Buttaro, T. M., Trybulski, J., Polgar Bailey, P., & Sandberg-Cook, J. (2017). Primary care: A collaborative practice (5th ed.). St. Louis, MO: Elsevier.

Part 5, “Evaluation and Management of Skin Disorders” (pp. 237-325)

This part explores the pathophysiology, clinical presentation, and management of various skin disorders, including dermatitis, dry skin, fungal infections, and herpes. It also examines the pathophysiology, clinical presentation, physical examination, diagnostics, and management of wound healing.

Diagnosing Integumentary Disorders

When entering examination rooms, advanced practice nurses often immediately begin assessing patients by looking for external abnormalities such as skin irritations or cloudy eyes. By making these simple observations, they can determine how to proceed with their patient evaluations. During the patient evaluation, advanced practice nurses will use initial observations to guide them in acquiring the necessary medical history, performing additional assessments, and ordering the appropriate diagnostics. The information obtained during this evaluation process will help in the development of a differential diagnosis. Once a diagnosis is made, the advanced practice nurse can consider potential treatment options and work with the patient to develop a plan of care. For this Discussion, consider the following three case studies of patients presenting with integumentary disorders.

Case Study 3

J.V. 50 year old patient with history of eczema is here today complaining of lesions on the right side of her face and neck. She thinks it is a flare up of her eczema and is asking for a refill of her ointment, TAC 0.1%.

She complains of some ‘itching’ and a bit of ‘tingling and pain’ to the lesions. She’s a pharmaceutical worker and thinks that the ‘pain’ maybe due to contaminate exposure. Denies any other associating symptoms.

To prepare:

  1. Review Part 5 of the Buttaro et al. text and the case studies provided
  2. Reflect on the provided patient information including history and physical exams.
  3. Think about a differential diagnosis. Consider the role the patient history and physical exam played in your diagnosis.
  4. Reflect on potential treatment options based on your diagnosis.

Assignment Requirement: Please use scholar resources.

Diagnosis Hint: she has Contact Dermatitis.

Write: an explanation of the primary diagnosis, as well as 3 differential diagnoses, for the patient in the case study that you selected or were assigned. Describe the role the patient history and physical exam played in the diagnosis. Then, suggest potential treatment options based on your patient diagnosis

2) List the primary diagnosis with rationale

3) List THREE differential diagnoses with rationale and how you would rule each out

4) Describe the pertinent history required to make the primary diagnosis

5) Describe your physical exam findings that you anticipate seeing for your primary diagnosis

6) Discuss the primary diagnosis treatment plan for the patient including:


Interventions/ lifestyle changes


Follow up


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