Chief Complaint: “Rash over body”x 3 day

History of Present Illness:
7 y/o BIB mother due to concerns of outbreak of small red spots over her daughters skin
throughout the past 3 days. Mother states she first noticed red spots in lower back when helping
her daughter change clothes 3 days ago. Mother states that days she only saw a couple of spots
but throughout the course of 3 days, there has been an eruption of spots throughout her back. She
also states a similar lesion on her abdomen as well but primarily a rash is spread throughout her
back. Patient states the rash is itchy but denies any pain over the area. Denies any redness or
swelling in area.Denies using any medication but mother states she applied regular body lotion
over the area with no relief of itch. Denies any history of allergies, fever, cough,congestion
,swelling or discharge from the area.

Medications:
None
Medical history:
Denies
Surgical History:
None
Immunization Hx:

Per CIR Database: All immunizations up to date
Allergies:

NKDA,No known food or environmental allergies

Family History:
Father: Alive 38 yrs, no known medical history
Mother: Alive 34 yrs, no known medical history
Social History:
J.N is a 7 y/o girl who lives at home with mother and father in a single family house.
Diet: Admits to a well balanced diet including fruits and vegetables.
Sleep: 8-9 hours
Exercise: Active, plays at school and at the park daily.
Travel: Denies recent travel
Safety Measures: Mother walks daughter to school daily

Review of Systems:

General: Denies fever, chills, fatigue, loss of appetite.
Skin, hair, nails: Multiple pruritic red/pink lesions on trunk and abdomen
Head: Denies headache, head trauma, dizziness.

Eyes: Denies swelling, pruritus, warmth, and erythema.

Ears: Denies pruritus, pain, discharge, or hearing loss.

Nose/sinuses: Denies discharge, congestion, epistaxis and obstruction.
Mouth/throat: Denies bleeding gums, mouth ulcerations, sore throat, voice changes.
Neck: Denies swelling or decreased range of motion.
Pulmonary System: Denies shortness of breath, cough, wheezing.
Cardiovascular System: Denies chest pain or palpitations.
Gastrointestinal System: : Denies loss of appetite, nausea and vomiting, dysphagia, abdominal
pain, diarrhea.
Genitourinary: Denies urinary frequency, urgency, dysuria.

Musculoskeletal System: Denies deformity, swelling, pain.
Hematological System: Denies easy bruising or bleeding.

Physical:
General: 7 y/o healthy female appears as her stated age.In no acute distress, well groomed and
dresses appropriate for the weather.
Vitals:
Temperature: 97.5 F
Height: 45 inch
Weight: 44lb
BMI: 15.28 /44.73%

SpO2: 99% room air
Respiratory Rate: 16
PHYSICAL EXAM
Skin: Multiple pink, oval-shaped lesions, ranging from 0.5 to 2 centimeters in diameter,
distributed primarily on the trunk A larger, oval-shaped lesion with a scaly border noted on the
abdomen.
Hair: Average quantity. No lice or seborrhea noted.

Nails: No spooning or clubbing of nails.

Head: Head normocephalic, atraumatic.

Eyes: Symmetrical OU. Sclera white. Conjunctiva pink.
Ears: Symmetrical, no swelling or lesions to the external ear. No discharge or foreign bodies
present AU. TM pearly grey with light reflex in good position AU.

Nose: Nares patent bilaterally. No discharge or foreign bodies noted.
Mouth/Pharynx: Lips pink and moist with no cyanosis or lesions. Buccal mucosa pink and well
hydrated. Good dentition, no obvious dental caries noted. No gingival hyperplasia or erythema
present. Uvula midline. Tonsils present with no exudates.
Neck/Thyroid:The trachea is midline without masses or scars. No anterior cervical
lymphadenopathy on palpation.

Cardiac:Regular rate and rhythm, S1 and S2 present on auscultation. No murmurs, gallops, rubs,
S3, or S4.

Lungs: Clear to auscultation bilaterally, no adventitious sounds noted.

Abdomen: Abdomen flat and symmetric, non-distended, no masses, ecchymosis or striae noted.
Bowel sounds normoactive in all four quadrants. Non-tender to palpation, no guarding or
rebound noted.
Musculoskeletal: No soft tissue swelling. FROM in upper and lower extremities.
DDx
Pityriasis Rosea
Chicken Pox(Varicella)
Bed bug Bites

Assessment:
7 y/o female, with no pmhx presented to outpatient pediatric clinic with findings consistent with
Pityriasis Rosea. Patient will be treated symptomatically and educated on a typical course.

Plan

Pityriasis Rosea

• Start Diphenhydramine HCL Elixir, 6ml at night for 7 days.
• Education regarding the benign nature of pityriasis rosea and its self-limited course.