asleep or awakens him after hefalls asleep. (Generally, pruritus related to dermatoses prevents—but doesn’t disturb—sleep.) Is the itching localized or generalized? When is it most severe? How long does it last? Is there a relationship to activities (physical exertion, bathing, applying makeup, or use of perfumes)?
Ask the patient how he cleans his skin. In particular, look for excessive bathing, harsh soaps, contact allergy, and excessively hot water. Does he have occupational exposure to known skin irritants such as glass fiber insulation or chemicals? Ask about the patient’s general health and the medications he takes (new medications are suspect). Has he recently traveled abroad? Does he have any pets? Does anyone else in the house report itching? Does exercise, stress, fear, depression, or illness seem to aggravate the itching? Ask about contact with skin irritants, previous skin disorders, and related symptoms. Obtain a complete drug history.
Examine the patient for signs of scratching, such as excoriation, purpura, scabs, scars, or lichenification. Look for primary lesions to help confirm dermatoses.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Heat intolerance:
History and physical examination
(Professional Guide to Signs & Symptoms (Fifth Edition))
Ask the patient when he first noticed his heat intolerance. Did he gradually use fewer blankets at night? Does he have to turn up the air conditioning to keep cool? Is it hard for him to adjust to warm weather? Does he sweat a lot in a hot environment? Find out if his appetite or weight has changed. Also, ask about unusual nervousness or other personality changes. Then take a drug history, especially noting use of amphetamines or amphetamine-like drugs. Ask the patient if he takes a thyroid drug. If so, what is the daily dosage and when did he last take it?
As you begin the examination, notice how much clothing the patient is wearing. After taking vital signs, inspect the patient’s skin for flushing and diaphoresis. Also, note tremors and lid lag.
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Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Pruritus:
Physical examination
(The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter)
The physical examination includes a thorough examination of the skin in adequate lighting. Direct special attention to skin areas not easily observed or reached by the patient. Such areas may reveal a primary skin disorder or evidence of a systemic disease because some disorders present in particular areas. For example, scabies involves the interdigital webs, volar wrists, and genitalia, whereas atopic dermatitis occurs in the antecubital or popliteal fossae. Pityriasis rosea typically has a “herald patch” on the trunk. Fungal infections tend to occur in warm, dark, moist body surfaces (e.g., genitalia, feet, and inguinal folds).
Be able to recognize the classic signs of common skin disorders. Dematographism and wheals typically indicate uticaria (hives) (Chapter 13.7). Flat-topped polygonal papules with delicate white lines (“Wickham’s straiae”) are characteristic of lichen planus. Silver plaques on an erythematous base with a positive Auspitz sign (punctuate bleeding of the scale after blunt scraping) are characteristic of psoriasis. The application of lateral pressure on superficial, crusting lesions resulting in dislodging the epidermis, referred to as Nikolsky’s sign, indicates pemphigus foliaceus. The differential diagnosis of lymphadenopathy includes mycosis fungoides (Chapter 15.1). Pustular or lesions over hair follicles is a sign of folliculitis. Pay attention to new unscratched lesions because chronically excoriated skin from any cause has similar secondary changes. If lesions are present in unreachable areas, a systemic disease should be considered. In addition to the skin, examine other organ systems for organomegaly, lymphadenopathy, goiter, pregnancy, and signs of anemia or psychiatric disorders.
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Source: The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter, 2000
Pruritus:
Physical assessment
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
Observe the patient for signs of scratching, such as excoriation, purpura, scabs, scars, or lichenification. Look for primary lesions to help confirm dermatoses.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Pruritus:
History and physical examination
(Nursing: Interpreting Signs and Symptoms)
If the patient reports pruritus, have him describe its onset, frequency, and intensity. If pruritus occurs at night, ask whether it prevents him from falling asleep or awakens him after he falls asleep. (Generally, pruritus related to dermatoses prevents—but doesn't disturb—sleep.) Is the itching localized or generalized? When is it most severe? How long does it last? Is there a relationship to activities (physical exertion, bathing, applying makeup, or the use of perfumes)?
Ask the patient how he cleans his skin and clothes. In particular, look for excessive bathing, harsh soaps, contact allergy, and excessively hot water. Does he have occupational exposure to known skin irritants, such as glass fiber insulation or chemicals? Ask about the patient's general health and the medications he takes (new medications are suspect). Has he recently traveled abroad? Does he have pets? Does anyone else in the house report itching? Does exercise, stress, fear, depression, or illness seem to aggravate the itching? Ask about contact with skin irritants, previous skin disorders, and related symptoms. Obtain a complete drug history. Ask about abdominal pain and the appearance of stools.
Examine the patient for signs of scratching, such as excoriation, purpura, scabs, scars, or lichenification. Look for primary lesions to help confirm dermatoses. Note any jaundice. Check for hepatomegaly or abdominal pain.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
Heat intolerance:
History and physical examination
(Nursing: Interpreting Signs and Symptoms)
Ask the patient when he first noticed his heat intolerance. Did he gradually use fewer blankets at night? Does he have to turn up the air conditioning to keep cool? Is it hard for him to adjust to warm weather? Does he sweat in a hot environment? Find out if his appetite or weight has changed. Also, ask about unusual nervousness or other personality changes. Then take a drug history, especially noting the use of amphetamines or amphetamine-like drugs. Ask the patient if he takes a thyroid drug. If so, what's the daily dose? When did he last take it?
As you begin the examination, notice how much clothing the patient is wearing. After taking his vital signs, inspect his skin for flushing and diaphoresis. Also, note tremors and lid lag.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
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