{ "text": "[PERSON_NAME] [PERSON_NAME], date of birth [DATE_OF_BIRTH] [DATE_OF_BIRTH]. New patient self referral for [MEDICAL_PROCESS] [MEDICAL_PROCESS]. Hello? Sorry, that was a weak knock. Hi, [PERSON_NAME]. [PERSON_NAME]. [PERSON_NAME]. Thanks for your patience. I was doing so well for the first half of the morning. Perfect. And then the phone is just helping me take my notes, so it just sits there and I promise, I'm not sure. No worries. Fine. Not a problem. Good. And you are new to me, correct? Correct. Well, tell me, what brings you to see us today? Well, I've got some growth in the back and the front. And my [MARITAL_STATUS], one of the ones on the back, he said, I think it's growing. And so he said, you might want to have that checked. I have a little bit of itching going on back there, but I don't know if it's [MEDICAL_CONDITION] [MEDICAL_CONDITION] or what. Okay. I'm very fair. So I. It's okay. Me too. As my daughter says, mom, your sidewalk white. I said I did not think. That is a compliment. I'm not sure if it is. Not. Trust me, I know that. So. Oh, man. Good. And are any of the spots painful, bothersome, itchy, anything like that? The itchy. Like I said, I'm not sure if it's coming from one of the spots. Okay. In that general area, so. Sounds good. And then you are otherwise pretty healthy? Just [DRUG] [DRUG]. Correct. And that's it? Yes. Awesome. Yeah. Well, let me. I just want to get a little more information about your risk factors. So, squamous cell in your brother, just [DURATION] [DURATION] ago, he had [MEDICAL_PROCESS]? Yes. And any other family members, like parents or siblings with [MEDICAL_CONDITION] [MEDICAL_CONDITION] that you know? Yeah. And then you've not had [MEDICAL_CONDITION] [MEDICAL_CONDITION] yourself? Just these [INJURY] [INJURY] [INJURY] [INJURY]. Is that right? Okay. Yeah. They were benign. Yeah. Excellent. And then a couple of blistering sunburns, it looks like. And then now mostly you just avoid the sun. Yeah. A long time. Yeah. Burn appeal as being fair. That's been my life. Could you tan at all if you try? No. You just. Okay. Yeah. Yeah. Sounds good. Well, let me take a look at you. Okay. We'll just start at the top and work our way down. Let me know if that's too high up. Oh, I think probably. Good. Yeah. Good. So I'm going to look through hair first. Yeah, that's fine. And you still work? I [OCCUPATION] about [DURATION] [DURATION] [DURATION] [DURATION] [DURATION] ago. I worked for [DURATION] [DURATION] at [ORGANIZATION] [ORGANIZATION]. Amazing. How's retirement treating you? Oh, I love it. Great. Yeah. I was ready. Yeah. I'm always amazed by those people that want to work forever. I mean, I love my job, but it just takes up so much of your life. And you know, my [MARITAL_STATUS] [DURATION] [DURATION] older than I am and he has had health issues through the years. And he says if you wait and retire until you're [PERSON_AGE] or [PERSON_AGE], he said, I may not even be around anymore. So he's like, you know, if you want to up it a little bit. Yeah, it's time. I'm like, well, let me think about that. Okay. Hard question. Yes. Good. I don't see anything up on scalp now, so that's great. Yeah, I have a couple little ones, but they. Yeah, they are just. It's a genetic thing. Yeah. Do you usually leave them alone until they start to bother you? I do, yeah. Until they're starting to get annoying. Yeah, they do weirdly run in families. Yeah, it's very odd. There's like five of us in the family that have those. Good. Sorry, my hands are super cold. Oh, yeah, no, that's okay. Good. Well, the very good news back here is everything's benign. So what he is seeing are these bigger, irregularly shaped brown ones. Yes. And these are these weird little benign growths we just start getting as we get older. Okay. So they're called [MEDICAL_CONDITION] [MEDICAL_CONDITION]. Where do you feel itchy? Like kind or like more. In the middle area there's like a little. I don't know if there's. Cuz you don't. Oh, you do have a. You have a teeny one down here. But most of them are not in that area. So I wonder if you are more just itchy from dryness as opposed to. Yeah, yeah. Cuz these do sometimes get itchy. The. The good news is for as weird as they look, they're not dangerous. They don't turn into anything. They can be [MEDICAL_PROCESS] [MEDICAL_PROCESS] [MEDICAL_PROCESS] [MEDICAL_PROCESS] [MEDICAL_PROCESS] if they're itchy or irritated. Otherwise insurance considers it cosmetic and they won't pay for it. Oh yeah. You definitely get a little dry on your hands here and then today's a good day. Actually looks pretty good. Do they bother you enough that you'd want to talk about options for it beyond just moisturizer? My hands have problems with that too. So we've been using [DRUG]. Oh yeah. And that's been working really good. The one thing I'll sometimes add if we need it is a prescription [DRUG] [DRUG] which helps with inflammation. You just have some [MEDICAL_CONDITION] [MEDICAL_CONDITION] because it's dry and we have to wash our hands a lot. But if you feel like the [DRUG] is keeping things under control, and I usually use it before I go to bed. Perfect. So we don't necessarily have to do the [DRUG] [DRUG] unless you feel like it's necessary. Now, on the neck. These are really annoying, and