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These include:

  • Patches of dry, inflamed, red skin
  • Itching at the affected area



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If yes, then please list them


If so, then please list them. This includes over the counter medication, prescription medication, and recreational drugs


If yes, then please list them




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The photo will only be used to verify your identity and will not be shared elsewhere. We aim to strictly adhere to data protection legislation and rigorously maintain patient confidentiality.

Only .jpg, .jpeg, .png, and .gif formats are allowed.(10MB file size limit)