Differential Diagnosis for 18-year-old with Acne and Nexplanon Complaints
- Single most likely diagnosis:
- Polycystic Ovary Syndrome (PCOS): The patient's symptoms of acne along the jawline and chin, weight gain, and potential hormonal imbalance due to Nexplanon use are consistent with PCOS. The condition is common in women of reproductive age and is often associated with hormonal contraceptives.
- Other Likely diagnoses:
- Hormonal Imbalance: Nexplanon, a progestin-only contraceptive, can cause hormonal changes leading to acne and weight gain. The patient's symptoms could be a result of these hormonal fluctuations.
- Nexplanon Side Effects: The complaints of the implant feeling like it's tugging and causing pain with exercise or movement could be due to the implant itself, possibly being improperly placed or causing local irritation.
- Acne Vulgaris: The patient's acne could be a separate condition, exacerbated by hormonal changes from Nexplanon or other factors such as stress, diet, or genetics.
- Do Not Miss diagnoses:
- Ectopic Pregnancy: Although unlikely if the Nexplanon is properly placed and functioning, an ectopic pregnancy is a life-threatening condition that must be considered, especially if the patient experiences severe abdominal pain or other symptoms suggestive of pregnancy.
- Ovarian Torsion: If the patient experiences severe pelvic pain, ovarian torsion, although rare, is a condition that requires immediate medical attention to preserve ovarian function.
- Deep Vein Thrombosis (DVT): Hormonal contraceptives can increase the risk of DVT, and if the patient complains of leg pain or swelling, this condition must be ruled out due to its potential severity.
- Rare diagnoses:
- Adrenal Disorders: Conditions like Congenital Adrenal Hyperplasia or Cushing's Syndrome could cause acne and weight gain but are less likely given the patient's age and presentation.
- Androgen-Secreting Tumors: Rare tumors that produce androgens could lead to acne and other symptoms of hyperandrogenism but are uncommon and would typically present with more severe symptoms.