Ponder this oh-so-common catch-22. Have you ever requested authorization from an insurance company to do a procedure on a patient and received a comment that they won't approve the procedure, but they will consider payment after the procedure has been performed? Or have your patients been denied approval when they have a medically necessary or medically related condition that should be legitimately approved?
Marge and Sam Smith, the hypothetical principals in a dermatology practice, recently returned from attending a meeting in another state. During the course of that three-day event, the Smiths made a lot of contacts, absorbed a number of great ideas, and even ordered a few things that they felt would benefit their dermatology practice.
San Francisco - Topical photodynamic therapy is effective in improving the signs of aging, particularly when associated with actinic keratoses but even in their absence, according to Dany J. Touma, M.D., assistant professor of dermatology, Boston University School of Medicine, and director, Boston University Center for Cosmetic and Laser Surgery.
San Francisco - Rapid relief of pruritus of atopic dermatitis can be obtained by combining a mid-potency topical corticosteroid and calcineurin inhibitor, and tolerability of the combination is very good, according to James Q. Del Rosso, D.O., clinical assistant professor of dermatology, University of Nevada School of Medicine, Las Vegas.
San Diego - The U.S. Food and Drug Administration approved a supplemental new drug application for Valtrex (valacyclovir HCl) caplets (Glaxo SmithKline) for the suppression of recurrent genital herpes in HIV-infected individuals. Once daily dosage has been shown to reduce the transmission of symptomatic genital herpes in healthy heterosexual monogamous couples by more than three-quarters, according to Lawrence Corey, M.D.
The use of biologics to treat psoriasis is on the move. A couple of systemic medications have received FDA approval for psoriasis and related conditions, and several more are in the pipeline. Although the drugs are reputed to cause fewer and less serious side effects than traditional psoriasis treatments, that doesn't mean side effects don't exist, and that makes them an issue for some doctors and patients alike.
We have recently been in the extended process of recruiting a full-time clinical academician to staff busy resident-run clinics. While we wait for lightening to strike and successfully identify such an individual, several excellent community dermatologists, as a favor to our program, have volunteered to provide staff coverage until the position is filled.
Q: I see patients at this home for the elderly. It's not a skilled or intermediate facility, but there is a mini-clinic set up where various physicians come in and see patients who live there. It's kind of an assisted living place.
San Francisco -- Alitretinoin 0.1 percent gel (Panretin) appears to be an effective modality for improving the appearance of photoaged skin and may have an added benefit for treating some benign and precancerous lesions common in aging skin, according to preliminary results of a pilot trial conducted by investigators from the Cosmetic Center of the University of Miami.
San Francisco -- It might not be the first, second, or even third treatment modality that is the charm for a chronic wound, but once the appropriate therapy is identified, the patient should have noticeable improvement within three to four weeks, Marketa Limova, M.D., said at the annual meeting of the American Academy of Dermatology.
Bal Harbour, Fla. - The excessive sweating of hyperhidrosis causes significant stress and has been shown to affect quality of life, especially in those who develop it at a young age. Of all the treatments available today, one of the safest and most effective for hyperhidrosis patients is botulinum toxin, according to Leslie Baumann, M.D.
Birmingham, England - Uncomplicated hemangiomas that clear well with a pulsed dye laser (PDL) are probably limited to superficial lesions that would have resolved without treatment, according to Kapila Batta, M.D.
La Jolla, Calif. - Physicians long have been pivotal in protecting children. But recognizing behavioral and social problems in addition to making medical diagnoses might be more important than ever. Juveniles ages 12-17 who were the victims of a serious violent crime in 1999 knew their offenders 64 percent of the time, and one-third of sexual assaults are committed against children younger than 12 years old, according to FBI data compiled by the National Center for Juvenile Justice.
