N.H., a 4-year-old male is brought into your office by grandmother with c/o rash on neck and back which started after a birthday party at an indoor play place with a bouncy house and a ball pit earlier today. GM describes spots as looking like mosquito bites and seem itchy. First noticed one on the back of his neck then a couple of spots appeared on his back and the one on his neck went away. No new foods eaten (had pizza, cake, and candy at the party), no new soaps or detergents used recently. No fever, has had some mild nasal congestion for about one week. Denies cough, difficulty breathing, swelling. Seems tired per GM, but he was very active at the party. Vomited once in the car, GM thinks he “ate his cake too fast” PMH: No major illnesses or hospitalizations. Immun: UTD. MMR & Varicella were given two weeks ago at WCV. Meds: None Allergies: NKA, NKDA PE: VS: Wt. 16 kg, HR 116, RR 24, BP: 86/48, 02 Sat 97% On exam, NH is alert and anxious on exam table. Skin: 3 raised irregularly shaped pink areas with central edges, on the back of neck and left posterior upper back with some scratch marks surrounding the ones on back, remainder of skin clear. Rest of exam WNL. Is there any additional information you would like to know? Is there any testing you would like to do? What are your differential diagnosis and your assessment diagnosis? How will you manage this child? How will you treat him? Will you prescribe any medication? Is there any testing you would like to do? What education do you provide the caregiver?
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[Expert Solution]: N.H., a 4-year-old male is brought…