A 10-year-old child presents to the school nurse with complaints of an itchy rash on the right arm.
Based on these findings, identify the medical term of this rash, and what would be the common topical treatment drug class.

Choice A rationale

Eczema, also known as atopic dermatitis, is a chronic inflammatory skin condition characterized by pruritus (itching), erythema (redness), and scaling. Topical corticosteroids are the first-line treatment due to their potent anti-inflammatory and immunosuppressive properties, which help to reduce the inflammatory response in the skin and alleviate itching.

Choice B rationale

Psoriasis is a chronic autoimmune skin disorder characterized by thickened, scaly plaques. Topical calcineurin inhibitors are used to treat psoriasis by suppressing the activity of T-cells, which are involved in the inflammatory process. The presentation of an itchy rash as the primary finding is less consistent with typical psoriasis.

Choice C rationale

Contact dermatitis is an inflammatory skin reaction resulting from direct contact with an irritant or allergen, often presenting with redness, swelling, and vesicles in addition to itching. While topical antihistamines can help with itching associated with allergic reactions, topical corticosteroids are generally more effective for managing the inflammation in contact dermatitis.

Choice D rationale

Tinea corporis, or ringworm, is a fungal infection of the skin characterized by circular, raised, scaly patches with central clearing. Topical antifungals are the appropriate treatment for tinea infections as they inhibit the growth and reproduction of the dermatophyte fungi causing the infection.

Choice A rationale

Inserting a nasogastric tube for decompression of the abdomen is a standard intervention for suspected Hirschsprung's disease, which is characterized by a lack of ganglion cells in a segment of the colon, leading to impaired motility and potential bowel obstruction. Decompression helps relieve abdominal distension and pressure.

Choice B rationale

NPO status and initiating IV fluids are appropriate initial management for a child with suspected Hirschsprung's disease to rest the bowel and maintain hydration and electrolyte balance while further diagnostic tests are performed.

Choice C rationale

Monitoring abdominal girth every 4 hours is essential to assess for increasing abdominal distension, which can indicate worsening obstruction in Hirschsprung's disease. An increasing girth would warrant further investigation and intervention.

Choice D rationale

Administering a large-volume liquid enema is contraindicated in suspected Hirschsprung's disease. Due to the aganglionic segment's impaired motility, the enema fluid may not be expelled and could lead to fluid overload or bowel perforation. Diagnostic enemas using contrast are performed under controlled conditions.