News

Destination Unknown : Accountable care organizations & similar shared-savings models likely will impact dermatologists’ role in healthcare, but to what extent remains largely uncertain RNA & UV rays : Research sheds light on the inflammatory mechanism of sunburn Clinical Dermatology : Once-daily application of brimonidine tartrate gel safe, effective for facial erythema of rosacea Cosmetic Dermatology : Glycans and glycobiology emerge in development of anti-aging skincare products Cutaneous Oncology : AJCC’s melanoma staging system elicits debate among dermatologists Practice Management : Successful outsourcing can improve patient throughput, lower staffing costs

About 76,000 new cases of invasive melanoma occur in the United States each year, according to the American Cancer Society, and patients who have had one melanoma have a 5 to 10 percent risk of developing another primary tumor during their lifetime. As a result of this increased melanoma risk, careful follow-up of these patients is critical, a Harvard clinician advises.

Galderma Laboratories has pledged $450,000 to help support the dermatology residency program at Baylor University Medical Center at Dallas.

Sandoz has announced the introduction of its first-to-file calcipotriene cream, the first generic version of LEO Pharma’s Dovonex 0.005 percent, which is indicated for the treatment of plaque psoriasis.

Sound Surgical Technologies has announced its launch of VASERsmooth, a minimally invasive cellulite solution that works with the company’s VASER Lipo System.

ELITech Molecular Diagnostics has received FDA clearance for its MRSA/SA ELITe MGB test, a multiplex, qualitative real-time polymerase chain reaction assay for the detection of Staphylococcus aureus and methicillin-resistant Staphylococcus aureus (MRSA) DNA purified from human nasal swab specimens.

Ellman International, a developer of radiofrequency technology for precision surgical and aesthetic procedures, has announced its acquisition of Sandstone Medical Technologies, developer of aesthetic laser and intense pulsed light technologies.

RXI Pharmaceuticals has appointed Jeannette Graf, M.D., and Leroy Young, M.D., to its scientific advisory board.

Glycomics is the study of glycans, which are sugars. Sugars are very important in cell-to-cell communication and represent the newest frontier in skin biology.

Once-daily application of Sansrosa (brimonidine tartrate/BT gel, Galderma) 0.5 percent has proven safe and effective for treating the persistent facial erythema of rosacea, according to the results of a phase 2 trial.

Although dermatologic conditions most apparently affect the skin, dermatologists commonly encounter three types of psychodermatologic disorders where the mind and skin may interact, according to John Koo, M.D., professor and vice chairman, department of dermatology, University of California, San Francisco Medical Center.

Dermatologist Joe Psoriasis is known throughout the country as an expert in the treatment of psoriasis. An inherent risk of treating such challenging patients is the higher risk of medical malpractice lawsuits. Dr. Psoriasis has now had five such lawsuits filed against him. He is contemplating discontinuing this portion of his practice. Will the HEALTH Act of 2011 provide him with more protection from such lawsuits?

While the incidence of melanoma is lower among African-Americans than it is among Caucasians, mortality due to melanoma is higher among the former. The reason, experts say, is because skin cancers in African-Americans appear on sites where they behave more aggressively, and there is a delay in diagnosis with this patient population.

Ultraviolet B (UVB) radiation damage to noncoding RNAs in keratinocytes initiates a cascade of events leading to the release of tumor necrosis factor-alpha (TNF-alpha), a cytokine central to the inflammatory skin response commonly known as sunburn. The surprising discovery of this mechanism has potential implications for better understanding of prevention, carcinogenesis and phototherapy, researchers say.

Barbara Mathes, M.D., started her healthcare career as an emergency room nurse. She remembers answering medical residents' questions, and the residents would tell her she might as well go into medicine. Her reply? "One day I think I will." So started a multifaceted professional life in dermatology, which has included private practice, teaching, industry work, research and more.

Patients with skin of color cope with a number of skin concerns, but treatment advances are helping dermatologists treat these patients effectively. Pigmentation changes are a major concern for these patients, experts say.

