Vitiligo

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Date: [Insert Date] Thank you for referring this [Insert Patient Age] year old [Insert Patient Gender] for vitiligo. HISTORY OF PRESENTING ILLNESS: This patient was referred for white patches of skin occurring for a few [months][years] on the [face][torso][limbs]. The patches are asymptomatic. The patient has tried [no treatment thus far][topical steroids][topical antifungals][topical antibiotics][phototherapy]. PAST MEDICAL HISTORY: Problem History: None Recorded Medical History of Skin / Hair issues: [Insert details or None Recorded] Family History of Skin / Hair issues: [Insert details or None Recorded] MEDICATIONS: External Medications: [Insert details or None Recorded] ALLERGIES: Known Allergies: [Insert details or None Recorded] OCCUPATION: [Insert Occupation] PHYSICAL EXAM: [Full|Partial] skin exam completed Fitzpatrick type [1|2|3|4|5|6] On examination there are multiple sharply demarcated white depigmented [macules][macules and patches][patches] on the [face][torso][limbs]. Wood's lamp examination accentuates the patches. Dermoscopy: [Insert findings] ASSESSMENT: Vitiligo PLAN: I explained the autoimmune etiology of this condition and the chronic course. Importance of sun protection emphasized ideally with a mineral sunscreen. The first-line treatment would be topical steroids and topical calcineurin inhibitors for involvement < 10% of body surface. A prescription was provided today for [elocom 0.1% cream BID x 2 weeks][desonide 0.05% cream BID x weeks for axilla and genitals] to be alternated with [protopic 0.1% ointment BID x 1 week][elidel 1 % cream BID x 1 week] for up to 4 months. I have counselled the patient that treatment response in vitiligo is very slow, so we should try this modality for 4-6 months. If this fails, we can consider narrowband UVB phototherapy next. Add: Opzelura cream- Ruxolitinib Follow-up will be [in 1 month][in 2 months][in 4 months][as needed]. Thank you for involving me in the care of this pleasant patient. Please do not hesitate to contact me. Sincerely,