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Scenario: Mohamed Ali, a 30 years old male comes to the general practice complaining of an itchy rash.

Presenting Complaint:

• Site: Rash is at the back of hands and fingers bilaterally
• Onset: 2 weeks ago
• Character: Itchy especially at night. Skin looks red, dry and rough
• Radiation: None
• Associated symptoms: None
• Time course: Gradually worsened and spread more across her hands
• Exacerbating factor: Stress (works as a teacher, exams have concluded 3 weeks ago -> increased workload of grading and completing paperwork)
• Relieving factor: Ice, cold shower
• Severity: Not painful but very itchy, 10/10

History of Presenting Complaint:

• No fever, weight loss, loss of appetite, fatigue
• No bleeding from rash
• No swelling
• No trauma
• No joint pain

Ideas, Concerns and Expectations:

• Ideas: Might have something to do with the rash I had as a child, which my mum has to apply creams to the back of my knees and elbows
• Concerns: Worried that it will spread to his face
• Expectations: I hope I can get some creams for the rash
• Perception: I’ve heard of eczema before, and I know that it has something to do with the skin, but I’m not sure. Is this what’s going on with me? I want to know what’s causing the rash and how to deal with it.

Past Medical History:

• Childhood asthma
• Hay fever

Drug History:

• Salbutamol inhaler PRN
• Cetirizine PRN
• NKDA

Family History:

• Dad has psoriasis
• Mum has asthma

Social History:

• Smokes 5 cigarettes a day to relieve stress for the past 10 years
• Social drinker, drinks 1-2 cans of beer per week since teenager
• No recreational drugs
• Works as a teacher
• Currently happy and coping well with stress
• Lives with his girlfriend
• Adopted a new golden retriever 1 month ago

Questions for the role player to ask the candidate

1. What do you think is the cause of my rashes?
2. What is eczema?
3. Since you say it’s due to stress, what can I do to help with my stress?
4. I can’t give up on my pet dog isn’t it? What can I do about this then?
5. Is there any advice you can give me to help make my eczema better?
6. Is there any medication for my eczema?
7. When and how to apply the emollients?
8. Does that mean my illness is incurable?
9. What are the signs of my eczema getting worse to the point I need to come and see you again? </aside>