ASMR Roleplay | Dermatologist Skin Exam ? (layered sounds)
Entertainment
Introduction
Hello, I'm Dr. Lavender, the dermatologist who will be performing your skin check and mole check today. How are you? Good to hear. The nurse has already gathered most of your information, but we're still missing a couple of things. Can I get you a glass of water or anything? Perfect.
First, I need to confirm your current phone number and address; are they the same as before? Wonderful. And your insurance remains the same? I'll note that. You mentioned wanting to change your pharmacy to a location closer to your home on MLK, correct? Great, I'll update that in the system.
Since we are doing a mole check today, I'd like to ask if you have any family history of skin cancer. Okay, I see you have a couple of moles. When was your last mole check? I recommend that my patients with moles or freckles get a mole check at least once a year. I know it can be difficult to fit into the schedule, but it's very important.
Alright, are there any areas of concern for you? I see that spot you’re referring to, so I'll take a closer look and discuss treatment options. Have you noticed any moles or freckles that have grown or changed, even if they have gotten smaller? Okay, and lastly, are you on any medications?
Let's start the skin exam. First, I'm going to sanitize my hands and put some gloves on. While I'm doing that, can you describe your skin type and skincare routine? Do you use any harsh chemicals or get any skin treatments? Perfect, so you are on tretinoin. Any side effects? It’s a great treatment but it can cause dry skin and flaking. What strength are you on?
When did this little area of irritation start? Sometimes our skin reacts in weird ways; it could be the powerful cream causing a reaction or just irritating the skin. Do you have a history of eczema? In high school, okay.
If I have your permission, I'll get a little closer to examine the area. Any pain or tenderness here? Does it itch or burn when you apply your skincare? Are you wearing any makeup or skincare products right now? Vitamin C serum and moisturizer, okay.
When you apply an active like vitamin C along with tretinoin, it can increase irritation. Tretinoin is so powerful that it can often be the only skincare you need. I'll press a bit; let me know if you feel any pain. Now, I'll take a look around your ears. This area here looks like it might need special attention.
For this spot, let's take a closer look. I recommend avoiding tretinoin on this irritated area and not applying it near your eyes. Tretinoin can cause permanent dry eye, so don't apply it anywhere near the eye socket, and remember to wash your hands after application.
Your skin appears to be responding well to tretinoin; it has a nice, even texture and a glow. Are you using it mainly for acne or anti-aging? You have very little acne, so it seems to be working.
Given your history and symptoms, I think this could be facial eczema or perioral dermatitis. Eczema is usually treated with steroid cream, but if it’s perioral dermatitis, steroids will worsen it. I suggest taking a swab of the area to check if it’s fungal or bacterial before proceeding. It won't hurt; it’ll just feel like a light scratch.
Let's clean the area first. Now, I'll take a little scrape and a swab. We’ll send these to the lab for analysis. While we wait for the results, stop using tretinoin to let your skin heal.
I recommend a zinc and copper cream like one by Avene, or even diaper cream, which helps with itchiness and redness. Apply it morning and night after cleansing your face. If you want, I can also prescribe a topical antifungal while we wait for the lab results. If there's no further irritation, it should be harmless, and you'll wait for the results.
Let me change gloves, and we’ll start the mole check. We’ll use the ABCDE rule: Asymmetry, Border, Color, Diameter, and Evolving. I'll mark any moles of concern with this special pencil.
I’ll examine all moles for any abnormal features. Let's start with your scalp. When you get a haircut, has your barber mentioned any moles on your head?
All done! I'll note that we’ll keep an eye on one particular mole. I recommend doing a self-check monthly to monitor your moles and freckles for any changes.
We’ll have your lab results in less than 72 hours, and we'll schedule a follow-up appointment for next steps. Whether it requires antibiotics, antifungal cream, or steroids, we’ll discuss it then. If you have any more questions, feel free to ask.
I'm glad you came in today; your skin looks wonderful, and we’ll get it on the path to healing. Have a good day, and you can check out with the receptionist.
Thank you!
Keywords
- Dermatologist
- Skin check
- Mole check
- Family history
- Skin cancer
- Skincare routine
- Tretinoin
- Irritation
- Eczema
- Perioral dermatitis
- Steroid cream
- Zinc cream
- ABCDE rule
- Self-check
- Lab results
FAQ
What should I expect during a dermatologist skin exam?
During a dermatologist skin exam, your dermatologist will ask about your medical history, current medications, and skincare routine. You'll undergo a full-body skin check for any concerning moles or skin changes.
How often should I get a mole check?
A mole check is recommended at least once a year, especially if you have a family history of skin cancer or multiple moles and freckles.
What is the ABCDE rule?
The ABCDE rule helps in identifying concerning moles:
- Asymmetry: Uneven shape
- Border: Irregular edges
- Color: Varied or unusual color
- Diameter: Larger than a pencil eraser
- Evolving: Changes over time
Can tretinoin cause skin irritation?
Yes, tretinoin is a powerful cream and can cause dry skin, irritation, or flaking, especially when combined with other active skincare ingredients like Vitamin C.
What should I do if I notice a problematic mole?
If you notice a mole that's changing in size, shape, or color, or one that becomes symptomatic (itching or pain), you should schedule a follow-up appointment with your dermatologist.
How do I care for my skin if I have eczema or perioral dermatitis?
Avoid harsh treatments like tretinoin until the diagnosis is clear. Use a gentle cleanser and a zinc and copper cream to soothe the skin. Your dermatologist may recommend further treatments based on lab results.