IHUMAN CASE STUDY WEEK VICTORIA LEWIS NEW RASHES
DIAGNOSTIC COMPLETE SOLUTION
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Victoria Lewis, a 25-year-old previously healthy female, presents to the dermatology
clinic with a new, spreading rash associated with moderate pruritus. The rash began 12
days ago and has evolved significantly. This case study follows a complete history,
detailed physical examination, appropriate diagnostic tests, and a comprehensive
management plan reflective of 2025/2026 evidence-based guidelines. All elements
below represent the gold-standard iHuman response for “New Rash” presentation.
📌 Patient Profile & Chief Complaint
Name: Victoria Lewis | Age: 25 years | Gender: Female | DOB: 04/10/2000
Encounter Date: May 12, 2025 | Setting: Outpatient dermatology | Chief Complaint: “I
have this itchy rash all over my trunk and arms that started two weeks ago, and it’s
getting worse.”
📖 History of Present Illness (HPI)
Victoria was in her usual state of good health until approximately 14 days before
presentation. She first noticed a single, isolated oval patch on her left upper back —
slightly scaly, salmon-colored, measuring 2.5 cm in diameter. The patch was minimally
pruritic and she thought it was a dry spot. Five to seven days later, she developed
multiple smaller oval macules and thin plaques on the central chest, abdomen, and
along the back. Over the subsequent days, the eruption spread to the proximal upper
arms, inner thighs, and neck region, avoiding the face, palms, and soles. Pruritus is
graded 5/10 (worst in the evening after warm showers). No associated fever, chills,
myalgia, arthralgia, or mucosal lesions. She denies any new topical skin products,
lotions, perfumes, or detergents apart from switching to an “eco-friendly” laundry sheet
3 weeks ago (no temporal association). She recalls no recent illness, no travel outside
the state, no new medications or supplements. No sick contacts with similar rash. She
has tried over-the-counter 1% hydrocortisone cream for the past 3 days, which provided
minimal relief. No prior history of similar rash, psoriasis, or eczema. Social stressors:
graduate student, recent final exams but denies sleep deprivation.
🔍 Additional HPI pearls: The rash shows a “Christmas tree” distribution on the back,
with the largest herald patch still visible. Lesions evolve with fine peripheral scale
(collarette). Pruritus intensifies with heat or sweating.
📋 Past Medical, Surgical, Medication & Allergy
History
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