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National report — Does practice make perfect? A recent Harvard Medical School review suggests that as physicians age, the quality of care they provide decreases — the plethora of continuing medical education (CME) options available and the presumed benefits of wisdom notwithstanding.

New Orleans — Whether it is serious intraoperative bleeding, the presence of a life-threatening disease or a lethal drug reaction, the dermatologist's office should be prepared for the emergent crisis that can happen at any time and anywhere, Glenn D. Goldman, M.D., says.

The New Jersey legislature instituted a 6 percent sales tax on cosmetic procedures so quickly last fall that doctors say organized opposition had little time to form. The state has been collecting the levy for several months.

As the Vioxx/Celebrex scandal lays waste to the American healthcare landscape as we know it, the U.S. Food and Drug Administration (FDA) finds itself under relentless pressure to get things right. Congress is demanding more stringent safety standards and even threatening to create a new federal agency to take safety approvals and monitoring out of the FDA's hands.

New Orleans — A pair of new studies sheds light on body art complications while linking tattoos and piercings to demographic and behavioral factors, ranging from age to sexual activity and mental health.

An investigational topical antifungal product containing miconazole nitrate 0.25 percent in a petrolatum/zinc oxide barrier ointment base (Zimycan, Barrier Therapeutics) has demonstrated positive efficacy and safety results in a phase 3 study of the treatment of Candida diaper dermatitis.

New Orleans - In today's global, transient and sometimes overcrowded society, the spread of superficial cutaneous infections and infestations in children appears to be even more common than previously thought. International travel, immigration and foreign adoption have altered the typical distribution of some pediatric infections and infestations.

There have been a number of important advances in pediatric dermatology, ranging from finding the optimal use for tissue adhesives to gaining a better understanding of general and local anesthetic use in the pediatric population and a greater appreciation for dermatologic surgeons' roles in treating vascular lesions and birthmarks.

New Orleans — Rare, life-threatening dermatoses are presenting in pediatric patients across the country, and some dermatologists are missing these critical diagnoses, according to Patricia Treadwell, M.D., professor of pediatrics, Riley Hospital for Children, Indianapolis.

New Orleans — Initial clinical experience indicates injectable poly-L-lactic acid (Sculptra) can be used safely and effectively to achieve natural-appearing restoration of facial volume and contour in patients with age-related facial lipodystrophy, said Douglas Key, M.D., at the 63rd Annual Meeting of the American Academy of Dermatology (AAD) here.

Boston — Although, for many patients, hyaluronic acid (HA) fillers have become the treatment of choice in the United States, Gary D. Monheit, M.D., says many questions remain: Can Hylaform (Inamed), Restylane (Q-Med) and Juvederm (LEA Derm) be improved to achieve more than a three- to six-month longevity? How will the fillers compare after more extensive head-to-head testing? And where will HA products ultimately fit in an armamentarium ranging from bovine collagen to polylactic acid?

Washington — Anidulafungin (Vicuron, Vicuron Pharmaceuticals Inc.), a new echinocandin presently being developed for the treatment of serious fungal infections, has been shown to be effective and well-tolerated in a large majority of patients who have azole-refractory mucosal candidiasis (ARMC), said Jennifer A. Schranz, M.D., in a presentation at the 44th Interscience Conference on Antimicrobial Agents and Chemotherapy here.

Making the maximum allowable deposits into your 401(k) or IRA account as early in the year as possible can reduce your tax load.

New Orleans — Dermatologists who want to publish their research in peer-reviewed journals received many valuable tips in a focus session given at the 63rd Annual Meeting of the American Academy of Dermatology (AAD) here. June K. Robinson, M.D., discussed reasons to publish, the writing process, submission and review of the manuscript, and the publishing process, while extending advice gained from her experience as editor of Archives of Dermatology. Dr. Robinson also serves as section chief of dermatology at Dartmouth-Hitchcock Medical Center.

New Orleans — Understanding basic computer technology principles helps physicians make sound computer purchases for their practices and homes.

Miami — No doctor would treat a patient as haphazardly as many seem to treat their practices. From improper coding to trust placed in the wrong people, many physicians' practices suffer from a variety of treatable ills, according to Mark S. Nestor, M.D., Ph.D., director, Center for Cosmetic Enhancement, and clinical associate professor of dermatology and cutaneous surgery at the University of Miami School of Medicine, Miami.

Las Vegas — Immunohistochemical stains can be a valuable aid to the dermatopathologist for determining diagnosis and prognosis of skin diseases, said Clay J. Cockerell, M.D., at the Fall and Winter 2004 Dermatology Conference here.

Orlando — Scars require individual assessment and treatment because no one solution will solve all problems, according to Susan H. Weinkle, M.D., a dermatologist specializing in Mohs surgery and practicing in the Tampa Bay Area.

Nail surgery 101

New Orleans — Many dermatologists do not feel comfortable doing nail surgery. Sometimes, lack of exposure to nail surgery during residency training is to blame. Even those who have adequate training might eventually avoid nail surgery if they have not gained enough experience doing the procedures in practice.

New Orleans — Careful preoperative assessment to identify risk factors for increased perioperative bleeding, meticulous surgical technique to gain control of vessels and appropriate use of surgical adjuncts form the foundation for safe and effective hemostasis in dermatologic surgery, says David E. Kent, M.D., at the 63rd Annual Meeting of the American Academy of Dermatology.

Los Angeles — For stubborn keloids that do not respond to intralesional triamcinolone acetonide (Kenalog, Bristol-Myers Squibb), especially post-CABG sternal keloids, William V.R. Shellow, M.D., has successfully used methylprednisolone acetate (Depo-Medrol, Pharmacia & Upjohn), normally used by orthopedists for injecting joints.

Florence — Alopecia areata is a disease with important aesthetic implications that may affect the patient psychologically and socially, and treatment can be challenging, according to Ana Kaminsky, M.D., Ph.D., professor of dermatology, School of Medicine, University of Buenos Aires, Argentina.

Washington — Clinical studies have already demonstrated proof of concept for both prophylactic and therapeutic vaccines for herpes simplex virus (HSV)-2. Both types of HSV-2 vaccines are currently under development and the next few years should bring promising results, accordingto Lawrence R. Stanberry, M.D., Ph.D., chairman of the department of pediatrics and director of the Sealy Center for Vaccine Development at the University of Texas Medical Branch in Galveston.

Aruba — Newer antibiotics with novel mechanisms of action offer activity against drug-resistant gram-positive organisms and are important additions to the dermatologist's therapeutic arsenal for treating cutaneous infections, according to Bernardo Vainrub, M.D., consultant in internal medicine and infectious diseases, Hospital de Clinicas, Caracas, Venezuela.

New Orleans — Results of a multicenter phase 4 study confirm the efficacy and safety of photodynamic therapy (PDT) using 20 percent 5-aminolevulinic acid (5-ALA) topical solution (Levulan Kerastick, DUSA) for the treatment of face and scalp non-hyperkeratotic actinic keratoses (AKs), according to Eduardo H. Tschen, M.D., who spoke at the 63rd Annual Meeting of the American Academy of Dermatology (AAD).