[patient] OK. Ohh, OK.
[doctor] Hello?
[patient] Hello, can you hear me?
[doctor] Hello. Uh, just before we go any further, can I confirm your name and, age please?
[patient] Uh, my name's Itha, and I'm twenty six.
[doctor] Twenty six, OK. And how can I help you this afternoon?
[patient] Um, so basically, I've been really stressed at work for the past few days.
[patient] And, I've realised that I've got, really dry itchy skin.
[doctor] OK. Um, sorry to hear work's been so stressful. Um.
[doctor] Tell me more about your skin first, Lou. Tell me uh, you mentioned it's been dry and itchy. Um, whereabouts on your skin?
[patient] All over my arms, um, and my hands mainly.
[doctor] OK. Um, and is this something you've had before?
[patient] Uh, no. Never had .
[doctor] So, uh, did it, did it come about quite suddenly, or was it more, kind of a gradual thing?
[patient] I think it started a few days ago.
[doctor] OK. And, has this spread anywhere else? Has it spread to your, to your chest, your legs, your face?
[doctor] No, OK. So apart from being dry and itchy, um, any other symptoms? Has it been sore? Has it been, uh, have you noticed any cracked skin?
[patient] Um, so my skin's quite red, um, and I'm using coconut butter for the past few days.
[doctor] OK. Has that.
[patient] I don't have any spots, and no fever , and I'm not sweating either.
[doctor] OK.
[doctor] Thank you, for mentioning all those. Um, OK. Uh, so the coconut butter hasn't helped, with the itch?
[patient] No, .
[doctor] OK. And, uh, you mentioned work's been quite stressful. What do you do for work?
[patient] Um, I work as a teacher.
[doctor] OK. And, uh, in what way has work been stressful?
[patient] I think the kids have been really annoying these days.
[doctor] OK. .
[patient] And, I've been working really long hours.
[doctor] OK, all right. Well I'm sorry to hear that, and I hope it gets better.
[doctor] Um, going back to your skin. I mean is it anything you've done perhaps, uh, which may have triggered your symptoms? Anything you've touched or, you know, for example shower gels, soaps, fabric , fabric cleaners?
[patient] , I went swimming a few days ago.
[doctor] OK. Is that the first time in your life or have you been before?
[patient] Uh, no, I've been before.
[doctor] OK. And did your symptoms start after you went swimming?
[patient] Uh, yes, .
[doctor] OK, all right. Um, you mentioned you've had no other fevers, is that right? No fevers? No vomiting?
[patient] No.
[doctor] No. How's your health otherwise?
[patient] It's pretty good, yeah. I'm not on any medication.
[doctor] And all , we'll get to medication in just a second. Um, , do you, do you feel generally run-down? Do you feel tired?
[patient] Uh, yeah, I think I have been, quite tired.
[doctor] OK, OK. Are you eating and drinking OK?
[patient] Yeah, I've been drinking, and eating as normal.
[doctor] Your appetite's fine is it? OK. And your bowels, are your bowels working OK?
[patient] Yeah.
[doctor] Uh, no, no problems with vomiting, or loose stools?
[patient] No.
[doctor] OK. And your waterworks are uh, all OK? You're passing urine OK?
[patient] Yep.
[doctor] OK, all right. Um, so just moving on. In terms of your other medical history, is there anything else I should be aware of?
[patient] I'm currently taking .
[doctor] Microgynon.
[patient] Yeah.
[doctor] OK. Do you know what that is?
[patient] Uh, no.
[doctor] OK. , it's a contraceptive pill
[doctor] Does that make sense? Is that something you're, is that, does that ring a bell now?
[patient] Ohh yeah.
[doctor] OK. Is there, any other medications that you take?
[patient] Uh, no.
[doctor] No. So, in terms of your medical history, there's no, problems of skin problems in the past, things like eczema or, um, dermatitis?
[patient] Uh, no, I think it might just be the weather.