Bal Harbour, Fla. - Genetic updates on neurofibromatosis and tuberous sclerosis and Langerhans cell histiocytosis presentation in the neonatal period were among the topics discussed by Lawrence F. Eichenfield, M.D., clinical professor of pediatrics and medicine (dermatology), University of California, San Diego, at the annual meeting of the Masters of Pediatrics, hosted by the University of Miami School of Medicine.
Maui, Hawaii - Preliminary results from an open-label study suggest PUVA-bexarotene is a safe and effective combination regimen for the treatment of early cutaneous T-cell lymphoma (CTCL), Joan Guitart, M.D., said at the annual Hawaii Dermatology Seminar, sponsored by the Skin Disease Education Foundation.
Bal Harbour, Fla. - The use of topically applied immune response modifier imiquimod (Aldara) goes beyond its FDA-approved application for the treatment of genital and perianal warts.
San Francisco - Based on the theory that rosacea shares the same inflammatory features of acne, a recent study showed that, just as the combination of benzoyl peroxide 1 percent and clindamycin 5 percent gel is a powerful treatment modality for reducing Propionibacterium acnes levels, it also significantly reduces the papules and pustules of rosacea, according to Debra L. Breneman, M.D.
Maui, Hawaii - A 12-week dose-finding study evaluating oral pimecrolimus for the treatment of chronic plaque-type psoriasis has yielded encouraging safety and efficacy results, Alice B. Gottlieb, M.D., Ph.D., said at the annual Hawaii Dermatology Seminar, sponsored by the Skin Disease Education Foundation.
San Francisco -- Results from Phase III clinical trials support the efficacy and safety of efalizumab (Raptiva), the humanized CD-11a monoclonal antibody, as a chronic treatment for moderate-to-severe plaque psoriasis, Kim A. Papp, M.D., said at the annual meeting of the American Academy of Dermatology.
San Francisco - The anti-CD40 ligand monoclonal antibody IDEC-131, manufactured by IDEC Pharmaceuticals, was developed to treat autoimmune and inflammatory diseases, such as psoriasis. IDEC-131 targets the CD40 ligand on T cells and regulates the interaction between T cells and B cells.
Boston - Herpes zoster infection rates in individuals living with HIV-1 infection have not improved since the availability of highly active antiretroviral therapy (HAART), according to research presented here at the Conference on Retroviruses and Opportunistic Infections.
Maui, Hawaii - Is it less important to treat onychomycosis in older patients? Do they just not care to bother? Is it a lack of prescription coverage?
Galveston, Texas - A recent analysis of data from an ongoing open-label trial provides strong validation of an earlier finding that adjunctive treatment of acute herpes zoster using the anticonvulsant drug gabapentin (Neurontin) dramatically reduces the incidence of postherpetic neuralgia, Mathijs H. Brentjens, M.D.
Washington - A spate of deaths and other significant risks prompted the U.S. Food and Drug Administration to issue a public-health advisory regarding the safety of topical formulations of Lindane shampoo and lotion products for the treatment of scabies and lice.
San Francisco - Inamed Corp. received approval from the U.S. Food and Drug Administration to compete against what it considers a formidable foe - its own ZyDerm and ZyPlast products.
Q My insurance agent is recommending that I purchase life insurance in order to pay for my estate taxes. Does this strategy make sense?
Most of you know by now that simply deleting material will not erase it from your hard disc. Until the space on your hard disc occupied by deleted files is used for some other purpose - or is deliberately erased - the "deleted" files will remain and easily can be recovered. Medical and personal files thus remain at risk for accidental or deliberate recovery and misuse until the physical space they occupied is deliberately overwritten or erased.
Q. Why do sunscreens cause "break outs" in adolescent patients?
San Francisco - When a dermatologist treats a patient with scleromyxedema, the therapy strategies are often limited and based on a review of the scant case reports in the literature.
Washington - The U.S. Food and Drug Administration in late March approved a liquid decontamination lotion for soldiers exposed to chemical weapons. Called Reactive Skin Decontamination Lotion (RSDL), the product is designed as a single-use sponge pad and is meant to be applied immediately after contamination.
