Patient comes in for a recheck. We have not seen her since 2013. She is a long time patient of Dr.. She has developed a rash on her arms and legs that led her to an urgent care clinic. They did give her prednisone taper and a triamcinolone cream to put on her rash. It seems to occur when she was at a softball game last Thursday while being outside. She does feel like it is due to her allergies. This began about two weeks ago last Thursday and then went to the urgent care again last night to get it reevaluated. She does have a memory problem. She forgets things easily and I cannot remember what she has and has not done. She does know that she was on allergy shots in the past with Dr. and had a remarkable improvement with a lot of her rashes that she has had in the past and allergy troubles. She would like to begin allergy shots again and would very much prefer this treatment route since it was so beneficial for her in the past.
1. Irritant contact dermatitis versus allergic contact dermatitis versus atopic dermatitis.
2. Allergic rhinitis.
3. Allergic conjunctivitis.
4. Memory deficit with dementia.
1. At this time, we will go ahead and try doing allergy immunotherapy as this was suppressant and feels that she can get here regularly even though she does have some memory issues. We will go ahead and mix her serum and see if she can become a regular patient and get her treatment to prevent these rashes and allergic symptoms from occurring.
2. I also encouraged her to use Zyrtec or Allegra daily to help with itching and allergy symptoms. She will continue using Singulair, triamcinolone cream, and prednisone taper to help continue to resolve this rash. We will see her for her first shot.