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Washington, D.C. - There are several clinical variants of Kaposi's sarcoma (KS), and appropriate treatment and response to treatment differ according to the clinical variant, according to Katie Pang, M.D., a clinical research fellow working with Dr. Stephen Tyring at the Center for Clinical Studies in Houston, Texas. The four major clinical variants are classic KS, KS in iatrogenically immunosuppressed patients, AIDS-related epidemic KS, and African endemic KS. HHV-8 is the etiological agent of all of the clinical types of KS.

Washington - A novel thermophobic foam containing three active ingredients to fight dandruff is at least as effective as standard anti-dandruff treatment, and offers the advantages of a non-greasy formulation that is fast-acting and not irritating to the hair or scalp, according to Massimo Milani, M.D., the medical director and head of technology and development at Mipharm SpA in Milan, Italy.

Waikoloa, Hawaii- When counseling rosacea patients on routine skincare products, the dermatologist's main mission is to keep the skincare simple and thus avoid the irritation that triggers an exacerbation of rosacea, according to Zoe D. Draelos, M.D.

Waikoloa, Hawaii - Psoriasis patients report a dramatic improvement in their quality of life when they are treated with a biologic therapy, according to Alexandra B. Kimball, M.D., M.P.H.

Miami - Atopic dermatitis (AD) can be challenging to diagnose even for the seasoned dermatologist because it mimics other common skin diseases in the pediatric population. It also can be challenging to treat, with the addition of new agents on the market. There are key points to consider when making the diagnosis and tried-and-true methods of treatment to keep in mind when recommending therapies to parents and their children, according to Bernice Krafchik, M.D., dermatologist, and professor emeritus at the University of Toronto.

Boutique. Concierge. Express service. There are a variety of names but the end result is the same: patients pay an annual retainer, and for that money - usually between $1000 to $2000 - patients receive a variety of special services: a smaller patient base which allows for no-wait appointments, longer appointments, and quicker return phone calls. It probably can not be called a trend yet, but a number of physicians around the country have dropped Medicare and others have stopped accepting managed care. Now, this new twist is being added - personalized medical care - for a fee.

Diagnostic challenge

Washington - The standard multi-drug therapy for multi-bacillary leprosy (MDT-MB) recommended by the World Health Organization proved effective in treating patients with Lucio's phenomenon, a rare necrotizing reaction sometimes seen in patients with Lucio's leprosy, according to Luna Azulay-Abulafia, assistant professor of dermatology at the Universidade do Estado do Rio de Janeiro and at the Universidade Gama Filho, Brazil. At the February American Academy of Dermatology annual meeting, Dr. Azulay-Abulafia described two cases of Lucio's phenomenon in Brazilian patients with Lucio's leprosy successfully treated with MDT-MB, with no need for systemic therapy with corticosteroids or thalidomide.

Washington - Langerhans cell sarcoma is a rare neoplasm that can involve multiple organs, including lymph nodes, bone, lung, bone marrow, skin, and brain. A single, cutaneous tumor is an unusual primary presentation, said Tammie Ferringer, M.D., dermatopathology fellow at the Medical University of South Carolina.

Washington - Cryosurgery should be offered as a treatment option for a variety of skin cancers because it is an effective modality with numerous advantages, said Gloria F. Graham, M.D., at the annual meeting of the American Academy of Dermatology.

Washington -- A new study presented in poster form at the recent AAD meeting concludes that etanercept continues to post an excellent record for the treatment of rheumatoid arthritis. The drug maintains its safety profile and clinical efficacy for treatment durations of more than five years.

Washington, D.C. - Ongoing work regarding aminolevulinic acid (ALA) for photodynamic therapy provides a shining example of the value of off-label uses. The drug has earned UK approval for treating skin cancer and FDA approval for actinic keratoses. However, its most effective applications may well be cosmetic treatments including photo-rejuvenation, acne, and sebaceous gland hyperplasia.

Waikoloa, Hawaii - Oral contraceptives are effective therapies for treating severe acne in younger women, and dermatologists should feel at liberty to prescribe oral contraceptives to their patients to control acne, according to one dermatologist.

Washington D.C. - In treating patients with non-responsive conditions, it's important to consider altering your method of inquiry, said Alan M. Dattner, M.D., FAAD. "I go beyond a clinical diagnosis to make an etiological diagnosis and treat on the basis of that," he said.

Dermatologists hoping for some form of relief from the increasingly high cost of medial malpractice insurance may have to wait a while longer for that itch to be eased, although there was still some hope that a modified bill might be considered.

Satisfactory response

Washington - Etanercept can be safely administered to AIDS patients with difficult-to-treat inflammatory conditions, according to Robert Wallis, associate professor of medicine at UMDNJ-NJMS, who presented a poster at the February 2004 AAD meeting describing results of a Phase I trial conducted in Kampala, Uganda. "There does not appear to be a substantial risk that either opportunistic infections or HIV disease will be deleteriously affected by this treatment," said Dr. Wallis.

