Obstetrics-Gynecology & Women's Health
Eight years after the Women's Health Initiative (WHI) linked estrogen supplementation to breast cancer and heart disease, the impact of estrogen withdrawal is obvious in a less-than-obvious location; hormone-deficient vulvar disease is becoming more common, according to F. William Danby, M.D.
A systematic approach helps to guide the workup and management of female pattern alopecia (FPA), according to Mary Gail Mercurio, M.D.
For young women with polycystic ovary syndrome (PCOS), dermatologists must diagnose the underlying hormonal issues to best treat the related skin symptoms, explains Helen M. Torok, M.D., medical director, Trillium Creek Dermatology & Surgery, Medina, Ohio.
The use of bioidentical hormone replacement therapy (BHRT) in dermatology is preferable to using synthetic hormones because potential overdose is less hazardous, and bioidentical hormones are not known to be carcinogenic, says Julie T. Hunter, M.D., founder and director of Wholistic Dermatology in Beverly Hills, Calif.
Although treating patients with vulvar disorders can be challenging, confidence and compassion go a long way toward helping these patients. Sometimes, dermatologists allow themselves to be intimidated by the idea that vulvar and mucosal problems differ vastly from the usual issues they treat.
In refractory cases of localized, provoked vulvodynia, botulinum toxin type A can be considered a therapeutic option, according to Jennifer MacGregor, M.D., of Washington Institute of Dermatologic Laser Surgery, Washington.
Although azathioprine requires caution and ongoing patient monitoring, some say their side effects are less severe than many patients — and some dermatologists — think. Even some medically oriented dermatologists express the concern that "these pills will wreck your liver," which overstates the actual clinical risk, says Neil Shear, M.D.
Physicians immersed in the world of continuing medical education (CME) say big changes are happening. And doctors of all specialties, including dermatology, will be affected by the emerging CME focus: individual outcomes improvement.
A plastic surgeon is conducting a clinical trial testing the use of botulinum toxin A on severe cases of vaginismus, msnbc.com reports.