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Too many physicians over the last decade have sought cookie-cutter asset protection plans to give them some "peace of mind" that if they ever endure an outrageous malpractice case, they won't lose everything. While we admire these doctors' commitment to pro-actively managing their risk, we have to remind doctors that all "asset protection plans" are not created equal. In fact, many will not even "work" if they ever are relied on.

Several therapies are available for the treatment of superficial basal cell carcinoma (BCC), including excision, PDT, 5-fluorouracil and imiquimod; however, not all of them have the same safety and efficacy profile. A recent study proves that imiquimod is safe and effective for the treatment of superficial BCC and assures sustained clearance over at least five years.

Targeting the melanocytes in the hypermelanosis seen in melasma is a common and effective therapy. Many therapies exist, including topical approaches, lasers and light therapy. A new approach targeting the vasculature, not the melanocytes, using a copper bromide dual 578 nm yellow laser has proven very effective in the treatment of melasma, a recent study shows.

An article published Aug. 14, 2008, in the online version of the Journal of Investigative Dermatology created quite a stir among the media. This paper, titled "Tumorigenic Effect of Some Commonly Used Moisturizing Creams when Applied Topically to UVB-Pretreated High-Risk Mice" (Yao-Ping Lu et al), drew some dubious conclusions regarding the relationship between moisturizers and skin cancer.

Cathelicidins appear to have dual roles in the skin, working not just as antimicrobials that act as natural antibiotics but also as proponents of healing. Researchers are looking into the underlying workings of antimicrobial cathelicidins with the hope of better understanding their role in osacea. Factors such as toll-like receptors and vitamin D3 appear to be part of the equation.

Cosmeceuticals such as Kinerase (Valeant), niacinamide and a combination of methylsulfonylmethane and silymarin can have a place in treating rosacea, particularly when there is a reason why pharmacological therapies can be used. However, as the number of treatments claiming to help with skin redness grows, physicians shouldwarn patients that just because something can treat redness, that doesn't necessarily mean it can treat rosacea.

Although there is a lot of ongoing research into rosacea and a number of FDA-approved medications, very little of either have to do with skin of color. Research protocols have not included ethnic skin, and medications were approved before the FDA required the inclusion of ethnic subjects.

Some research has demonstrated efficacy with the off-label use of tumor necrosis factor-alpha in treating inflammatory skin conditions such as pyoderma gangrenosum and hidradenitis suppurativa. The use of infliximab, in particular, has resulted in disease quiescence in patients who had either condition, and its use has demonstrated a steroid-sparing effect in patients with pyoderma gangrenosum.

Several ingredients found in topical preparations help treat dry skin and the subsequent symptom of pruritus. The results of a recent study with dihydroavenanthramide D demonstrate the agent is very effective in the treatment of pruritus, and according to one expert, should be considered an option when trying to treat and subdue pruritic symptoms.