C10027422 / invoice 10000

Reason: Cytopoint InjectionAppointment Notes: + poss check lumppcp has seen lump before, thinks its growing NRIncrease in itch level againNoted crusting around both eyes Lump on upper chest appears about the same but wanting to recheck Examine: BARExamined in hospital with towelOtic: both ears clearOcular: bilateral mild blepharitis and crusting SNS bilatCornea/AC clear, non inflamed eyes CVS: HR 120bpm, regular rhythm. HS WNL. MM pinkResp: WNLAbdo palp WNLLNN WNLIntegumentary:Seborrheoic skin condition Hyperpigmentation and thickened ventrum, thickened fibrosed region caudal mammary area near vulva Mild crusting axillary and perineal/perivulval skin SQ lump approx 1cm right  cranial mammary region - similar Assessment: Blepharitis Allergic/Atopic dermatitisSeborrhoeaPyoderma Treatment: Cytopoint - antibody ant-allergy injection given SC = 10mg SQPlan: Due to Ellies temperament limitations to tx options - will not allow anything around eyes and not much topical skin txCan adminster chlorhexidine spray so will use 0.2% dilution and spray affected areas daily Cephelexin Antibiotic Tablets 200mg 1/2 tab BID Ideally topical amacin/chloroptosone but unlikely to be able at home Review in 2 weeks    Vital Signs