News

An expert says physicians sometimes overlook the key element of chronic woundcare - properly diagnosing the causes of chronic wounds.

Physicians historically have used antiangiogenic agents in oncologic and ophthalmologic indications, but dermatologic applications for these medications are under investigation, an expert says.

Preliminary, yet promising, outcomes in two patients suggests dual therapy involving limited surgical excision followed by topical application of imiquimod 5 percent cream (Aldara, Graceway) may be an option to consider for treating invasive malignant melanoma surrounded by lentigo maligna (LM) in patients who refuse or are not good candidates for more extensive surgery, according to researchers from the department of dermatology, Saint Louis University School of Medicine, St. Louis.

As a result of the American Recovery and Reinvestment Act (ARRA) - the "stimulus package" - a bonanza of new research money is now available at the National Institutes of Health (NIH), and skin disease research is in a position to benefit.

As attorneys and consultants to thousands of physicians across the country, we are constantly astounded by the attitudes of physicians regarding the sale of their medical practices. Most often, today, we hear the complaint that doctors do not feel they can sell a practice for any significant value. They generally do not feel the practice is "worth anything," especially if they do not have younger partners to buy them out.

Systemic retinoids can be used to help transplant patients, long-term phototherapy patients, and patients with cutaneous T-cell lymphoma fight skin cancer. Systemic retinoids are also used in psoriasis patients with long-term exposure to phototherapy.

Dr. Derm formerly employed three secretaries. One secretary was terminated, and the remaining ones must do the work of three staff members. He still has 17 employees.

Charles E. Crutchfield III, M.D., seemed destined for a career in medicine. His mother, Susan, a family practitioner, was the first black female - and youngest, at age 23 - to graduate from the University of Minnesota Medical School, in 1963. His father, Charles II, is a nationally recognized obstetrician-gynecologist.

Although Aldara (imiquimod, Graceway) is effective treatment for basal cell carcinomas and actinic keratosis, researchers are looking for alternative topicals with fewer drawbacks.

A few months ago, I wrote an editorial for Dermatology Times on the subject of Mohs micrographic surgery and its potential abuses. I noted that while the procedure is very beneficial, it is sometimes overused for questionable indications.

Biologic therapy is proven to increase the quality of life in adult patients suffering from moderate-to-severe psoriasis. A recent study shows that etanercept (Enbrel, Immunex) can achieve similar positive results in children and adolescents, offering hope to this patient population.

Results of a prospective, split-side controlled trial enrolling 22 patients with skin types II-VI indicate hair removal with the long-pulsed 1,064 nm Nd:YAG laser is associated with significant improvement in lesions of hidradenitis suppurativa without causing significant adverse effects.

Recent study results indicate that there is a relationship between the severity of psoriasis and CRP levels, as well as BMI in pediatric patients. These patients are also at a higher cardiovascular risk, begging the need for treatment strategies in terms of lipid-lowering therapies.

Practice management consultants Elizabeth W. Woodcock, M.B.A., the founder of Woodcock & Associates, Atlanta, and Pamela L. Moore, Ph.D., director of content and strategy for Physicians Practice, Inc., offer these tips for protecting your practice during tough times

The spectrum of male genital dermatoses encompasses a range of infectious, inflammatory and neoplastic disorders. In providing proper diagnosis and management, the dermatologist can play an important role in minimizing the morbidity and mortality that can accompany these conditions.

Revenue is flat, even dropping, at many dermatology practices. The recession that began last year is leading more Americans to cut back on preventive care, as well as elective procedures and treatments.

Early identification of dysplastic nevi (DM) is crucial, as patients with DM are at significantly greater risk of developing malignant melanoma. An expert advocates a DN management strategy that utilizes total cutaneous examination, total cutaneous photography and dermoscopy.

Dermatologists play a key role in the health and well-being of armed services throughout the world. Climate, hygiene and environmental factors all contribute to the spread of cutaneous disorders and infections.

The co-pioneer of Botox Cosmetic (botulinum toxin A, Allergan) traces the inspiration for the product back to one testy patient's plea.

Even Mohs surgeons with ample experience in detecting basal cell and squamous cell carcinomas can have difficulty detecting malignant melanocytes in frozen sections, making many apprehensive about using Mohs surgery for lentigo maligna. But proponents of the technique say the fast results and reduced rate of recurrence make Mohs well worth the effort.

Research suggests that AKs are most likely early-stage superficial SCCs. The dermatology, pathology and dermatopathology communities need to change their classification or prove that AKs are distinct, an expert says. Virtually all AK research is fraught with inadequate data and lack of standardized protocols, he says.

Dr. Richey suggests that anyone interested in developing a Brighter Days program follow these recommendations:

As the Food and Drug Administration (FDA) reviews the safety of therapeutic and cosmetic botulinum toxin injections, dermatologists say adding warnings to Botox Cosmetic (botulinum toxin A, Allergan) would be unwarranted.

Stress, depression and anxiety can increase skin, hair or nail problems. Therefore, in some cases, dermatologic therapies should be used in conjunction with appropriate stress-management strategies.

Nearly two decades after the introduction of botulinum toxin A for therapeutic indications, Botox Cosmetic (botulinum toxin A, Allergan) ranks among the safest and most successful æsthetic treatments available, dermatologists say. But, because of its relatively high cost, doctors say they would welcome competitive botulinum toxin options.

IPL," "photo-facial," light treatment, laser treatment - whichever name you use, intense pulsed light systems have become the single most popular light devices in use today. Their sales are largely unregulated, with most of the devices being used in spas, "medi-spas" and "rejuvenation facilities." Though universally offered, can IPL treatments differ at these "nonphysician facilities" and physicians' offices?

The use of photodynamic therapy is increasing, and yet the modality hasn't made much headway in the United States as a treatment for nonmelanoma skin cancers. Two dermatologists face off on its prospects for skin cancer treatment in the United States.

Occupational dermatitis is common, but often overlooked by primary care physicians. Therefore, dermatologists' skills are needed to not only diagnose work-related dermatitis, but also to identify the offending agents and manage the condition.

Brighter Days, a program launched by dermatologist Donald Richey, M.D., of Chico, Calif., adds a humanitarian touch to oncology treatment protocols. The program offers personalized skincare to help patients manage the side effects of chemotherapy and radiation, in a group therapy environment.

Dermatology is not recession-proof. However, protecting revenue and containing costs can help your practice survive and even thrive, even in challenging economic times.