{ "text": "[PERSON_NAME] [PERSON_NAME]. Date of birth, [DATE_OF_BIRTH] [DATE_OF_BIRTH], [DATE_OF_BIRTH]. Follow up for [MEDICAL_PROCESS] [MEDICAL_PROCESS] [MEDICAL_PROCESS]. Last visit, [DATE] [DATE], [DATE], when she had a [MEDICAL_PROCESS] [MEDICAL_PROCESS]. Placeable for order. Derm history from the [DATE], [DATE], [DATE] note. Hello, [PERSON_NAME]. Welcome back. Yeah, I figured I had a lot of problems. I know. It's fine. It's. Oh, boy. It's been a whole [EVENT] since we've seen each other and I wanted to stay within the established period. Yes. No, that's a very. And I'm having some trouble, so I thought I'm going to keep. Yeah, tell me. I know we're doing [MEDICAL_PROCESS] [MEDICAL_PROCESS] [MEDICAL_PROCESS] today, but tell me about what particular things have popped up since I saw you last. Well, I want your help and advice on. I cannot. You can see how dry I am. And you see these [INJURY] [INJURY] here. Yep. On the hands and fingers. I cannot. This one is so painful. I just. I cannot get them to heal. I have tried everything. This one is [DURATION] [DURATION]. This one is [DURATION] [DURATION] [DURATION] [DURATION] [DURATION]. This one finally healed. I finally get it to where I can. Can use it. And it's only this hand. Just the. Are you [PHYSICAL_ATTRIBUTE] [PHYSICAL_ATTRIBUTE]? So just the right hand. First three. Yeah. And I'm. Now. I mean, I've. What I've been doing for the month last [DURATION] [DURATION] is that disgusting white Vaseline lotion. And I stick it on it and I put a band aid over it because if I try and put gloves on it, it washes off. Yeah. I cannot. This one I just [INJURY] [INJURY] taking my bra off again. I was like, scream. I was like, I cannot get these to heal. Okay. And I cannot find lotion that. Yeah, I mean, I'm just bleeding. We'll talk about it. I think we've. You've gone beyond [MEDICAL_CONDITION] [MEDICAL_CONDITION] to actual [MEDICAL_CONDITION], which is what's causing this flaking and cracking. So we'll add a [DRUG] [DRUG] that I think will help a lot. My mom used to have to do that as an rn, but this. I mean, I lotion and I band aid and it's so painful. I know. I literally. When I took my bra off, this was bleeding and I was like. But I don't have it on this hand. I do get the drying here on the back of the left hand, but I cannot. These [INJURY] [INJURY] [INJURY] [INJURY] all the time and I just. And sometimes it happens more on our dominant hand just because we're coming into contact with a lot more irritating things that with our hand that we use. I'm a [OCCUPATION] [OCCUPATION]. I can't stand that hand sanitizer. So I. I do not do extra hand sanitizer. Cuz obviously. I'll be very honest though. Hand washing dries you bad. It is. And I have. I've tried [ORGANIZATION] Ultra Healing. I've tried Gold Bond. I mean I'll give you our good handout on some. Some other good ones to try that are really thick and then it sounds terrible. But something greasy at bed like Vaseline Aquaphor. That's what I'm using. Is that aqua. But I can't keep it on. Yeah. I put the gloves on and it pulls it right off. It just pulls [MEDICAL_PROCESS] [MEDICAL_PROCESS]. So there's harder. So that's why I've been band aiding it. But I think if we add a [DRUG] [DRUG] it'll help calm things down a lot. So. Good. And then other particular concerns. Just that mole that's in the middle of my back still. I've been hooking it on my bra and it's okay. And I'm wondering if it goes up here. We'll take a look. Yeah, we'll take a look. That one's been a lot of my whole life. But more annoying. It's very. Starting to be very rubbing on my bra and so that one's giving me some grief. It's just so tiny. Yeah. It must just be in the spot I think it is of where it rubs on my bra all the time. And then it bleeds. Of course. I'm just going to measure about 4 millimeter fleshy brown papule on the right. Almost central back. Good. Rest [MEDICAL_PROCESS] [MEDICAL_PROCESS] looks great. Few [PHYSICAL_ATTRIBUTE], few normal [PHYSICAL_ATTRIBUTE]. And then there's a. There's a [PHYSICAL_ATTRIBUTE] in here that I cannot. That's been there for [DURATION]. That takes. I have one there and I