CHART NOTE
HISTORY
This patient returned today with a spreading rash on her shoulders, upper chest, and back, which has been present for over the last couple of months. She is concerned that this represents a flare-up of her chronic lupus erythematosus.
Examination, however, reveals lesions strongly consistent with tinea versicolor. A wet mount preparation revealed short batlike hyphae, confirming the diagnosis.
PLAN
I have reassured her that this is a minor treatable condition and that has no relationship to her lupus. Since she is not pregnant or breast-feeding, I have started her on a 10-day course of Nizoral 200 mg per day and propylene glycol in distilled aqua to be applied b.i.d. for 1 month. She will return p.r.n. for her skin rash if needed and is to be rechecked on a yearly basis for her lupus.
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