[doctor] Sorry what was that? You think it's.
[doctor] The .
[patient] I think it might just be the weather.
[doctor] The weather?
[patient] Yeah, .
[doctor] Ohh, you think the , OK. You think the weather, OK.
[doctor] OK. No that's OK, no, no problems. Well um, uh, move . Do you, do you suffer from allergies? Are you someone who suffers from allergies?
[patient] Um.
[doctor] Food allergies? Medication allergies?
[patient] I think, um, I might be lactose intolerant.
[doctor] Lactose intolerant, OK, that could be helpful to know. Um, fine. And tell me of family history, is there anything in the family that you're aware of?
[patient] Um, yeah, so um, my dad has asthma, and, my mum has hayfever.
[doctor] Hayfever, OK. Um, fine, but any, again, any skin problems that you're aware of?
[patient] Yep.
[patient] Uh, no.
[doctor] No, OK, all right. Socially, who do you live with at home?
[patient] Ohh, it's just me.
[doctor] Live alone?
[patient] Yep.
[doctor] And, uh, do you smoke at all? Do you, can I ask? Do you smoke? Are you a smoker?
[patient] Uh, no, I don't smoke.
[doctor] Do you drink much in the way of alcohol?
[patient] Uh, no.
[doctor] Recreational drugs?
[patient] No.
[doctor] OK. And you said you , you work as a primary school teacher?
[patient] Yes, that's right.
[doctor] Uh , the reason I ask is sometimes stress can be a , contributing factor. Um, you felt, you noticed yourself, find, uh, , life's been more stressful recently. Is that right?
[doctor] Do you think that might have any correlation to your symptoms?
[patient] I don't. I certainly think so.
[doctor] OK, all right. Um, fine. Um.
[doctor] OK, well, normally at this stage I like to proceed to examination, but um, based on your uh, story.
[doctor] Um, it's difficult. I think that, you know, , you've, essentially the story is you've got a dry itchy rash on your, mainly your hands. you mentioned. Um and your arms which started, perhaps after swimming a few days ago.
[doctor] Um, but no other symptoms, you're feeling otherwise, well, no fevers, no bleeding or discharge from skin.
[patient] Yep.
[doctor] I wonder whether you may have something called dermatitis. Um, have you heard of that condition before?
[patient] I have, yeah.
[doctor] OK. Um, great. Well I can give you a patient information leaflet about that, which gives a bit more information about the disease, but, um, it, it's something that we can readily treated. Um.
[doctor] With couple options, we have steroid creams I can give you, um, which will help with the inflammation.
[doctor] And, uh, something called emollients, which can help with the dry, dry skin.
[doctor] And that's something you just need to kind of paste on, uh, on to your skin, uh, , throughout the day for the next few days. Um, and hopefully that helps your symptoms.
[patient] OK, it's cool. Thank you very much.
[doctor] Um, , you can also try antihistamines, so you can get things over the counter, Piriton, Loratadine, they can sometimes help with the itchiness.
[patient] Yeah, that sounds good.
[doctor] OK. And um, that's probably what I recommend. Paracetamol on this occasion, wouldn't be helpful.
[doctor] Um, uh, uh, painkillers wouldn't be helpful , on this occasion, but let's, let's, let's see how the next few days go.
[doctor] And if it's still not getting better, come back and see me next week, and we can have another look again, at your symptoms.
[patient] OK, perfect. Thank you very much.
[doctor] Right. Do you have any questions for me?
[patient] Uh, no.
[doctor] OK. Well, I wish you all the best. Have a good day.
[patient] Well, thank you very much. Bye.
[doctor] Thank you. Bye bye.

Medical orders:
description: steroid creams
order_type: medication
reason: hands arms may have something called dermatitis
description: emollients
order_type: medication
reason: hands arms may have something called dermatitis
description: Piriton
order_type: medication
reason: itchiness
description: Loratadine
order_type: medication
reason: itchiness