News

Q How much life insurance coverage is recommended for a physician who has a family?

Hong Kong - Cryogen spray cooling of the epidermis is a valuable adjunct to pulsed dye laser treatment of port wine stains in Asian patients because it allows the procedure to be performed more safely and effectively compared to use of the pulsed dye laser alone, according to the results of a recently reported prospective study undertaken by researchers at the University of Hong Kong.

Chicago - Cosmetic surgeons need to freshen up their understanding of sedation and analgesia in order to competently supervise staff, according to P. Allan Klock, M.D., associate professor of anesthesia and critical care at the University of Chicago.

Tucker, Ga. - Three mechanisms are purported to induce cutaneous malignancies: initiating events, promotional effects, and effects on the immune system, according to Kathleen J. Smith, M.D., from Quest Diagnostics.

Washington, D.C. -- Tattooing, body piercing, and other skin adornments are nothing new. When the body of the Ice Man was discovered frozen in the mountains of Northern Italy, the well-preserved, 5,300-year-old corpse had tattoos on its knees. One belief is that the tattooing might have been for medicinal reasons - to remedy his arthritic knees.

Washington, D.C. - With a handful of new options expected to receive FDA approval within a year, the field of tissue augmentation stands poised to undergo a seismic shift. "The bottom line is, tissue augmentation is about to change dramatically," said Mariano E. Busso, M.D. He is clinical professor in the University of Miami's department of dermatology, chief of dermatology at Mercy Hospital, also in Miami, Fla., and a private practitioner who is board-certified in dermatology.

Q. Why do so many topical moisturizing products claim to have effects similar to botulinum toxin A injections?

New Orleans - For Michael J. Fazio M.D., avoiding complications can be a difficult task in vermilion and perioral reconstruction, but as with any reconstructive surgery, a cautious prevention is simpler than the cure.

Houston - Dermatologists should treat actinic keratoses (AKs) more aggressively because AKs are part of a tremendous epidemic of skin cancer - melanoma and nonmelanoma, according to Leonard H. Goldberg, M.D.

New York - Results from the largest-ever phase III trial in advanced metastatic melanoma, while preliminary, suggest dacarbazine (DTIC) plus an investigational antisense compound (oblimersen sodium, or Genasense) may significantly improve overall survival versus DTIC alone, according to Anna C. Pavlick, D.O.

Montreal - Physicians must use information obtained about Kaposi's sarcoma-associated herpes virus learned through basic research to help prevent and treat KS in the clinical setting, a virology expert said.

Tucker, Ga. - Three mechanisms are purported to induce cutaneous malignancies: initiating events, promotional effects, and effects on the immune system, according to Kathleen J. Smith, M.D., from Quest Diagnostics.

Barcelona, Spain - Identifying the cause of itch is the key to treating it. New research is helping better characterize pruritus, leading to more effective therapies for this frustrating condition, according to physicians reporting at the 2003 meeting of the European Academy of Dermatology and Venereology (EADV).

Barcelona, Spain - New research demonstrates the pathophysiology of itch may be more complex than once believed. Recently discovered pruritic pathways, such as those involving proteases or neuropeptides, are opening doors to new therapeutic targets for this uncomfortable, hard-to-control phenomenon.

New York - Lesion-directed, narrowband UVB phototherapy with the 308-nm excimer laser offers a safe and useful modality for treatment of localized psoriasis and vitiligo in properly selected patients, said Suhail M. Hadi, M.D., assistant professor of dermatology, Mount Sinai School of Medicine.

Montreal - Mycobacterial infections are on the rise. Physicians should be aware of the key clinical features of these conditions and use microbiology laboratory facilities to confirm diagnoses. While some of these infections respond to antimicrobials, others require more intensive therapy, such as surgery.

Washington, D.C. - Tacrolimus and pimecrolimus may spring to mind first when atopic dermatitis is diagnosed, but it turns out that these topical immunomodulators are also effective for a host of previously difficult-to-treat diseases. Granuloma faciale, Hailey Hailey disease, hand and foot eczema and chromic actinic dermatitis are among the lengthy list of conditions these work well for, according to Mark Lebwohl, M.D., Professor and Chairman, Department of Dermatology, Mt. Sinai School of Medicine.

Detroit - Topical treatment allows medication delivery directly to the skin with reduced systemic exposure compared to orally administered agents, but local drug application is not without risk to internal organ systems, according to Peter J. Aronson, M.D.

Montreal - Methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococcus, once believed to be a problem of hospitals only, have hit the community. Now, more than ever, clinicians must adopt basic infection-control practices, both in hospital and in their clinics, to prevent further spread of these problem pathogens.

Montreal - Diagnosing unusual sexually transmitted infections can be a unique challenge, particularly for physicians lacking expertise in this area.

Washington D.C.- New concepts in the management of ulcerations as well as new treatments and dressings have emerged, Mark D. P. Davis, M.D., said.

Montreal - Whether caused by an infection or a drug, severe cutaneous reactions must be quickly identified and treated, as many are associated with significant morbidity and mortality.

San Diego - The incidence of community-acquired methicillin-resistant staphyloccocus aureus (CA-MRSA) infections rapidly increased in 2003, and the infections appear to be getting more serious, according to Dennis L. Stevens, M.D., Ph.D.

Washington - When patients come in complaining of weeks, months, and even years of chronic eczema, the physician should immediately suspect overuse of and subsequent addiction to topical corticosteroids.

Las Vegas -- New options for the treatment of actinic keratoses allow dermatologists to tailor therapy according to patient needs and the lesion characteristics, said Roger I. Ceilley, M.D., at the Fall Clinical Dermatology Conference.

Washington, D.C. - The rash was like nothing John Melski, M.D., had ever seen before and he had reason to be alarmed. Bitten by a prairie dog, his 3-year-old patient had been hospitalized with a fever that raged for days despite intravenous antibiotics. Meanwhile, her parents became sick as well. It took Dr. Melski nine days of high-tech sleuthing to find out he was the first dermatologist in the Western Hemisphere to diagnose monkeypox in humans.

A person of my acquaintance is a middle-aged man in good health, although he has a moderately elevated cholesterol level. He has been treated with one of the statin drugs for several years.

While Medicare recipients now have some help in covering the cost of prescription drugs, the new Medicare reform law passed by Congress carries some hidden costs that may result in difficulties in obtaining care for some patients. This applies, in particular, to physicians who administer drugs in their offices.

Amsterdam - Dermatologists have long been aware that superficial burns tend to heal quickly and leave little or no scarring, and that burns of full thickness, affecting deeper layers of the dermis, are often very slow to heal and leave permanent scars. According to Christopher Dunkin and Jonathon Pleat of the Stoke Mandeville Burns and Reconstructive Surgery Research Trust, Aylesbury, UK, the explanation for this difference might be that there is a "threshold level" for wound depth, with wounds above the threshold healing quickly without scarring and wounds below the threshold healing slowly and developing a fibrotic scar.

Amsterdam - Second-generation PLA sheets dramatically inhibit wound contracture in the first three weeks and might have a useful role as a temporizing dressing for open wounds until skin grafts can be performed, according to Mayer Tenenhaus, M.D. FACS, who spoke at the 13th annual meeting of the European Tissue Repair Society. Dr. Tenenhaus is an assistant clinical professor of plastic and reconstructive surgery at the University of California at San Diego Medical School.