Phone Visit
Narrative: SPRUCE MESSAGE VISIT Date: 2026-08-01 Encounter: Spruce text message with photo review CC: Skin reaction following sunscreen application. HPI: Elsie presented with a skin reaction approximately 45 minutes after sunscreen was applied. The reaction was visibly notable (photo apparently shared) and was bothering her significantly, with irritation and likely itching. Dr. Hobbs noted the reaction could be a combination of sunscreen, sun exposure, sweat, or water. Elsie was improved by approximately 2 hours after initial message following intervention. Assessment: Contact skin reaction likely related to sunscreen application, possibly exacerbated by sun, sweat, or water exposure. Not felt to be a severe allergic reaction requiring emergency care. Plan: Advised to wash off the sunscreen and bathe Elsie to clean the skin. For significant itching, Benadryl 2.5ml or Zyrtec 2.5ml was recommended. Getting Elsie cool and clean was emphasized as the most important step. Follow-up message confirmed she was much improved. Medications: - Benadryl (diphenhydramine) 2.5ml (new) - Zyrtec (cetirizine) 2.5ml (new) Key clinical quotes: "It could also be a combo of sunscreen sun and sweat or water. I'd try to clean it off and when you can bathe her to get his skin cleaned off" "if she's itching a lot, some benadryl (2.5ml) or zyrtec (2.5ml) is a good start, but getting her cool and clean will help the most" Source: Spruce conversation t_2JKAFP7F8NO00