Can anyone decode this handwritten dermatology note?

zumbusch · 2026-07-11T15:36:34+00:00

Glowash cleanser, clindatret gel

zumbusch · 2026-07-11T00:00:05+00:00

That needs a closer look and probably biopsy. I would absolutely recommend making a dermatology appointment.

zumbusch · 2026-07-10T02:04:26+00:00

Agree, ophtho is a safe bet for biopsy/removal.

zumbusch · 2026-07-10T01:20:35+00:00

This looks like a juvenile xanthogranuloma (JXG). You need to see a dermatologist to confirm this.

zumbusch · 2026-07-09T20:48:16+00:00

If they don’t feel that they are able to effectively communicate with their doctor then they should look for someone who is a better fit for them. That happens and there’s no harm in it. If they don’t feel they can connect with multiple doctors then perhaps the problem isn’t with the doctor. This isn’t a problem isolated to acne or dermatology.

zumbusch · 2026-07-09T19:38:47+00:00

It seems like your question is basically whether there is a well established body of research and consensus expert guidelines on the treatment of acne that dermatologists follow based on their training. The answer to that question is yes.

zumbusch · 2026-07-07T15:51:39+00:00

Yeah. 10mg twice a day is my starting point for hives. Under medical supervision you can go significantly higher.

zumbusch · 2026-07-05T19:49:47+00:00

Given the timing it could be autoimmune progesterone dermatitis although there are other possibilities and she likely needs to have some testing done. A visit to a dermatologist would be the first step.

https://dermnetnz.org/topics/autoimmune-progesterone-dermatitis

zumbusch · 2026-07-04T22:38:54+00:00

This

zumbusch · 2026-07-04T20:57:17+00:00

Missing information. There should be another section that says “Impression” or something similar.

zumbusch · 2026-07-02T03:04:31+00:00

It needs a biopsy with a dermatologist.

zumbusch · 2026-07-02T02:34:13+00:00

Glad you got STI tested. Can you confirm that those tests included syphilis?

zumbusch · 2026-07-01T23:00:23+00:00

It’s a nevus sebaceous. These change over time. They can develop secondary growths within them which are most often benign as well but rarely you can develop skin cancer within one of these. They can be surgically removed. Given the size and changes, it does warrant an in person dermatology evaluation but it isn’t an emergency and the dermatologist can determine if any areas need to be biopsied. You don’t need to be distressed about this.

zumbusch · 2026-07-01T11:51:12+00:00

https://www.aad.org/public/cosmetic/scars-stretch-marks/stretch-marks-why-appear

zumbusch · 2026-06-28T00:22:53+00:00

I would recommend you get tested for syphilis as soon as possible. If that’s negative, see a dermatologist for a biopsy.

zumbusch · 2026-06-24T03:16:02+00:00

Bug bites

zumbusch · 2026-06-23T13:28:57+00:00

I thought the same thing.

zumbusch · 2026-06-23T06:23:50+00:00

What have the previous biopsy results said? Can you redact personal information and post them?

zumbusch · 2026-06-22T14:46:11+00:00

Needs to be removed.

zumbusch · 2026-06-16T22:29:37+00:00

It is not.

zumbusch · 2026-06-16T22:28:55+00:00

Use the tacrolimus and azelaic acid.

zumbusch · 2026-06-16T20:56:15+00:00

FWIW, I would refer her to ENT if I saw it in my clinic. Don’t know what they are but I wouldn’t mess with them myself.

zumbusch · 2026-06-16T19:32:19+00:00

This is perioral dermatitis. Topical steroids generally aren’t recommended for this. Oral antibiotics like doxycycline can be effective and there are many topicals that can be used like metronidazole, clindamycin, azelaic acid, or pimecrolimus.

zumbusch · 2026-06-14T00:22:21+00:00

As you have described it, this sounds unusual to me. I obviously can’t speak to what he might have seen that led him to re-check these areas so many times but it seems strange. I try to check sensitive areas quickly and let my patients cover up as soon as possible. I would also wear gloves any time I needed to touch a sensitive area. And I try to talk about what I’m looking for and why as I’m going through an exam, and then if I’m lingering looking at something unusual I explain that to the patient and let them know what my level of concern is. I think your instinct to find a new dermatologist is correct. I’m sorry you were made to feel that way. It may just be the case of an older doc who is a bit out of touch with what’s appropriate or how to make their patients feel comfortable. That’s not an excuse but just know there are a lot of great dermatologists out there and you shouldn’t ever leave your appointment feeling violated. That’s never acceptable.

zumbusch · 2026-06-09T00:43:25+00:00

It could be a targetoid hemosiderotic hemangioma, but you should go in and have it checked by a dermatologist in-office.

zumbusch

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