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A new topical therapy combining low-dose 5-fluorouracil (5-FU) with salicylic acid is proving very effective in the treatment of actinic keratosis (AK), particularly in more difficult to treat advanced hyperkeratotic AK lesions, study results show.

Protein glycation is an important event in skin aging, self-tanning creams and the toasting of bread. While these activities may seem unrelated, all of them involve a chemical reaction known as protein glycation.

Although numerous hydroquinone-free compounds for skin lightening are available, their effectiveness depends on the severity of the condition, according to Marta Rendon, M.D., who practices in Boca Raton, Fla.

While the implementation of health information technology (HIT) systems in medical practices has the potential of improving healthcare efficiency and patient care, there are obstacles that medical practices must overcome, and those problems are especially acute for small practices such as those operated by many dermatologists.

The addition of afamelanotide, known by the trademark Scenesse (Clinuvel), may represent a major advance in the treatment of vitiligo, a condition for which there is no therapy in the United States that has been approved by the Food and Drug Administration.

When the United States reached a virtual gridlock in July over raising the country's debt ceiling, most politicians agreed that the country needed to cut spending to bring the nation's budget back into line. With the medical component of the proposed spending cuts, On Call wondered how dermatologists viewed the political gymnastics occurring in Washington and how the impact on Medicare and Medicaid would affect their practices and medicine in the future.

Although large, randomized, controlled trials of topical treatments for alopecia areata (AA) are lacking, experts say many such treatments provide varying degrees of success. When it comes to AA, says Jerry Shapiro, M.D., "Some dermatologists still believe nothing works." He is adjunct professor, department of dermatology, New York University, New York.

Although patterned pigmentation in children can include a variety of clinical findings involving neurologic, musculoskeletal and cardiac abnormalities, most localized pigmentary disorders are not associated with systemic manifestations, according to pediatric dermatologist James Treat, M.D., University of Pennsylvania School of Medicine, Philadelphia.

Supplementation with a combination of calcium and vitamin D may cut the chance of melanoma in half for a group of high-risk women, researchers at Stanford University say.

Electrolysis provides a safe, permanent alternative for patients who don't want or are not appropriate for laser treatments. Electrolysis, which uses current passed through a needle inserted down the hair follicle, is the only method approved by the Food and Drug Administration (FDA) for permanent hair removal.

Though the most common indications for fillers include the treatment of wrinkles, acne scars and lip augmentation, these devices also can prove extremely useful for more esoteric cosmetic and medical issues.

With the mandatory integration of electronic medical records (EMR) into the physician's practice, it would seem that future RAC or carrier audits will be seamlessly easy to navigate and win. As more and more dermatologists start using this electronic documentation tool in their offices, however, I am being bombarded by questions and concerns from the new users - both physicians who are clients and those who are not.

Treatment of pigmented lesions has evolved over the past five to 10 years, according to Eliot Battle Jr., M.D., cosmetic dermatologist and chief executive officer, Cultura Dermatology & Laser Center, Washington, and clinical instructor, department of dermatology, Howard University Hospital.

Recent publications in pediatric literature are driving practice changes relative to conditions ranging from Kawasaki disease to child abuse to hemangiomas. Perhaps the most important recent pediatric publication many dermatologists may have missed addresses evaluating abuse versus accidental trauma in infants and young children, says Robert Sidbury, M.D., M.P.H., chief of pediatric dermatology and associate professor of pediatrics, Seattle Children's Hospital.

Diane Berson, M.D., lives for life's interactions. "I just enjoy interactions on a daily basis, whether that's with my patients, my family, my colleagues or my friends," she says.

Melasma can be both recurrent and persistent, so it is imperative that clinicians treat it sooner rather than later, according to a dermatologist specializing in treating the condition.

Mr. Eye, who was hearing impaired, was to be scheduled for Mohs micrographic surgery. Unfortunately, before his surgery he became ill and did not recover, nor did he return to Dr. Skin's office for six months. Unfortunately, Dr. Skin's staff had forgotten about Mr. Eye's hearing impairment. They took his lack of response as senility consistent with his age. Dr. Skin chose to use only palliative treatment while watching the carcinoma invade Mr. Eye's orbit over the next year.

Molecular diagnostic strategies are redefining the clinical management of a wide range of skin disorders, facilitating diagnosis, staging and prognostication, selection of appropriate therapy, monitoring of treatment response and identification of novel therapeutic targets.

When analyzing suspicious lesions, any diagnostic tool is only as good as the physician using it. Besides patients' suspicions, dermatologists can rely on objective diagnostic tools including dermoscopy and total body photography.

Although treating patients with vulvar disorders can be challenging, confidence and compassion go a long way toward helping these patients. Sometimes, dermatologists allow themselves to be intimidated by the idea that vulvar and mucosal problems differ vastly from the usual issues they treat.

Many physicians don't understand the key characteristics that differentiate currently available hyaluronic acid (HA) dermal fillers, says Derek H. Jones, M.D., clinical associate professor of dermatology, University of California, Los Angeles.

There are innovations in nonsurgical modalities for the treatment of actinic keratoses (AKs) and nonmelanoma skin cancers (NMSCs) and a basis for broadening the use of preventive strategies, says Leonard H. Goldberg, M.D.

Most of us have had experiences of being unjustly accused of poor medical care by a person whose capabilities to make these sorts of judgments are suboptimal at best. What can be done to combat these annoying and sometimes slanderous utterances placed online?

Approaches to treatment of primary Merkel cell carcinoma (MCC) have varied widely, but results of a published study (Schwartz JL, et al. J Clin Oncol. 2011;29(8):1036-1041) support nodal staging as an important component in managing this cutaneous malignancy, according to investigators from the University of Michigan, Ann Arbor.

In healing persistent surgical or other wounds of the lower leg, says Jeffrey E. Petersen, M.D., it's dermatologists' understanding of the fine balance required for wound healing - and how to manipulate this balance - that "allows us to walk where others fear to tread."

Analyses of prospectively collected data from the Nurses' Health Study (NHS) suggest periodontal disease (PD) may be a risk factor for psoriasis, reported Sarah Nakib, M.D., M.P.H., at the 2011 meeting of the Society for Investigative Dermatology.

Dermatology practices are busy places where even a small delay in the morning can throw physicians off schedule for the remainder of the day. The result isn't just more stress; it can include unhappy patients and perhaps even staff overtime costs. None of those outcomes is good for you, your patients or your staff.

Medina, Ohio, dermatologist Helen M. Torok, M.D., says her busy practice could spend $3,000 to $5,000 every quarter on a printed and snail-mailed patient newsletter. Instead, creating a business page on Facebook eliminated that expense and allows her to offer patients more timely information.

While the standard of care to treat melanomas is surgery, when melanomas appear as in situ or as lentigo malignas, which have the potential for invasion, imiquimod can serve as a first-line option for treatment.

A review of published studies suggests that a new, effective class of psoriasis drugs may not raise the risk of heart problems, but researchers say the analysis is likely too small to detect rare cases, Reuters reports.