п»їDermatology Chart Be aware 1
Might 2, 2015В
Individual is a being unfaithful year old teenage male, presents with a two day great itching coated sores especially around the mouth area. Parent can be using OVER THE COUNTER antibiotic lotion with no improvement, no the past of fever. Parent says that pat recently stopped at a pampering zoo OBJECTIVE
HEENT happen to be basically unrevealing. Temp at the office today is usually 98. four. The outer area of the mouth advancing into the chin reveals macules, vesicles, large purulent exudate forming honey- colored brown crust area on a erythematous base. Skin area on trunk area, arms and legs is clear. No other symptomology ASSESSMENT
1 . Rx for Mupirocin ointment put on infected region TID.
installment payments on your Advised mom on appropriate hand cleaning technique.
a few. To phone if zero significant improvement over the subsequent 48 hours.
LeandroВ D. В Cot, В MDВ
d& t: 5/2/2015
Dermatology History and Physical (H& P)
May a couple of, 2015
This is a forty five year old guy admitted by way of emergency division. He gives history of open ulcerations of both decrease extremities of several weeks period. A fever of unfamiliar etiology the past 48 several hours
PAST MEDICAL HISTORY
Patient is experiencing morbid unhealthy weight. He features known peripheral and arterial disease. His diabetes managing is poor. He denies accidents or injuries to the lower extremities
He is handicapped. No good tobacco use
VITAL SYMPTOMS: T ciento tres. 2, P 105, RSP 20, BP 155/95
BASIC: Obese, English language speaking Black male
EENT: No low abnormalities, Pupils restricted, poor dental hygiene NECK: Throat supple. No palpable nodes
CHEST: Lungs are clear.
HEART: Cardiovascular is standard, no murmurs.
ABDOMEN: Very soft with no evidente masses.
EXTREMITIES: Examination of the left decrease extremity uncovered a generalized area of tender cellulitis which has a moderate sum of edema 1 to 2+ for the knees, with erythema and diffuse excoriation he features 4cm By 4cm succinct, pithy ulcer in the lateral facet of the core shin location on the proper leg. We have a 4cm X 3cm ulceration noted on the left hand side lateral rearfoot. Moderate quantity of serious draining noted via both ulcerations.
1 . Bilateral leg ulceration.
installment payments on your Bilateral low cellulitis.
three or more. Diabetes uncontrolled
Declare for 4 antibiotics, twisted management and diabetes managing. EarlineВ M. В Bishop, В MD
May 2, 2015
d& t: 5/3/2015
Dermatology Chart Note a couple of
Balkcom, TawanaВ LawandaВ
May several, 2015
This kind of 37 yr old female affected person is seen in follow up today for her Rosacea. HISTORY OF PRESENT ILLNESS
On her behalf last go to in 06 of this yr, she was found to acquire multiple papules on the cheeks, nose, as well as visible telangiectases. Patient's epidermis on temple, cheeks and nose will be noted to become oily. Right eyelid infection also present. PHYSICAL EXAM
Today it truly is noted that there is mark improvement in person's skin condition. Skin area is sharper and very few comedones will be noted. Pores and skin does remains oily and telangiectases is noted. Patient does statement a ongoing sense of burning or flushing to the deal with when subjected to the cold or underneath emotional causes but total feels there is improvement in her state. Patient information she has recently been applying the metronidazole as ordered. ANALYSIS
Acne Rosacea, treated with metronidazole.
Treatment options had been discussed currently. Patient is questioning in the event laser remedy would be suitable for treatment of telangiectases. I advised the patient that at this time the condition is not really severe enough to need further medical intervention and limit skin area exposure in the cold. Affected person is to continue with the metronidazole application and follow up in a single year since needed.
DarrellВ EllsworthВ Cook, В MD
d& big t: 5/3/2015