Final answer:
In assessing circular lesions on an adolescent's back and shoulders, a nurse should consider ringworm (tinea corporis), contact dermatitis, herpes zoster, tinea versicolor, and poison ivy. However, due to the circular nature, ringworm or tinea versicolor would be the most probable causes, with ringworm being diagnosable by its characteristic fluorescence under Wood's lamp.
Step-by-step explanation:
During the assessment of an adolescent client's skin, the nurse notes circular lesions on the upper back and shoulders. Several health problems should be considered as potential causes for these lesions. The differential diagnosis may include:
- Contact dermatitis, which is an allergic reaction to something that has touched the skin, causing localized inflammation.
- Herpes zoster, also known as shingles, which can cause a painful rash with a circle or halo appearance and is usually limited to one side of the body.
- Ringworm (tinea corporis), a fungal infection of the skin that typically presents as a red, itchy, circular patch with a clear center.
- Tinea versicolor, a yeast infection that causes small, discolored patches on the skin.
- Poison ivy, which is a type of allergic contact dermatitis that results from exposure to urushiol in poison ivy plants.
Based on the description of the lesion as circular, the most likely causes would be Ringworm or Tinea versicolor. Herpes zoster could be a possibility if the lesions follow a dermatomal distribution and are accompanied by pain or a tingling sensation. However, contact dermatitis and poison ivy usually present with different patterns and features.
If the appearance of the lesions is more akin to tinea corporis, confirmed by fluorescence under a Wood's lamp as in the case described with Sarah, the diagnosis is more likely to be ringworm.