ROWAN A SCOTT | DOB: 19-Mar-1997 | IHI: 8003 6011 5191 0572

MRN: 115-39-15 Name: SCOTT, Rowan Andrew DOB: 19/03/1997

Royal Prince Alfred Hospital

Attendance Date: 02/06/2023

OPD Dermatology
Signed By: Cordas,Daniel Michael (Trainee Specialist)
(02/11/2023 11:38)

CONFIDENTIAL
2ND June, 2023.

Dr. JEREMY CHOY

George Street Medical Centre
308 George St
SYDNEY NSW 2000

Dear Dr. Choy,

Re: Rowan SCOTT - DOB: 19.3.1997 - MRN 115 39 15

I had the pleasure of reviewing Rowan with Assoc/Professor Lowe for follow up on Rinvoq 30mg once daily
for atopic dermatitis since 18/8/2022, with dose increased 1/3/2023.

Rowan is compliant with Rinvoq 30mg daily. He was on Keflex QID for several weeks and stopped this four
days ago.

His current topicals include:-

· Epaderm ointment twice daily
· Diprosone ointment to the body with one tube lasting four days now
· Advantan fatty ointment to the face which he is using sparingly
· Dermeze moisturising soap free wash
· Laundry detergent – he isn’t sure of the exact name but some kind of environmentally friendly baby
detergent

Rowan remains on Valtrex 1g BD for recurrent HSV keratitis for which he sees Ophthalmology at RPAH.

His most recent monitoring bloods on the 3/3/2023 showed a CK 170.

On examination he had generalised xerosis and lichenification. There was ongoing eczema particularly in the
flexural areas. He had crusted vesicles below the right eye which we have swabbed today for bacterial
culture and viral PCR. We have also swabbed an eroded area on the left retroauricular region. He had a
patchy scaly erythematous rash on the anterior chest suspicious for granular parakeratosis. He also had a
curvy linear hypertrophic scar on the right back which we think is secondary to excoriation.

Overall Rowan’s eczema has improved over the last few weeks though remains quite severe to the face with
concern for secondary viral / bacterial infection. Given a possible element of granular parakeratosis also –
we suggest he switches laundry detergents.

Skin swabs taken today:

1. Below right eye

- HSV 1 positive, VZV negative
- 3+ S.aureus, 3+ S.dysgalactiae

2. Left retroauricular
- HSV 1 positive, VZV negative

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 ROWAN A SCOTT | DOB: 19-Mar-1997 | IHI: 8003 6011 5191 0572

MRN:115-39-15 Name:SCOTT, Rowan Andrew DOB:19/03/1997 Attendance Date:02/06/2023

OPD Dermatology
- 3+ Staph argenteus, 3+ S. dysgalactiae

I have discussed the swab results with Prof Lowe. We have asked Rowan to do a basic immunodeficiency
screen including IgG/A/M, IgG subclass, IgE, C3/C4, T and B cell subsets. These remain outstanding.

I have discussed the swab results with the infectious disease registrar, who has suggested flucloxacillin 1g
QID for 7 days, then a prolonged / tapering course as we have previously done with Keflex. He should also
remain on Valtrex 1g BD.

I have liaised with the Ophthalmology registrar who has kindly booked Rowan in for review again, noting he
has missed his recent appointment. Rowan's last attended appointment was on 17/05/23, at which point the
plan was to increase Valtrex 1g BD to TDS for HSV keratitis.

Plan: 1. Continue Rinvoq 30mg daily.

2. Continue general skin care measures and topicals including optimising emollients
especially to the face.
3. Continue topical steroids to the flexures and face.
4. Change laundry detergent to Omo Sensitive which all household members should
use. In particular there should be no use of drum cleaners.
5. We wonder whether there was an irritant component from his glasses given the
facial accentuation, we have suggested avoiding using cleansing
wipes on his glasses.
6. Surveillance of the hypertrophic scar on the right back.
7. Immunodeficiency screening bloods as above.
8. Antimicrobials as above.
9. Follow up end of October for script renewal.

With kind regards,

Dr. Daniel Cordas – electronic signature

DR. DANIEL CORDAS

Dermatology Advanced Therapeutic Registrar for and on behalf of
CLINICAL ASSOC/PROFESSOR PATRICIA LOWE
Consultant Dermatologist.

Typist's name: McDonnell, Rhonda

Typing date: 08/06/2023

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 ROWAN A SCOTT | DOB: 19-Mar-1997 | IHI: 8003 6011 5191 0572

Letter
2 Nov 2023
Rowan SCOTT DoB 19 Mar 1997 (26 years*) SEX Male IHI 8003 6011 5191 0572 MRN 1153915

Start of Document

Royal Prince Alfred Hospital

Author Daniel Michael CORDAS (Medical Practitioners nfd)
Phone (02) 9515 6111

Letter
Attachment

Administrative Details

Encounter Details Value Facility Details Value

Start Date 2 Jun 2023 10:00+1000 Name Royal Prince Alfred Hospital
End Date 3 Jun 2023 23:59+1000 Work Place 50 Missenden Road,
Camperdown, NSW, 2050,
Responsible Health Value Australia
Professional Phone (02) 9515 6111 (Workplace)
Name PATRICIA LOWE FAX (02) 9515 6179 (Workplace)
Address Not Provided Department Royal Prince Alfred Hospital
Contact Details Not Provided
Organisation Royal Prince Alfred Hospital

Patient Details Value Author Details Value

Name Rowan Andrew SCOTT Name Daniel Michael CORDAS
Sex Male (Medical Practitioners nfd)
Indigenous Status Neither Aboriginal nor Torres Organisation Royal Prince Alfred Hospital
Strait Islander origin Department Royal Prince Alfred Hospital
Date of Birth 19 Mar 1997 (26 years) Work Place 50 Missenden Road,
* Age is calculated from DoB Camperdown, NSW, 2050,
IHI 8003 6011 5191 0572 Australia
Local Identifiers 1153915 (Royal Prince Alfred Phone (02) 9515 6111 (Workplace)
MRN) FAX (02) 9515 6179 (Workplace)
2227099 (SSWAHS AUID)
28739962821 (Medicare Card Clinical Document Details Value
Number) Document Type Specialist Letter
Creation Date 2 Nov 2023 11:38+1100
Date Attested 2 Nov 2023 11:38+1100
Document ID 572c90b4-837d-4cfd-803c-
64e733950a2e
Document Set ID 1.2.36.1.2001.1005.16.50.2.3.1
005500.1300004.9585356603
Document Version 3
Completion Code Final

Primary Recipients
Name Contact Address Organisation
DR JEREMY CHOY Not Provided Not Provided

End of Document

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