An uncommon skin condition illustrates the need for caution when prescribing for friends.
OBJECTIVE
A dual-focused case study written to discuss the legal and medical hazards of informally writing prescriptions for friends or family members and to provide knowledge of early-stage mycosis fungoides (MF), its course, and treatment.


METHODS
A review of the prescribing practices of clinicians, the cognitive processes needed in diagnosis and treatment, the current ethical guidelines, and a review of MF, its course, and treatments.


CONCLUSIONS
Treating acquaintances and family informally places clinicians at risk for liability and patients at risk for inaccurate diagnosis and treatment. This case illustrates the potential hazard of casually treating a friend for what looks like a benign condition. Resembling atopic dermatitis in its early stages, MF is the most common of a rare group of skin lymphomas. Early diagnosis and treatment are crucial for a better prognosis. Had this clinician complied with the request of her friend, his diagnosis would have been missed and timely treatment delayed.


CONCLUSIONS
No matter what the prior relationship may have been, once a clinician treats a patient, a legally binding relationship begins, requiring the due standard of care. Nurse practitioners (NPs) need to be aware of the potential for error when treating acquaintances. Available NP standards of practice and ethical guidelines should address informal treatment situations.
Ares
Ella
E
Columbia University School of Nursing, New York, New York, USA. ema40@columbia.edu
D001706:Biopsy; D003876:Dermatitis, Atopic / Q000188:drug therapy / Q000451:nursing; D003937:Diagnosis, Differential; D003951:Diagnostic Errors / Q000331:legislation & jurisprudence / Q000379:methods / Q000451:nursing / Q000517:prevention & control*; D011307:Drug Prescriptions / Q000451:nursing*; D042241:Early Diagnosis; D005190:Family; D033062:Friends; D006801:Humans; D016365:Liability, Legal; D008297:Male; D008318:Malpractice / Q000331:legislation & jurisprudence; D009182:Mycosis Fungoides / Q000175:diagnosis* / Q000188:drug therapy; D009367:Neoplasm Staging; D009722:Nurse Practitioners / Q000458:organization & administration*; D009730:Nursing Assessment; D010808:Physical Examination; D017410:Practice Guidelines as Topic; D017009:Professional Autonomy; D011379:Prognosis; D035583:Rare Diseases