went on [MEDICAL_CONDITION] [MEDICAL_CONDITION] that I want to have you look. I cannot get [MEDICAL_PROCESS] [MEDICAL_PROCESS] and it just. It just irritates me. Like sometimes I can. Eventually it'll come or the little piece will come out. I don't know how to. I don't know how to treat that one. I'm honestly not sure it's a [PHYSICAL_ATTRIBUTE]. I think it. It may have started with something like that and I. But I can feel like there's something. Yeah. And I can never get it. So what it is now is that the skin has gotten thickened from getting picked [MEDICAL_PROCESS] [MEDICAL_PROCESS] and then it gets thicker and then it makes it feel like there's something in there to get out because everyone's In. I can see the little whitehead and I can. Yeah. And that's [MEDICAL_PROCESS] [MEDICAL_PROCESS]. That's like thickened top layer of your skin that makes that white. Look, there's a couple things we could do for it. We could either try the same [DRUG] that we're going to use for hands, or I could freeze with liquid nitrogen. It's called a Prurigo nodule. It has a name, but it's. They're just annoying. Yeah. Whatever works for you. Yeah. Because I got. I got some skin tags on [MEDICAL_CONDITION] [MEDICAL_CONDITION] that are driving me crazy. And I have a [MEDICAL_CONDITION] [MEDICAL_CONDITION] [MEDICAL_CONDITION] [MEDICAL_CONDITION]. And you'll be able to see it. It takes about [DURATION] [DURATION] for it to come to a head so that I can. So that I can pop it. Yeah. And then it just drives me. It's this one right here. Oh, yeah. That is [MEDICAL_PROCESS] [MEDICAL_PROCESS] [INJURY] there. And it just constantly. I. And that's been aggravating me. I can't get that. If you want it gone is a [MEDICAL_PROCESS]. It's a small [MEDICAL_PROCESS]. We actually have to [MEDICAL_PROCESS] [MEDICAL_PROCESS] [MEDICAL_PROCESS]. So you have to decide whether you want that done or not. You'd trade it for a straight line scar with some [MEDICAL_PROCESS], probably about. But it would stop 4 or 5 millimeters long. It would stop festering in the office. I can. Yes. I would definitely do that in the future. It drives me crazy. And you can see all these skin tags, front of neck. And it's about me measure. It's only about 5 millimeters. It'll be bigger. I know it. It can. So what happens is eventually I can pop it. Yeah. And you kind of watch [MEDICAL_PROCESS] [MEDICAL_PROCESS]. Like it comes out. Yeah. I don't care about the booby cheesy white stuff. And then it's good for like [DURATION] [DURATION] under breasts. And then it fills back up. And then it fills back up. Yeah. Yeah. These are my. Just normal ones. Yeah. This is the only other one that still. We have been watching. Yeah. And that one's totally fine. It's still doing [MEDICAL_CONDITION] [MEDICAL_CONDITION]. It does bleed still once in a while if I have to. Nice rub it. But it hasn't grown good. Yeah. Just leave that old belly. I have one of those here. I do have one there and there two on the moms. Yeah. But those have never become raised like this one is. Yeah. And it. Why one does and one doesn't. We have no idea. Yeah. I mean, I would like to get rid of this one because it's right on the fold of [MEDICAL_CONDITION] [MEDICAL_CONDITION]. We can get you scheduled to do that? I'm usually booked out [DURATION] [DURATION] [DURATION] for [MEDICAL_PROCESS], but it's been like that for. Yeah. Yeah. This one. Sorry, guys. I've been exercising and stuff, but I get little pimples in here, but that's just because I'm fat and they pop right off. Well, you know, I've lost the weight, but it's still, you know. You haven't noticed anything really? No. Legs look great. Yeah, I've never. A lot of these little light spots. That's a funny genetic thing called [MEDICAL_CONDITION] [MEDICAL_CONDITION]. Oh, I was gonna ask you that. My mom has that, so. Just becomes more noticeable the more sun you get, so. Yeah. Are you still tanning? A [MEDICAL_PROCESS] [MEDICAL_PROCESS]. Okay. Just in the winter. I know we've talked, but it's just like. Yeah. I don't do it. Just do it once [DURATION] [DURATION]. Stand up for me and we'll get back. Like, you know what I'm gonna say. I