La Jolla, Calif. - Digital cameras have improved so much in recent years that dermatologists should think seriously about purchasing and using one in their clinical practices. Instead of rifling through old slides in crowded file drawers or three ring binders, a doctor with a digital camera can store images on a computer and easily compare skin changes over time.

Washington - Get the facts first, then regulate. So urged Rajesh Balkirshnan, Ph.D., associate professor of management and policy sciences at the University of Texas School of Public Health in Houston.

Washington - Findings of a retrospective analysis designed to characterize comorbidities in the psoriasis population and adverse events associated with systemic therapies will hopefully increase physician understanding of their psoriasis patients and thereby enhance patient care, said Daniel J. Pearce, M.D., at the annual meeting of the American Academy of Dermatology.

Dermatologists and their patients have numerous cosmeceutical productsfrom which to choose. Doctors who categorize the agents can better helptheir patients understand how the novel therapies fit into skincare regimens.According to Zoe Diana Draelos, M.D., clinical associate professor ofdermatology, Wake Forest University School of Medicine, Winston Salem, N.C.,key cosmeceutical categories include: barrier-enhancing vitamins, receptor-mediatedvitamins, regulators of collagen breakdown, anti-inflammatories, exfoliates,and botanicals.

Should a biological attack reach American soil, dermatologists must positionthemselves on the front lines, according to Michael J. Franzblau, M.D.,clinical professor of dermatology at the University of California at SanFrancisco's School of Medicine, and a respected researcher and speaker onbio-terrorism.

Taking a thorough patient history and performing precise surgery aretwo ways to avoid acute complications in cutaneous surgery, according toHugh M. Gloster, Jr., M.D., director of dermatologic surgery and Mohs micrographicsurgery, University of Cincinnati, Ohio. "However, if prevention fails,any physician who performs cutaneous surgery should be prepared to treathematoma, infection, dehiscence, and necrosis," he said.

Washington D.C. - Stephen E. Chiarello, M.D., began his presentationat the AAD annual meeting yesterday by asking those attending the sessionhow many had heard of Syndrome X. Based on the number of hands raised, hesaid that more dermatologists seem to be aware of this condition, also calledMetabolic Syndrome, which affects 90 million Americans and finds its rootsin high glycerin and insulin levels.

Dermatologists should be aware of new concepts in the management of ulcerationsas well as new treatments and dressings, according to Mark D. P. Davis,M.D., who spoke yesterday at the AAD annual meeting.

Medium and deep peels are the only peels to give appreciable resultswith skin tightening. And properly performed phenol peels can eliminatewrinkles "extraordinarily better than any TCA peel," said HaroldJ. Brody, M.D., clinical professor of dermatology, Emory University, Atlanta,Ga. He is discussing the topic today at the AAD annual meeting.

Taking a thorough patient history and performing precise surgery aretwo ways to avoid acute complications in cutaneous surgery, according toHugh M. Gloster, Jr., M.D., director of dermatologic surgery and Mohs micrographicsurgery, University of Cincinnati, Ohio. "However, if prevention fails,any physician who performs cutaneous surgery should be prepared to treathematoma, infection, dehiscence, and necrosis," he said.

Santa Barbara, Calif. - Inamed Corporation and its partner Ipsen,a European pharmaceutical company, reported results of a Phase II dosingstudy of their botulinum toxin type A product yesterday at the AAD meeting.

Schaumburg, Ill. - The American Academy of Dermatology Association (AADA)urged the FDA to stop internet sales of isotretinoin, the active ingredientin Accutane, arguing that such sales pose potential health risks to thepublic. The statement was released at the AAD 2004 annual meeting.

Biologics in psoriasis are a hot buzzword asthe 62nd meeting of the American Academy of Dermatology hits stride today,with sources hailing the progression as a needed "new era." Technicalexhibits open today at 11 a.m. at the Wasington Convention Center, whilethe conference, symposia, and educational programs are in full gear.Dermatologists must enhance patients' understanding of biologics andmake them realize they have an option when other treatment modalities fail,sources added, as leveraging the patient-physician relationship is key.

The youthful appearance of the eyelid can best be restored by reconstructinga proper continuum between the lower eyelid and the cheek, rather than simplyby removing fat, said Jean Carruthers, M.D., of Carruthers Aesthetic FacialOphthalmology, Vancouver, British Columbia, Canada.

With a handful of new options expected to receive FDA approval withina year, the field of tissue augmentation stands poised to undergo a seismicshift. "The bottom line is, tissue augmentation is about to changedramatically," said Mariano E. Busso, M.D. He is clinical professorin the University of Miami's department of dermatology, chief of dermatologyat Mercy Hospital, also in Miami, Fla., and a private practitioner who isboard-certified in dermatology.