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Taming Tantrums

San Francisco - Making laser surgery as pleasant an experience as possible is important when the patient is a child because optimal clearing of many common pediatric lesions treated with a laser involves multiple sessions, Heidi A. Waldorf, M.D., said at the annual meeting of the American Academy of Dermatology.

Barcelona - Until now, scientists have known that estrogens significantly affect the hair cycle in rodents, although disparities have lingered as to the hormone's impact on human hair.

Barcelona - Ebastine, a second-generation antihistamine currently marketed in Europe and Japan, offers many advantages as a treatment for mild to moderate alopecia areata, according to Yusuke Yoshizawa, M.D., assistant professor of dermatology, Nippon Medical School, Tokyo.

Chicago - The promise of biochemotherapy for stage IV malignant melanoma has not held up to scrutiny, and the value of this form of treatment seems nil, according to recent discouraging findings from major phase III clinical trials.

Chicago - Escalating doses of an antibody to CTLA-4 in conjunction with a peptide vaccine showed the induction of antigen-specific immune responses and potential evidence of autoimmunity in patients with stage III/IV resected melanoma, according to Jeffrey M. Weber, M.D., Ph.D.

Chicago - A phase II trial of a new recombinant agent in the fight against melanoma has accrued 28 patients so far, yielding interesting data but so far no conclusive results, according to an abstract presented at this year's annual meeting of the American Society of Clinical Oncology.

Chicago - As patient accrual to phase III trials of Canvaxin therapeutic polyvalent cancer vaccine nears the 1,000-mark, a randomized phase II trial of the vaccine was reported at the annual meeting of the American Society of Clinical Oncology. The trial used an immunostimulant to enhance the antibody response to a tumor-associated antigen (TA90) found on melanoma cells.

Chicago - Data involving the first 60 patients in a phase II clinical trial of a multi-epitope peptide vaccination, as combined with other agents, showed a median survival of 21 months for immunological responders as compared to 13 months in immunologic nonresponders.

San Francisco - The future of melanoma treatment may include a union of surgical and medical oncology in which treatments such as interferon play an important role, according to Donald P. Lawrence, M.D. However, it is less likely that melanoma treatment will evolve to include genetically targeted therapies such as imatinib (Gleevec) in the future.

Maui, Hawaii - Applied in a foam, ketoconazole may penetrate more easily -- and treat cutaneous fungal infections more effectively - than it does in the cream formulations currently on the market, Dr. Sheila Fallon-Friedlander, M.D.

San Francisco - Although bacterial sexually transmitted diseases are decreasing in prevalence in the United States, viral STDs are on the rise, according to Ted Rosen, M.D. Of particular concern, he said, are the increasing numbers of people infected with herpes simplex virus (HSV) and human papilloma virus (HPV).

Rookie Sensations

San Francisco - Accumulating evidence suggests new biologic agents may be used with potential benefit in the management of dermatomyositis, pyoderma gangrenosum, bullous diseases, cutaneous sarcoidosis, and severe atopic dermatitis.Dermatologists, however, have also been looking to use various older therapies in new ways to treat these disabling diseases, Jeffrey P. Callen, M.D., said.

Americans are getting barely half of the appropriate medical care they should be getting - that's the analysis of a study released recently in the New England Journal of Medicine. Through patient interviews and reviews of medical records of 30 medical conditions for thousands of patients in 12 metropolitan centers around the country, researchers determined that patients get the appropriate care just 54 percent of the time. That percentage can vary from 40 percent for alcohol dependency to 78 percent for senile cataracts.

Ottawa - Ethical issues in medicine are not that different across practice specialties, and ultimately, physicians should be acting with the interests of their patients first and foremost, according to a professor in the department of dermatology and the departmental chair at Mayo Clinic, Scottsdale, Ariz.

Dr. Sun runs a large medical and cosmetic dermatology practice in a moderately wealthy, middle-class Sun Belt community. A large portion of his practice base is above the age of 65. Many of these patients present with a variety of skin cancers. The same patients seek cosmetic treatments with lasers, peels, botulinum toxin, and filler agents. Dr. Sun finds that treating the sola-induced comedones in these patients is not cost-effective. Thus, he gives gratis comedone extractors to his combined medical-surgical patients. He finds that his purchasing and providing such medical devices is a very subtle marketing tool. His patients are very appreciative of this gesture. A fellow jealous competing physician has reported this activity to the state medical board. The complaining physician

Heady Subject

Chicago - With all the new at-home hair treatments and recent reports of contact dermatitis and other cutaneous manifestations from using shampoos, conditioners and hair dyes, dermatologists should be keenly aware of products that can harm patients' hair and skin.

San Francisco - Free fatty acids play a role in the development of dandruff-like conditions, said Joseph R. Kaczvinsky, Jr., Ph.D., principal scientist, beauty care technology division with Procter & Gamble. Based on a study he co-authored with Thomas L. Dawson, Jr., Ph.D., and James R. Schwartz, Ph.D., he presents an advance toward understanding the cause of dandruff.

Rather than simply nod their heads at the importance of exercise for cosmetic surgery candidates, physicians would be well advised to actually "prescribe" exercise as a prerequisite to surgery, said Todd Bezilla, D.O., M.Ed., a certified strength and conditioning specialist board-certified in neuromusculoskeletal medicine, osteopathic manipulative medicine, and holistic medicine.

Nashville - For the first time, patients with recurrent head and neck tumors have a less invasive alternative to conventional 10- to 12-hour surgery.

San Francisco - Compared with first-generation antihistamines, second-generation agents are more specific antihistamine antagonists that are less sedating and have a longer half-life, Michael D. Tharp, M.D., said.

There is high drama playing out in Washington this summer, and it pits the insurance industry against trial lawyers, Republicans against Democrats; and dermatologists, like other physicians, are caught in the middle.

So many times physicians think of marketing as Yellow Page ads, flashy brochures, or radio and TV commercials. Of course, that is one component of marketing, but the easiest way to market your practice is to provide stellar service to current patients.

San Francisco - Use of the European Organization for Research and Treatment of Cancer (EORTC) classification system for primary cutaneous lymphomas will help dermatologists make an accurate diagnosis and select appropriate treatment for patients with primary cutaneous B-cell lymphoma, Rein Willemze, M.D., said at the annual meeting of the American Academy of Dermatology.

San Francisco - When treating cutaneous T-cell lymphoma (CTCL), dermatologists will want to tailor their treatment to the stage of the disease, according to Madeleine Duvic, M.D., who spoke at the annual meeting of the American Academy of Dermatology.

Dr. Dave is always looking for ways to increase his practice revenues. In his practice, he has a good mix of general and surgical dermatology patients, has learned to ethically promote his talents, and has launched a successful Web site. He ponders what else he can do to increase revenues.