News

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.

Washington, D.C. -- Taking a thorough patient history and performing precise surgery are two ways to avoid acute complications in cutaneous surgery, according to Hugh M. Gloster, Jr. M.D. director of dermatologic surgery and Mohs micrographic surgery, University of Cincinnati. "However, if prevention fails, any physician who performs cutaneous surgery should be prepared to treat hematoma, infection, dehiscence, and necrosis," he said.

Barcelona, Spain. - Treatments of malignant wounds should be designed not only to promote healing, but also to prevent and manage clinical infection, control and prevent bleeding, contain drainage from the wound, control and prevent odor, and promote the patient's comfort, according to Uwe Wollina, M.D., professor of dermatology and venerology at the Hautklinik Dresden-Friedrichstadt in Germany. Dr. Wollina spoke at the 12th Congress of the European Academy of Dermatology and Venereology in Barcelona.

Q. It seems that every discussion about investments focuses on "risk." What are the different types of risks of which investors should be aware?

All of us see great cases from time to time, and make valuable clinical observations. Often there is an opportunity to present this material as a poster at scientific meetings. Until recently, the production of a high-quality scientific poster required the use of an outside graphic arts firm at a cost of more than $1,000.

I continue to be fascinated by the interesting faxes sent to my office. In the past month, I received several "three-pronged" questions and felt that sharing those questions and responses with my readers would be beneficial, especially as everyone gets ready to reflect on 2003, regroup, and move confidently into 2004.

Las Vegas -- In the dermatologist's universal quest for great results, Rhoda S. Narins, M.D., envisions a dermatological landscape where fillers work together cooperatively to treat the myriad skin problems that vary with each individual patient. These substances would ideally be temporary but long lasting, non-allergenic, and safe. It would be even better if results were immediate, achieved with less volume of the substance, and administered with minimal pain. With the variety of new fillers waiting for FDA approval, perhaps this utopia is not beyond reach.

New Orleans - The cosmetically engaged dermatologist has to pay attention to trends in botulinum use, according to Jean Carruthers, M.D. Dr. Carruthers and her husband, Alistair, introduced the neurotoxin for treatment of frown lines at the 1991 meeting of the American Society of Dermatologic Surgeons. The society embraced the born-again toxin and now, peering into 2004, predicts that it will prick through new frontiers. These include: enhancing upper lip fullness, treating enlarged masseter muscles, contouring the mandible area of the lower face, and eliminating multiple benign cystic lesions of the face.

Q. What is the best way to treat cracked skin over the heels?

Las Vegas ?? New options for the treatment of actinic keratoses (AKs) 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.

Leuven, Belgium - Recent tests using liquid chromatography (LC) show that gels containing both erythromycin and benzoyl peroxide (Benzamycin) appear to be stable when stored as directed. "This study cannot conclude that these gels work better than others for patients, as only a chemical analysis by LC was carried out," stated Pieter Dehouck, a pharmacist and Ph.D. student in the Laboratory of Pharmaceutical Chemistry and Drug Analysis, Katholieke Universiteit Leuven, who oversaw the study.

Barcelona, Spain - A systematic approach is best when investigating patients who report itch but have no rash, according to Joanna Wallengren, M.D., Ph.D., associate professor in the department of dermatology, University Hospital in Lund, Sweden. Dr. Wallengren described her approach to this at the 12th Congress of the European Academy of Dermatology and Venereology here.

New York -- Now that hair transplant technology has advanced to the point where women with female-pattern baldness can expect as good results as men, one would think dermatologists would be quick to embrace the procedure for their many female patients who are devastated by hair loss.

New Orleans - Treatment with an ultraviolet laser system for hypopigmentation is more effective and protective against possible toxicity than standard photodynamic therapy, according to a study presented at the annual meeting of the American Society for Dermatologic Surgeons and the American College of Mohs Micrographic Surgery and Cutaneous Oncology here last month.

Las Vegas -- Dermatologists must avoid the shotgun approach to antibiotics and pay more attention to potential drug interactions, said James Q. Del Rosso, D.O., F.A.O.C.D. This way, they can avoid contributing to two alarming trends in pharmacologic therapy: antibiotic resistance and potentially significant dangerous drug reactions.

New Orleans - When performing surgery, doctors concern themselves foremost with their patients' safety and comfort. But what about physicians' comfort?

A study by Michael W. Ellis, M.D. and colleagues from Brooke Army Medical Center in Fort Sam Houston, Texas, suggests a five-day course of antibiotic therapy is as effective as a standard 10-day course in patients with uncomplicated cellulitis.

Las Vegas - Biologics, an emerging class of drugs derived from human and animal proteins, are providing effective, long-term relief to patients with moderate-to-severe psoriasis, says Mark Lebwohl, M.D., Soi and Clara Kest professor and chairman, department of dermatology, The Mount Sinai School of Medicine.

Las Vegas - According to Guy Webster, M.D., the best topical treatment for rosacea is metronidazole. Oral rosacea therapies he has found to be effective are tetra-, doxy- and minocycline, Cipro (ciprofloxacin hydrochloride), Bactrim (trimethoprim-sulfamethoxazole), and isotretinoin.

As editor-in-chief of Dermatology Times and its sister publication, Cosmetic Surgery Times, I have had the opportunity to watch myriad types of surgeons perform dermatologic surgery and cosmetic-surgery settings. Idon't need to tell you about the turf battles -- who should perform what types of surgeries and in what settings. It's the stuff of not only competition, but of intense study and eventual government regulation. What I would like to comment on, from what may perceived as a humble viewpoint, is the American Academy of Dermatology's recent study calling for mandatory reporting of all adverse events happening in in-office settings.

Minneapolis - To prevent outbreaks of herpes gladiatorum in high school athletes, closer scrutiny must be paid to prevention, diagnosis, and management of herpesvirus infections in this patient demographic, according to B. J. Anderson, M.D., Boynton Health Service, University of Minnesota, and team physician for the Augsburg College and University of Minnesota wrestling teams.

Schaumburg, Ill. - A study from the American Academy of Dermatology published by the American Academy of Dermatologic Surgery calls for nationwide mandatory reporting of adverse incidents of office-based surgery -- a leveling of the playing field for all specialties operating in a cosmetic surgical setting.

Boston - Cancer researchers have developed an experimental vaccine that showed promising results in early stage testing for the treatment of metastatic melanoma. The vaccine, which is made by transferring a gene into a patient's own melanoma cells, caused an immune system attack against melanoma tumors, with nearly one-third of 35 patients alive after three years, and four of them with no signs of the disease.

Chicago - Results from an observational study of 23 patients presented at this year's L'Oreal Ethnic Skin and Hair Conference held here Sept. 19-21 is shedding new light on a group of scalp disorders and offers new insight into the treatment of those disorders.