Adolescence is that turbulent transitional period between childhood and adulthood. Adolescence is generally acknowledged to begin with the appearance of secondary sexual characteristics, at approximately age 11 or 12 years, and to end with the cessation of physical growth, generally between age 18 and 20 years.1
Developmental tasks during adolescence include discovering self-identity, acquiring values to guide behavior, and increasing one’s sense of social responsibility. Despite overall rapid physical growth, portions of the adolescent brain may not reach maturity during this period, leading to poor judgment and risk-taking on the young person’s part.2,3
You have just completed an assessment on a 13-year-old female with the chief complaint of dysmenorrhea. She reports a 2-year history of monthly menses with occasional cramps that are relieved with ibuprofen. The physical examination is unremarkable, and the patient is verbal and cooperative, has good hygiene, and makes appropriate eye contact.
You notice a 2 cm x 3 cm irregular-shaped patch of intact, macular, ecchymotic skin on the patient’s right forearm. No blistering, peeling, scaling, underlying mass, or tenderness exists, and the lesion does not blanch. You inquire about the origin of the lesion and length of time it has been present. Your patient responds: “It’s the salt and ice challenge.” What?