News

Common legal issues facing physicians who perform cosmetic laser treatments include medical malpractice, as well as issues related to physician extenders and the Health Insurance Portability and Accountability Act (HIPAA), an expert says.

For many controversies surrounding laser treatments, there are no black-and-white answers. What works for one physician or patient may not work for another, says an expert.

Although many lasers have earned Food and Drug Administration (FDA) approval for treating patients of color, an expert says that physicians' expertise has yet to catch up with the technology available.

Used alone or in combination with aminolevulinic acid (ALA), lasers and light sources have shown effectiveness in treating acne, according to an expert.

Baltimore -- According to doctors at Johns Hopkins University here,pornography enthusiasts are finding a new source of online images:dermatology Web sites created to educate doctors.

Tallahasse, Fla. -- A proposed bill making its way through theFlorida House of Representatives would limit the number ofsatellite offices doctors could operate, with dermatologicalpractices getting the most restrictions.

St. Thomas, U.S. Virgin Islands - Effective treatments forpigment problems caused by radiation treatments include a varietyof skin creams and light sources, experts tell Dermatology Times.

Baltimore - Like organ transplant patients and those withchronically suppressed immune systems due to autoimmune diseasetreatment, cancer patients' immune systems weaken as a result ofchemotherapy treatment. Dermatologists might then enter the picturebecause several cutaneous manifestations can occur.

San Francisco - Preventive measures taken before radiation orchemotherapy treatments have helped reduce many of the bothersomeoral side effects, an expert tells Dermatology Times.

Ann Arbor, Mich. - Patients who have had radiation therapyfor cancer often find the therapy affects their skin at thetreatment site.

San Francisco ; Aside from boasting record-breaking attendance, the64th Annual Meeting of the American Academy of Dermatology (AAD),here, presented attendees with another first: A live demonstrationof cosmetic procedures.

National report - Chemotherapy and radiation can createunwanted results ranging from hair loss to pigment problems.However, an expert tells Dermatology Times that with some newbiologically targeted cancer therapies, skin-related side effectsseem to provide a barometer of these treatments' effectiveness.

Q. Many of my colleagues have been investing in emerging marketsand have done quite well. What's the attraction, and is it too lateto hop on board?

James W. Young, D.O., was on a plane, about to land in Uganda as avisiting physician on a mission for the Washington-based HealthVolunteers Overseas (HVO) organization, when a scary notion ranthrough his mind.

Last will and testament. Sounds majestic, doesn't it? Andreassuring: Once you've had your will prepared, signed andwitnessed, you'll probably feel you've done right by your heirs.But many doctors fail to realize how much of an estate may not fallunder the provisions of a will. Let's see where five of the biggestholes are, and how you might fill them.

According to some courts, an expert witness in certaincircumstances would not need to be a specialist, and could even beconsidered an expert based on study rather than actual experience.

The YAG laser can be used safely as long as it is not used withinone centimeter of the orbital rim where there would be a risk oflight being transmitted to the eye.

National report - For treating the lips and lower face,experts tell Dermatology Times that options including fillers,botulinum toxin injections and newer resurfacing technologies candeliver excellent cosmetic results usually with little or nodowntime.

San Francisco - Developed in France more than 50 years ago,mesotherapy has been slow to gain widespread acceptance in theUnited States.

National report - While soft-tissue fillers offer the uniquebenefit of providing fast correction for busy patients who don'twant to have the down-time for a face-lift, bruising can throw amonkey wrench into the best-laid plans for stellar patientsatisfaction.

Las Vegas - The calcium hydroxylapatite filler Radiesse(Bioform) has its share of caveats, but the filler generally offersgood correction that lasts for a year or more, with side effectsunlikely, according to Alastair Carruthers, M.D., speaking at theAnnual Meeting of the American Society of Cosmetic Dermatology andAesthetic Surgery.

Poly-L-lactic acid is also being used by some physicians off-labelas a volume restorer for cosmetic enhancement in non-HIV patients.

St. Louis - A surge of new dermatologic therapies hasrecently burst upon the scene, providing a variety of options fortreating skin diseases, especially in psoriasis.

Anaheim, Calif. - More than 30 years after the term apoptosiswas coined, researchers are just beginning to understand the roleof caspases in this process, despite a flurry of recent research.

New York - Treating pediatric atopic dermatitis (AD)effectively can involve both newer treatments, such as calcineurininhibitors and TNF agonists, as well as new twists on existingtreatments, according to Lisa A. Beck, M.D.

London - Intravaginal microbicides currently represent themost promising strategy for allowing women to protect themselvesagainst HIV transmission, according to Jonathan F. Weber, M.D., whospoke at the Annual Meeting of the European Academy of Dermatologyand Venereology.

Not only was there little to no correlation between drug resistanceand clinical response, but the rates of good responses were higherin the resistant patients than in those with non-resistant P. acnesfor four of the five antibiotics (75 percent to 100 percent vs. 65percent to 85 percent).

San Francisco - Interim results of a phase 2,vehicle-controlled, bilateral study evaluating the efficacy andsafety of broad area topical 5-aminolevulenic acid (ALA, LevulanKerastick, DUSA Pharmaceuticals) photodynamic therapy (PDT) withvarious light sources show that ALA plus blue light (BLU-U, DUSAPharmaceuticals) was significantly more effective than vehicle plusblue light in improving facial photodamage, but the statisticalanalyses did not find ALA pretreatment enhanced the benefitsachieved using an intense pulsed light source (IPL; Quantum,Lumenis) or a pulsed dye laser (PDL; VStar, Cynosure), said RobertA. Weiss, M.D., associate professor of dermatology, Johns HopkinsUniversity School of Medicine, Baltimore, and an investigator inthe phase 2 trial.

Future research will move in two directions: The timing and numberof electroporation treatments and experimentation with additionalgenes.

San Francisco - Faced with a jungle of potential conflicts ofinterest in their various roles as providers, educators, students,advisers, committee members and investigators, physicians mightconsider their answers to a few pragmatic questions in judging theethics of their conduct, according to David M. Pariser, M.D.,speaking at the 64th Annual Meeting of the American Academy ofDermatology (AAD), here.