Hidradenitis Suppurativa

OVERALL_INSTRUCTIONS

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Date: [Insert Date] HISTORY OF PRESENTING ILLNESS: [Insert history of presenting illness] PAST MEDICAL HISTORY: Problem History: [Insert problem history or 'None Recorded'] MEDICAL HISTORY OF SKIN/HAIR ISSUES: [Yes | No] FAMILY HISTORY OF SKIN/HAIR ISSUES: [Yes | No] MEDICATIONS: External Medications: [Insert external medications or 'None Recorded'] ALLERGIES: Known Allergies: [Insert known allergies or 'None Recorded'] OCCUPATION: [Insert occupation] PHYSICAL EXAM: [Full | Partial] skin exam completed. Fitzpatrick type [1|2|3|4|5|6]. DERMOSCOPY: [Insert dermoscopy findings] ASSESSMENT: Hidradenitis Suppurativa PLAN: 1. Hidradenitis suppurativa (HS), also called acne inversa, is a chronic inflammatory skin condition that affects apocrine gland bearing skin in the axillae, groin, and under the breasts. It is characterised by persistent or recurrent boil-like nodules and abscesses that culminate in a purulent discharge, sinuses, and scarring. 2. We had a long discussion about the disease and the fact that it is a chronic, inflammatory condition. It is not infectious. We talked about lifestyle measures that can alleviate symptoms including smoking cessation, weight loss and exercise. Treatment algorithm was outlined and printed disease information was provided. 3. Lifestyle measures: loose fitting clothing, weight loss, smoking cessation, decrease intake of dairy and high glycemic index foods. 4. Topicals: [BPO wash OD][Salicylic Acid Wash OD][Dapsone 5% PRN][2% clindamycin in BPO PRN]. 5. Oral: [Doxycycline 100 mg OD x 12 weeks][Apprilon 40 mg PO OD x 12 weeks][spironolactone 100 mg OD][Metformin 500 mg BID][referred for biologic therapy]. FOLLOW-UP: [2 weeks|4 weeks|6 weeks|8 weeks|3 months|6 months|1 year|PRN|When indicated] Sincerely,