do. I gotta just be careful with my [MEDICAL_CONDITION]. Sometimes I gotta be. And [PERSON_NAME]. [PERSON_NAME] put me on new [DRUG] today, so I. Well, it's the second dose because I hurt my arm. Can I look at your bottom? Oh, sure. Yeah. And then I. That gets me dizzy, so I have to get. Not help. You can sit. Let's do feet and we'll come back to face. Otherwise, so far, I don't see anything I'm worried about. Oh, good. I'm glad. Which is good. Yeah. And that's why I am very careful. I. I know what you do when I watch, and if I see anything, that's probably my tone to look like I ripped off. Yeah. Yeah. I got cut [MEDICAL_PROCESS] [MEDICAL_PROCESS] too low, and then, you know, you kind of screw together. Oh, great. Looking great. Can put those back and I'll take a look at face and we'll chat about spots. So you can slip off. Mask and glasses. I don't think I had. I do have one. I don't know. You know, might not be able to see it now, but I always get a giant one here that. It gets to be like the size of my pinky finger. Yeah. It's like a. I don't see it. Yeah. So I think it must just be. And that one's a. Like a plus, like a clear one. And then it'll eventually go away. And then just that mole on the side I always worry about. There's one. Is it. I don't know, that one. Okay. Is there, like [MEDICAL_PROCESS] [MEDICAL_PROCESS] tiny pink one? I don't Remember if that's the one. That might be the one. Yeah, it's probably this one. Okay. Yeah. So that one's okay. Totally fine. Totally fine. So let me mark around the one on the neck. Yeah, it's this one. Just because I'm gonna have the [OCCUPATION] [OCCUPATION] get a photo of it. Let me measure [MEDICAL_PROCESS] [MEDICAL_PROCESS] [MEDICAL_PROCESS]. It's an annoying one because it'll get bigger and then finally it'll just pop. Yeah. And then I'm like, oh, thank God. And then there's [MEDICAL_PROCESS] [MEDICAL_PROCESS] sack in there that keeps filling up, so. Oh, you're like [PERSON_NAME]. [PERSON_NAME]. Seven millimeters. That's it. I can't. I mean, I can handle a lot of stuff, but that does gross me. Who wants something that big? I. That's what I wonder. They do. They really do. So. So for. We're going to kind of go through things in order. So [MEDICAL_PROCESS] [MEDICAL_PROCESS] wise, nothing I'm worried about. Just some [MEDICAL_CONDITION] [PHYSICAL_ATTRIBUTE], some [MEDICAL_CONDITION] [MEDICAL_CONDITION]. I do think we should probably keep seeing you every [DURATION] [DURATION] [DURATION] [DURATION], especially if you continue tanning. But even the past tanning increases your risk of [MEDICAL_CONDITION], so we'll do that. Skin tags. I usually don't address those. Go to our cosmetic clinic, the form clinic at the [ORGANIZATION] [ORGANIZATION]. These are small enough that I don't think they'll do anything with them. Yeah, they might [MEDICAL_PROCESS] [MEDICAL_PROCESS] [MEDICAL_PROCESS] [MEDICAL_PROCESS] [MEDICAL_PROCESS], but otherwise just leave them. Cost money, obviously. Yeah, that's not. You know, because sometimes I'm like, no [INJURY] on the front of the left neck. We will get you scheduled to see me for a really small [MEDICAL_PROCESS] [MEDICAL_PROCESS]. Usually do that at the end of the day. On Thursday, you will have some [MEDICAL_PROCESS], but it'll be tiny. And usually we try to hide it kind of right in one of those little normal creases of the neck. So I think it'll be fine. Perfect. What about this one of my. That's what I was gonna ask. So if you want it gone, the way to do that would be to [MEDICAL_PROCESS] [MEDICAL_PROCESS] [MEDICAL_PROCESS] with [MEDICAL_PROCESS] [MEDICAL_PROCESS] shave. Yeah. Like they did here. Correct. If it's flat, I'm fine with that because it stops hooking on my part. Do you. Can we do it when you come back for the next. Okay, let's do those at the same time. And then hands. So for hands, what we'll do is prescribe a decently strong [DRUG] [DRUG] called [DRUG]. [DRUG] [DRUG] twice [MEDICAL_PROCESS] [MEDICAL_PROCESS] to any active areas. So anywhere where it's sort of rough and abnormal like you have on the whole back of your right hand fingers, all these areas. So twice [MEDICAL_PROCESS] [MEDICAL_PROCESS] it is [MEDICAL_PROCESS] [MEDICAL_PROCESS] greasy, but it works better than the cream one. And then I wrote down just some information about good [MEDICAL_CONDITION] [MEDICAL_CONDITION] care. Some different creams, but a lot of it is just effort. So creams, honestly, as many times [MEDICAL_PROCESS] [MEDICAL_PROCESS] as you can. In my ideal world, you would put on hand cream after every time you wash your hands. I realize in real life it's not feasible, but if that helps you understand. Sort of several times [MEDICAL_PROCESS] [MEDICAL_PROCESS]. But is that the cream you're prescribing? No. An over the counter one. Yeah, the prescription one. [MEDICAL_PROCESS] [MEDICAL_PROCESS] [MEDICAL_PROCESS]. Is that going to go on these too? It can, yep. And then for the [INJURY], this sounds bizarre, but honestly, one of the best ways to protect them while they heal is [MEDICAL_PROCESS] [MEDICAL_PROCESS] or liquid band aid. I use liquid band aid, but yeah, what happens is I put it on, it [INJURY] like a mother. So I'm blowing on it. It does hurt a lot. And then the minute you move [MEDICAL_PROCESS] [MEDICAL_PROCESS], it [INJURY] [INJURY]. Yeah. You could try [MEDICAL_PROCESS] [MEDICAL_PROCESS] instead. Then it might. It might like [MEDICAL_PROCESS] [MEDICAL_PROCESS] [MEDICAL_PROCESS] [MEDICAL_PROCESS] [MEDICAL_PROCESS]. Yeah. Because I've already tried to hold it shut and put the liquid banding on and then it just splits. Right? Yeah, but these are months. I can't. Yeah. And as soon as I think it's healed, it [INJURY] [INJURY] again. Yeah. And this one is so painful. Yeah. Because it's right here, I think with the combo of the [DRUG] and then. So we'll say four active areas. Use [DRUG] and alone. What's the over the counter you. You like the best? Because I tried everything. I mean, honestly, just like gentle, thick things. So I like the Neutrogena [NATIONALITY] hand cream. Okay. Otherwise just plain old cerave cream or [DRUG] cream. The ones that. They're like body creams that come in tubs. Oh, okay. I tried the pump stuff and that doesn't do anything. No, that does nothing. It's too liquidy, too much alcohol thick. Okay. I will go to [ORGANIZATION] on my way home. Absolutely. So I'll highlight [DURATION] [DURATION] of them that I like. I will do anything. Yes. I mean, like I said, I put the [DRUG] on it. I bandied. I have. So I usually have all [INJURY] [INJURY] with band aid on it. Oh, no. It's like I try to keep the [DRUG] on it while I'm sleeping. Yeah, exactly. And that's. It's hard to do. So [MEDICAL_PROCESS] for assist on the neck and [MEDICAL_PROCESS] [MEDICAL_PROCESS] [MEDICAL_PROCESS] [MEDICAL_PROCESS]. Okay. I feel like a [OCCUPATION]. Pimple popper. That's gonna be us in [DURATION] [DURATION] [DURATION]. In [MEDICAL_CONDITION] [MEDICAL_CONDITION]. Because that one, it's right in the crease and it. It drives me crazy. And I'm gonna have the [OCCUPATION] [OCCUPATION] grab a photo of that in the back just so we have them. And I remember when I see you. And then on your way out, you can get scheduled for the [MEDICAL_PROCESS] [MEDICAL_PROCESS]. Okay. And then go ahead. If you want to make a follow up in [DURATION] [DURATION] [DURATION] [DURATION], something like that. What I'll do is at my follow up at my [MEDICAL_PROCESS], I'll make [DURATION] [DURATION] from there. That sounds. Because I like to come to you within [DURATION] [DURATION]. Perfect. I think that sounds perfect. Unless I have issues, then. Yeah. And let me know sooner if the hands don't get better. I think they will, but just message me or something. All right, so she'll be in for photo and then you're welcome to head out. Do you want a printed copy of paperwork at all? Okay, it's on my chart. And then should I not get dressed? Should I get dressed? Don't get dressed until after she grabs the photos because we want your back. So. Bye. Oh, the tiger arm. Sorry. Oh, yeah. Paragonodule on right upper arm. She'll start [DRUG] on [MEDICAL_PROCESS]. Sorry? She'll start [DRUG] [DRUG] [DRUG] [MEDICAL_PROCESS] [MEDICAL_PROCESS] until her [INJURY] [INJURY]. 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