they do get caught sometimes. Is there anything that I can do to. I know they have some little medicine you can put on there, but it smells so bad and it's not usually super effective. So you do just have a whole bunch of little skin tags on the neck. Let me look at the rest of you and then we'll talk. Lift up on breasts for me if you'll. More under there. I'm just gonna look at your lower abdomen. Yeah. So that's exactly like what's on your back. More separate hair. Then you make the little. Yes, they are. You make the little red ones, too, which are called cherry angiomas, which are also benign. Yeah, you do get really dry. Just [DURATION] [DURATION] normal moles and freckles. That's fine. Good. Stand up for me so I can look at the back of your legs. All right. Little keratosis on the back of the thigh. And just [DURATION] [DURATION] normal small moles. Do you mind if I look at your bottom? Oh, not at all. It's just a hard spot. Yeah, no, that's fine. Just a couple normal moles and that is it. All right. You can sit. Concerns on your groin area at all that you want me to look at? No, under the underwear. Okay. I haven't had any problems. Good. So we'll do feet and then I'll come back to face. Okay. Just get that there in front of me. A little mole on the bottom of the right foot. Just make sure it looks fine. Looks fine. Homogenous pattern there. Great. Left foot. Perfect. Absolutely nothing. Great. You can have socks back if you want. And then I'll take a look at face. Thank you. I'm all cold. I know. It's freezing here. And then we make you undress so you can slip off your mask. Thank you. This looks great. Nothing at all? Just [DURATION] [DURATION] normal little moles, but nothing I see that I'm worried about at all. Good. Fantastic. Wonderful. Well, honestly, skin looks great. I don't see anything I'm worried about. So all the spots you pointed out are benign growths called [MEDICAL_CONDITION] [MEDICAL_CONDITION]. In general, I recommend just leaving them alone. But if you ever want a bunch of them treated just because of how they look, we do have a clinic where we do all of our what are called [MEDICAL_PROCESS] [MEDICAL_PROCESS]. Okay. It's nothing crazy. They actually just [MEDICAL_PROCESS] [MEDICAL_PROCESS] [MEDICAL_PROCESS] [MEDICAL_PROCESS] [MEDICAL_PROCESS] and it's [DURATION] [DURATION] [MONEY_AMOUNT] [MONEY_AMOUNT] just to get a bunch treated again. They're not dangerous, they're fine to leave alone. This is a very good segue into skin tags though, because skin tags, even irritated ones, insurance never pays to remove. They're sort of hard to self remove. If they're big enough that you can get like a tiny nail clippers or scissors around them, you can sort of snip them. Okay. Otherwise what we do is it's that same clinic, our cosmetic clinic, they just have a cash fee where you pay and they'll just snip or freeze a whole bunch of them off. Okay. Usually it depends on how many you do. If you have just [DURATION] [DURATION], then they have certain prices. Otherwise if you just want like all of them done, I think it's somewhere around [MONEY_AMOUNT] to $[MONEY_AMOUNT] just to have basically all of them that you can have done in [DURATION] [DURATION], which would easily be your whole neck. Yeah. So completely optional. I'll just put the information. It is a freighter clinic, but they just don't. Because it's all considered cosmetic. Nothing's run through insurance, it's just fee based. But if that, if you want a bunch of them done, that'd be a good place to go. You will get more, but you might be able to clear up enough that you're, you know, happy for a while and then maybe down the road you want to have more done again. Okay. Exactly. So something to think about, it is, and if you, like I said, zero pressure, I'll just put the info in your paperwork. If you want to make an appointment, go for it. If not, I get nothing out of it. So it's all for your, all for your joy. Yep. So, all right. This would be for [MEDICAL_PROCESS] [MEDICAL_PROCESS] or [MEDICAL_PROCESS] [MEDICAL_PROCESS]. Otherwise skin looks great. I don't necessarily think we need to see you every single year. Okay. What I would suggest is just kind of plan on popping back in [DURATION] [DURATION] [DURATION] or sooner if something new pops up. Spots that look different from other things on your body, things that are growing or changing sort of in an unusual way. And then the one we often don't think about that is more related to like the squamous cell or basal cell like your brother had is [INJURY] that aren't healing. So like [MEDICAL_CONDITION] like [INJURY] that bleed easily that don't heal, that's a [INJURY] suspicious sign too. So anything along those lines, call or my chart. Okay. Otherwise, we'll kind of leave it open ended and you can just plan to come back in [DURATION] [DURATION] [DURATION] just to check in again. Okay, that sounds good. Other questions or concerns for me at all? No, not at all. Thank you. Perfect. Yeah. Do you want a printed copy of this checkout paperwork? Yes, absolutely. I'll have the [OCCUPATION] [OCCUPATION] bring that in once you're done getting dressed, and then you can head out after that. Oh, thank you. Okay. Really nice to meet you. Oh, you, too. 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