October 9, 2013

On her last visit in August she was found to have multiply inflammatory papules and pustules with some deep cysts on her face, neck and back. There was some scaring on both cheeks. Various topical treatments and systemic antibiotics have not been successful in controlling her severe acne. After counselling with the patient and her mother the last visit, it was agreed that we would start her on Accutane.

Exam today shows remarkable improvements. There are some residual lesions without any new inflammatory cysts or pustules. A few comedones are present on the nose. She states she has been using the Accutane as directed and is taking her contraceptive pills faithfully.

Inflammatory acne vulgaris while on Accutane. She and her mother were again counselled about the high risk of birth defects should she become pregnant while taking Accutane. She denies being sexually active but her mother was present in the room

She is to follow up in the office in one (1) month.

James Wood, MD

JW: your initials


Don't know why they say this document is to short so adding information not to be used in your transcription.

These works are difficult sometimes but there is always google to help out when one word or another is not understandable.

Many times it is just a matter of slowing the roll to get the word..

This is being submitted as one word or another was difficult to hear.

A lot of blank areas sorry...