Phone Visit
Narrative: SPRUCE MESSAGE VISIT Date: 2026-03-03 CC: Psoriasis follow-up and persistent cough while eating HPI: Parent reports a recent check-in with dermatologist Dr. M regarding Nelly's psoriasis, noting that she continues to test positive for something each time she is evaluated. Parent also raises a concern about a persistent cough that occurs specifically while eating, questioning whether it may be related to her psoriasis or its treatment. The cough predates initiation of psoriasis medication and has not improved. Encounter: Dr. Hobbs confirmed the treating dermatologist is Dr. M. Expressed curiosity about the cough, which is isolated to eating and remains unexplained. Parent clarified that the cough was present before psoriasis medications were started and that the psoriasis medications are currently working well. Dr. Hobbs inquired about whether a change in psoriasis medications was being considered. The cough while eating warrants further investigation as a possible separate or comorbid condition (e.g., dysphagia, reflux, or esophageal involvement). Key clinical quotes: "Every time she is tested she seems to have some kind of result." "I am also wondering if this has a thing to do with that cough while eating?" "No this was happening before the meds too. And the psoriasis meds are working well"