Eight years after the Women's Health Initiative (WHI) linked estrogen supplementation to breast cancer and heart disease, the impact of estrogen withdrawal is obvious in a less-than-obvious location; hormone-deficient vulvar disease is becoming more common, according to F. William Danby, M.D.

For the first time in my life, I had the experience of being on the other side of the doctor-patient relationship. I would not recommend it to anyone, but I learned a lot of valuable lessons about medical care, some of which have direct relevance to the way we all should be practicing medicine.

After the U.S. Supreme Court of the United States upheld the constitutionality of the 2010 Patient Protection and Affordable Care Act (ACA), including the individual mandate requiring all Americans to purchase health insurance, a number of professional medical organizations reiterated concern about potential effects of the law.

Compared with colleagues in other medical specialties, dermatologists have enjoyed a relatively low risk of being sued for medical malpractice. However, when litigation comes to fruition and is successful, the judgment award to the plaintiff is typically much higher for dermatology cases compared with the national average, says Whitney A. High, M.D., J.D., M.Eng. What's more, dermatopathologists rank second-highest among medical specialists for the number of $1 million-plus verdicts.

When it comes to newer healthcare delivery models, experts say accountable care organizations (ACOs) may impact dermatology only in highly competitive markets. Still, dermatologists worry that ACOs could set primary care physicians (PCPs) and specialists at odds, and that specialists' roles in shared-savings programs remain highly uncertain in today's healthcare arena.

Advances in cosmetic and medical skin treatments are helping dermatologists both to avoid and to treat hyperpigmentation and other conditions in patients with Fitzpatrick skin types IV-VI, says Pearl E. Grimes, M.D., F.A.A.D., director of the Vitiligo and Pigmentation Institute of Southern California, Los Angeles.

Billing CPT codes that start with "17" - the destruction codes - remain a source of confusion for both billers and providers. Destruction means that you are destroying lesions using one of several methods. The most common methods in dermatology include liquid nitrogen, electrodessication and curettage, laser and the use of chemicals. Below is a snapshot summary of the destruction codes.

The first long-term trial of Latisse (bimatoprost ophthalmic solution 0.03 percent, Allergan) shows that daily application of the eyelash enhancer for up to one year is safe and effective for patients with idiopathic and chemotherapy-induced hypotrichosis.

A topical combination of vitamin C, vitamin E and ferulic acid (CE Ferulic, SkinCeuticals) appears to provide protection against skin damage induced by infrared A (IR-A) radiation, said Jean T. Krutmann, M.D., professor of dermatology and environmental medicine and director at the IUF – Leibniz Research Institute for Environmental Medicine, D?sseldorf, Germany, at the 70th annual meeting of the American Academy of Dermatology.

Topical corticosteroids are still the mainstay of therapy for pediatric atopic dermatitis (AD), but dermatologists have an array of other options at their disposal to use for steroid sparing or in challenging situations.

The latest melanoma staging system from the American Joint Committee on Cancer (AJCC) and a tool developed for predicting the clinical outcome of individual patients with localized or regional cutaneous melanoma (www.melanomaprognosis.org) have stirred debate among dermatopathologists.

Dermatology has a committed ambassador in Capitol Hill, but it's tragic as to why. Rep. Brian Bilbray (R-Calif.) and his youngest daughter, Briana, both have been diagnosed with skin cancer and are speaking out about it to encourage others to prevent and detect skin cancer early. The congressman has co-sponsored the Melanoma Research Act of 2012, which would provide funding for skin cancer research.

A dermatology practice is a hotbed of activity. In addition to the clinical care you provide, there is staff to manage in carrying out your orders, supplies to use, bills to be sent and money to be tracked. The complexity of a practice makes outsourcing - using outside firms to handle work you would normally perform in-house - appear quite appealing.

When treating patients with skin of color, dermatologists face a number of challenges, and they must choose products and therapies carefully. Diagnosis is the first challenge; common dermatological conditions may have a slightly different appearance in skin of color, depending on the hue of a patient's skin, says Charles Crutchfield III, M.D.