During the shadowing internship, there were plenty of opportunities to witness interesting cases that helped me to understand the field of dermatology. The first case I saw while shadowing was of a patient who presented with Proximal subungual onychomycosis under her toenails. Patient 1
Patient History/Present Illness: This patient, a middle aged women, presented with persistent, fungus under her toes. She described it as itchy and unsightly. The fungus is present under each toe but more so under her big toes. Her condition has been going on for months and no amount of over-the-counter medication have solved the problem. The patient mentioned that at …show more content…
The patient and her family are very fair skinned and are prone to changing moles. The patient does not have a family history of psoriasis
Physical Exam: The PA examined the patient again to note any changes in the rash. She noticed that it had spread to the back of her legs and to the upper portion of her thighs. The skin was a blotchy dark red and looked swollen. The patient had a large patch the front of her lower legs and smaller patches towards the back of her lower legs and on her lower back. The rash is also painful to the touch.
Diagnostic Impression: Following the examination/ review of the results of the punch biopsy and after consulting with her presiding physician, Mrs. Simon diagnosed the patient with Pityriasis Rosea. This is a common skin disease that causes patches on the skin. The larger patches are called “mother patches” and the smaller patches are called “daughter patches”. The rash will continue to disappear on its own but will also return with time. The PA prescribed DermaSmooth in order to help with the itch and dryness of the skin. The patient was also given the option of receiving a light treatment in order to relieve the itching. Mrs. Simon also suggested that the patient take lukewarm showers and to not become overheated. The patient was also given a followup appointment to return in six weeks to note progress in her condition, as well as to call the office with any