C10011403 / invoice 10000

Skin sf can only do 5pm
seen sp in sydney or other, get immuotherapy injections, has a few little red bits and skit is flaring up

Verified: NO

HISTORY
Presenting for: Frankie presented for scheduled immunotherapy injection and follow-up of dermatological conditions including bacterial skin infections and dermatitis.
Historical Conditions: Chronic atopic dermatitis with recurrent bacterial skin infections. Currently receiving immunotherapy injections.
Skin: Scabby crusts on back between shoulder blades present for a few days. Dermatitis around tail area in skin fold. Multiple facial lesions described as crusty and bacterial in nature. Owner reports lesions are improving but still present. Recent exposure to dog beach but has been there previously without issues.
Current Meds: Isaderm cream - using as needed for skin lesions. Medicated shampoo - using once weekly with 10 minutes contact time.

EXAM
Wt: 12.5 kg
Integumentary: Scabby crusts noted between shoulder blades consistent with superficial bacterial skin infection. Multiple round bacterial lesions present on face. Dermatitis present in tail fold area. Lesions described as crusty with bacterial overgrowth pattern.

ASSESSMENT
Superficial bacterial pyoderma - Multiple sites including facial lesions, lesions between shoulder blades, and tail fold dermatitis secondary to chronic atopic dermatitis

PLAN
Medications/Treatments:
- Immunotherapy injection 0.5 mL administered subcutaneously today
- Area between shoulder blades to be clipped to allow topical treatment access
- Neocort cream to be applied to clipped area on back and tail fold area (avoid facial application due to proximity to eyes)
- Thin application of topical cream to facial lesions with extra caution due to eye proximity

New Meds/Tx:
- Cephalexin 600 mg tablets dispensed, give 1/2 tablet BID for 7 days
- Isaderm cream to be dispensed for ongoing maintenance therapy

Additional Discussion:
- Continue current medicated shampoo regimen once weekly with 10 minutes contact time
- Topical treatments should focus on back and tail areas primarily, with minimal facial application due to safety concerns near eyes