Bob Kronemyer

Articles by Bob Kronemyer

Patients who carry a high-penetrance melanoma predisposition gene can often benefit from screening for other cancers. Patients who receive a positive genetic test result are more likely to embrace prevention and detection measures. A new “Rules of Three” proposes a point-based guideline to help determine who should be referred for genetic counseling and testing.

When it comes to choosing topical agents for treating acne, separating fact from fiction can be challenging for dermatologists.

TNF inhibitors adalimumab and infliximab have evidence-based efficacy for the treatment of hidradentitis suppurativa (HS). Anti-interleukin inhibitors ustekinumab and anakinra also being evaluated in small studies for treatment of HS. Antibiotics, hormones, retinoids, steroids and laser therapies directly targeting the lesions round out an effective treatment plan for HS patients.

Dermatologists should consider the features of the nasal defect when weighing options for repair.Consider the desires of the patient when assessing options for both repair and treatments to mitigate post-surgical scar formation.The dermatologist must determine the choice of which procedure will likely achieve the best aesthetic outcome overall.

Since its introduction, isotretinoin has been reported to cause psychiatric problems or irritable bowel disease. Because different studies over the past 35 years do not support these claims dermatologists should not hesitate to prescribe this medication for their acne patients.

Insurers tend to think of keloids as a cosmetic issue so they have a wide range of standards covering reimbursement for care and treatments. Practitioners must fully document the medical necessity of the care they provide and then code the conditions and treatments correctly to maximize their chance for reimbursement.

Laser treatments, non-steroid injectables, and topical applications of imiquimod cream are proving to be effective in the treatment of keloids and excessive scarring. In many cases, recurrence rates have dropped to 20% and lower from former highs of 70% or more.

For decades, a lack of scientific data and evidence-based medicine have resulted in essentially no changes in the treatment of keloid disorder. New studies confirm that cryotherapy and intralesional injections of vincristine can be effective treatments for different types of keloids.

While melanocytes have strong mechanisms for repair, those in individuals with certain risk factors may carry impaired repair responses. Studies have begun to examine melanocytes in patients at risk for developing melanoma with the hope of developing strategies for preventing deadly tumors.