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I-HUMAN WEEK 4 CASE STUDY 13-YEAR-OLD
FEMALE WITH ITCHY SKIN COMPREHENSIVE
CASE SOLUTION | VERIFIED ANSWERS | A+
RATED
**Case Type:** Pediatric Dermatology / Allergy
**Chief Complaint:** “My skin has been really itchy for the past few
weeks”
**Age:** 13 years, Female
**Setting:** Outpatient primary care clinic
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CHIEF COMPLAINT & HISTORY OF PRESENT ILLNESS (HPI)
### Chief Complaint (CC)
> *“I can’t stop scratching. My skin is so itchy, especially at night.”*
### History of Present Illness (HPI) – Key Information to Elicit
| Question | Expected Answer | Clinical Significance |
|----------|----------------|----------------------|
| **When did itching start?** | Approximately 3–4 weeks ago | Subacute
duration (not acute, not chronic) |
| **Where is the itching located?** | Inner elbows, behind knees, neck,
face (cheeks), wrists | Flexural distribution → atopic dermatitis |
| **What makes itching worse?** | Nighttime, dry air, stress, sweating,
wool clothing | Common triggers for eczema |
| **What makes it better?** | Cool compresses, moisturizers,
antihistamines (partial relief) | Supports allergic/inflammatory etiology |
| **Have you used any creams or medications?** | Over-the-counter
hydrocortisone cream (minimal relief), oral diphenhydramine at night
(helps with sleep, not itching) | Partial response to low-potency steroid
and antihistamine |
| **Any rash or visible skin changes?** | Yes – dry, red patches that ooze
sometimes. Patient reports scratching until skin bleeds | Excoriations,
erythema, possible lichenification |
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| **Any fever, fatigue, weight loss?** | No | Rules out systemic illness |
| **Any new soaps, detergents, lotions?** | New scented body wash
(used for 2 months) and fabric softener (used for 1 month) | Possible
irritant or allergic trigger |
| **Any seasonal allergies or asthma?** | Yes – seasonal allergies
(pollen) and mild asthma (uses albuterol PRN) | Atopic triad: eczema,
asthma, allergic rhinitis |
| **Any family history of eczema, allergies, asthma?** | Mother has
seasonal allergies; brother has asthma | Strong atopic family history |
| **Any new pets or environmental changes?** | New puppy
(labradoodle) 3 months ago; no known pet allergy | Possible animal
dander trigger |
| **Does itching interfere with sleep or school?** | Yes – wakes up 2–3
times per night to scratch; tired during school | Sleep disruption affects
quality of life |
---
## SECTION 2 – REVIEW OF SYSTEMS (ROS)
| System | Findings |
|--------|----------|
| **General** | Well-appearing, no fever, no weight loss, no fatigue
(except from poor sleep) |
| **HEENT** | No eye redness, no nasal congestion, no sore throat |
I-HUMAN WEEK 4 CASE STUDY 13-YEAR-OLD
FEMALE WITH ITCHY SKIN COMPREHENSIVE
CASE SOLUTION | VERIFIED ANSWERS | A+
RATED
**Case Type:** Pediatric Dermatology / Allergy
**Chief Complaint:** “My skin has been really itchy for the past few
weeks”
**Age:** 13 years, Female
**Setting:** Outpatient primary care clinic
,2|Page
CHIEF COMPLAINT & HISTORY OF PRESENT ILLNESS (HPI)
### Chief Complaint (CC)
> *“I can’t stop scratching. My skin is so itchy, especially at night.”*
### History of Present Illness (HPI) – Key Information to Elicit
| Question | Expected Answer | Clinical Significance |
|----------|----------------|----------------------|
| **When did itching start?** | Approximately 3–4 weeks ago | Subacute
duration (not acute, not chronic) |
| **Where is the itching located?** | Inner elbows, behind knees, neck,
face (cheeks), wrists | Flexural distribution → atopic dermatitis |
| **What makes itching worse?** | Nighttime, dry air, stress, sweating,
wool clothing | Common triggers for eczema |
| **What makes it better?** | Cool compresses, moisturizers,
antihistamines (partial relief) | Supports allergic/inflammatory etiology |
| **Have you used any creams or medications?** | Over-the-counter
hydrocortisone cream (minimal relief), oral diphenhydramine at night
(helps with sleep, not itching) | Partial response to low-potency steroid
and antihistamine |
| **Any rash or visible skin changes?** | Yes – dry, red patches that ooze
sometimes. Patient reports scratching until skin bleeds | Excoriations,
erythema, possible lichenification |
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| **Any fever, fatigue, weight loss?** | No | Rules out systemic illness |
| **Any new soaps, detergents, lotions?** | New scented body wash
(used for 2 months) and fabric softener (used for 1 month) | Possible
irritant or allergic trigger |
| **Any seasonal allergies or asthma?** | Yes – seasonal allergies
(pollen) and mild asthma (uses albuterol PRN) | Atopic triad: eczema,
asthma, allergic rhinitis |
| **Any family history of eczema, allergies, asthma?** | Mother has
seasonal allergies; brother has asthma | Strong atopic family history |
| **Any new pets or environmental changes?** | New puppy
(labradoodle) 3 months ago; no known pet allergy | Possible animal
dander trigger |
| **Does itching interfere with sleep or school?** | Yes – wakes up 2–3
times per night to scratch; tired during school | Sleep disruption affects
quality of life |
---
## SECTION 2 – REVIEW OF SYSTEMS (ROS)
| System | Findings |
|--------|----------|
| **General** | Well-appearing, no fever, no weight loss, no fatigue
(except from poor sleep) |
| **HEENT** | No eye redness, no nasal congestion, no sore throat |
