[Expert Solution]: Medical Record Excerpt 1 “I saw Sharon…

Medical Record Excerpt 1 “I saw Sharon today for a new spot of concern on her right forearm. She first noticed this spot three weeks ago. At first, she thought it might be a pimple, but it didn’t go away and could not be ‘popped. ’ It started to itch and she used Benadryl® cream to ease that, and it worked for a brief period of time. She has noticed over the last few days that it is getting bigger. It appears to have puss, but won’t pop. She has no fevers or chills. No chest pain or breathing troubles. She hasn’t noticed any other changes in her skin. Her medications include a multi-vitamin as well as Synthroid® 135 mcgs each morning. She is current with her flu shot. She has never smoked. She does drink socially. On exam her vitals are stable. PERRLA; no lymph nodes upon palpation. Her skin is normal in color and turgor. RRR. Chest is CTAB. Abdomen is soft, non-tender. No edema. After performing a more thorough skin examination, she has no other suspicious spots. Examining this area, it looks like it could have started as a pimple. She has been picking at it, and it’s now inflamed. I feel a pustule sack deep within it. The spot on her arm appears to be a sebaceous cyst that has become irritated. I think she will get relief if it’s drained. I suggested an I&D of the area. She is in agreement and understands the risks and benefits. I have gotten consent. In the procedure room, I draped the arm and administered a local anesthetic. Using a number 10 scalpel blade, I made a small incision in the center of the area. I was able to extract 5 mL of fluid. The site immediately smoothed. The pustule that I felt earlier decreased in size. I also was able to extract some tissue that I will send to pathology. She tolerated the procedure well. I explained what to look for and when to call me. I will be in touch with her upon receiving the pathology report. She was able to leave after a 20-minute rest following the procedure.