Table of Contents
Common Questions
Chat with CodyMD
Cody's Chat with Patient
Cody's AI Summary
Top 3 AI Diagnosis List
Review by Dr Albert DiPiero
Dr. DiPiero Video Guide to this Case Study
Resource Center
Testimonials
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Case Study
Meet your host
Albert DiPiero, MD MPH FACP
I am a co-founder and the Chief Medical Officer at CodyMD and your host for this edition of Cody Grand Rounds. I have been a practicing physician and faculty member at medical schools for over 26 years.
About The AI Doctor Case Study
CodyMD is a partnership between Human Doctors and AI Doctors. Cody is an AI Doctor who helps thousands of people every day. At each Cody Grand Rounds, I select a real case and review it with Cody, the AI Doctor.
Each case is based on a real patient but has been modified to maintain privacy and to emphasize certain teaching points.
Common Questions
What are common causes of facial outbreaks?
How can hormonal changes affect skin?
What are the treatments for acne?
Can emotional stress worsen skin conditions?
Should I see a dermatologist for severe acne?
What is rosacea, and how is it different from acne?
Chat with CodyMD
Click the button below to initiate a conversation with CodyMD, your AI Doctor.
Cody's Chat with Patient
Below is a conversation transcript between the patient and our AI Doctor CodyMd.
Cody, the AI Doctor
So you mentioned experiencing an “outbreak” on your face. When did this start?
Patient
Yeah, it's been about three weeks now.
Cody, the AI Doctor
I see. I'm here to help you find some answers. Could you describe the severity of your outbreak on a scale of 1 to 10, with 1 being very mild and 10 being very severe?
Patient
I’d say it’s about a 7. It’s pretty bad.
Cody, the AI Doctor
That sounds quite uncomfortable. When did you first start noticing outbreaks like this?
Patient
Well, I've had them on and off since I was like 13, but never this bad.
Cody, the AI Doctor
Understood. Have you noticed if the outbreaks tend to start at specific times or are there any patterns?
Patient
This one started around the time of my period.
Cody, the AI Doctor
Interesting. That's helpful information. Do you have any history of chronic illnesses such as diabetes, Polycystic Ovary Syndrome (PCOS), Hormonal Imbalances such as Cushing's syndrome, or chronic stress.
Patient
No, I’m generally pretty healthy.
Cody, the AI Doctor
Good to know. Are you currently taking any medications?
Patient
No, I’m not taking any medications right now.
Cody, the AI Doctor
Understood. You mentioned the outbreak is on your face. Are there any other areas affected?
Patient
Yeah, it's on my cheeks and my upper back.
Cody, the AI Doctor
Thanks for the details. Have you noticed if anything seems to make the rash better or worse?
Patient
Nothing really helps, and it just seems to get worse no matter what I do.
Cody, the AI Doctor
I see. Are the pimples or bumps filled with pus or are they just red?
Patient
Mostly, they are just red. Some of them have whiteheads, though.
Cody, the AI Doctor
That’s helpful to know. Do you experience any itching, burning, or any other sensations where the outbreak is?
Patient
Not really, just sometimes they feel a little itchy but not too bad.
Cody, the AI Doctor
Okay. Have you ever seen a doctor or dermatologist about these outbreaks in the past?
Patient
No, this is the first time I’m actually considering it because it’s gotten so bad.
Cody's AI Summary
- You are a 20-year-old woman experiencing a moderately severe outbreak on your face, which started about three weeks ago around the time of your period.
- You have had similar outbreaks since age 13, but none this severe. The rash consists of red pimples on your cheeks and upper back.
- You have no history of chronic illness and are not currently on any medications.
- The pimples are mostly red with some whiteheads and occasionally feel a little itchy.
Top 3 AI Diagnosis List
Based on the information and conversations with Cody, we have prepared a top 3 AI Diagnosis List.
1. Acne (inflammatory papules)( 70% probability)
Acne is a common skin condition that occurs when hair follicles become clogged with oil and dead skin cells. It often manifests as red pimples, particularly on the face and back, and is influenced by hormonal changes, such as those that occur around the menstrual cycle.
2. Rosacea(20 % probability)
Rosacea is a chronic skin condition characterized by facial redness and sometimes pimples. It primarily affects the cheeks and nose and may worsen during periods of stress or hormonal changes, although it rarely affects the back.
3. Perioral Dermatitis(10 % probability)
Perioral dermatitis is a facial rash that tends to occur around the mouth and sometimes the eyes. It is characterized by red bumps and pimples, but it is less common on the cheeks and does not typically affect the back.
Review by Dr Albert DiPiero
Dr. Albert DiPiero
In reviewing the patient’s history and symptoms, I agree with Cody that acne is the most likely diagnosis.
1. Acne(80% probability)
I find the primary diagnosis of acne to be highly likely, especially given the patient's age, the severity of the outbreak, and the influence of hormonal changes around the menstrual cycle.
2. Rosacea(15% probability)
Rosacea is a potential differential, but it typically doesn't affect both the face and back simultaneously. Its classical presentation is more confined to the central face, especially the nose and cheeks, and often includes visible blood vessels, which the patient did not report.
3. Perioral dermatitis(5% probability)
Perioral dermatitis is a less likely diagnosis as it usually affects the areas around the mouth and eyes and rarely impacts the cheeks and upper back.
Next Steps for Evaluation
Next steps for a definitive diagnosis should include a physical examination by a dermatologist to look for specific signs of acne or other conditions. Laboratory tests are generally not required unless there is a suspicion of an underlying systemic condition.
Potential Treatment Modalities
Topical treatments such as benzoyl peroxide, salicylic acid, topical antibiotics, or topical retinoids.
Oral antibiotics may be considered if topical treatments are insufficient.
Hormonal treatments, such as oral contraceptives, could be helpful given the periodic nature of the outbreaks.
Lifestyle Modifications: Adequate skin hygiene, dietary adjustments, and stress management can also be beneficial
In summary, the most likely diagnosis is acne, exacerbated by hormonal changes. Rosacea and perioral dermatitis are less likely but worth considering. A dermatologist’s evaluation is recommended for a definitive diagnosis and tailored treatment plan.
Dr. DiPiero Video Guide to this Case Study
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