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Allergic Contact Dermatitis in a Young Adult: A Comprehensive FNP Case Study on Assessment, Differential Diagnosis, and Management

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This comprehensive case study follows Sarah Mitchell, a 25-year-old female presenting with a progressive, pruritic rash following exposure to a new body lotion. Designed for MSN-FNP curriculum alignment, the case includes detailed history of present illness (HPI), review of systems (ROS), physical examination findings, differential diagnoses (contact dermatitis, urticaria, atopic dermatitis, drug eruption, viral exanthem), and final diagnosis of allergic contact dermatitis. The study provides evidence-based pharmacologic (topical corticosteroids, oral antihistamines) and non-pharmacologic interventions (trigger removal, cool compresses, oatmeal baths), patient education, follow-up criteria, and red flags for escalation. Key learning pearls emphasize trigger identification as the cornerstone of management.

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Institution
Sarah
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Sarah

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,🩺 iHuman Case Study: Sarah Mitchell – New
Rash
Comprehensive Guide + SOAP Note (Age 25)




� Patient Overview


Name: Sarah Mitchell


Age: 25 years


Gender: Female


Ethnicity: Caucasian (modifiable if needed)


Chief Complaint (CC):

“I have a rash that started a few days ago and it’s getting worse.”




� History of Present Illness (HPI)


Sarah Mitchell is a 25-year-old female presenting with a progressive rash that began

approximately 4–5 days ago.


Onset: Gradual


Location: Initially on forearms → spread to trunk and neck

,Duration: Persistent for 4–5 days


Characteristics:


Erythematous (red)


Pruritic (itchy)


Slightly raised patches


No vesicles or drainage


Aggravating factors:


Heat


Sweating


Relieving factors:


Mild relief with OTC antihistamines


Timing: Worse in the evening


Severity: 6/10 itching


Associated Symptoms:


Denies fever


Denies pain


Denies shortness of breath

, Denies recent illness


Relevant Exposure History:


Recently started using a new body lotion/perfume


No recent travel


No sick contacts


No new medications




� Past Medical History (PMH)


No chronic illnesses


No history of eczema or psoriasis


No autoimmune disorders




� Medications


Occasional OTC antihistamines (e.g., cetirizine)




Allergies


No known drug allergies (NKDA)

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Institution
Sarah
Course
Sarah

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Uploaded on
May 13, 2026
Number of pages
31
Written in
2025/2026
Type
CASE
Professor(s)
Expert
Grade
A+

Subjects

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