instruction: hello doctor I have been having rashes on my hands forearms trunk and feet for four weeks now the rashes on my hands and feet have lesions the rashes are not itchy except for those with lesions I also have a small wound or sore on my anus which has been there for three weeks now I believe this is syphilis I have taken loratadine for seven days as prescribed by a doctor here however nothing happened I cannot have it checked due to the quarantine in my area does my condition need immediate medical care or can I take medicine to treat this while waiting for the eco to be lifted I did not have a fever or flu when this started I would also like to add that I have been having dandruff on my beard and mustache and an itchy scalp there are also dry patches on the area near my chin and they are flakey they do not flake sometimes though I have been applying moisturizer on my face since they started to appear another thing the folded skin on my underarm and area behind my knee can sometimes have a burning sensation I did not know what is happening I hope you can help me with this
output: hello prior to the onset of rashes did you observe any lesion or wound on your penis or sexual encounter with someone who had such may I ask questions about your sexual history how many sexual partners have you had male or female are you aware of your partner promiscuity what do you do any other diseases is this the first time this has happened besides loratadine have you tried taking any other medications any allergies based on the given health data it is likely you may have secondary syphilis can you send photos of the rashes on your trunk or arms where did it start and how did it spread any throat pain or gun lesions if you are having difficulty of breathing fever changes in sensorium numbness or weakness please proceed to the er otherwise we could start treatment for now but will require laboratory results to confirm the diagnosis please do vdrl or ror whichever is available and fta abs or oppa whichever is available I suggest to start doxycycline 100 my twice daily for 14 days please do lab works before starting your medication the results may turn out negative if you have taken your dose and if it is negative we will have to stop the treatment regarding dandruff I suggest to shave your beard use anti dandruff shampoos may continue the application of moisturizer on the affected area regarding the burning sensation it maybe related to syphilis are there any rashes present is it often damp is the area reddish continue to take baths and maintain good proper hygiene please send your abc complete blood count results vdrl venereal disease research laboratory or ror rapid plasma reagin and fta abs fluorescent treponemal antibody absorption or oppa treponema palladium particle agglutination assay abstain from sex for now proper hygiene