News

What's so Important about Leadership in Dermatology? In today's volatile healthcare climate, everything Hope for Healing : Cell-based therapy holds promise for venous leg ulcers Clinical Dermatology : Therapies for female patients with acne are abundant, including hormonal options Cosmetic Dermatology : Investigating dry-down times for sunscreens and the efficacy of SPF-rated clothing Cutaneous Oncology : Serial screening may be the key to ensuring survival of high-risk melanoma patients Practice Management : The inside scoop on Stage 2 of the meaningful use requirements

When using fillers in the glabella, "The big concern is vascular compromise, which can lead to necrosis. We certainly hope this won't happen to our patients and us. But it's important to be prepared,"

Treating severe atopic dermatitis presents numerous hurdles for patients and doctors alike. Many patients with severe atopic dermatitis disease have tried and failed numerous treatments in the past; part of the challenge is regaining their trust in medicine, says Peter Lio, M.D., a dermatologist in practice in Chicago and clinical assistant professor of dermatology, Feinberg School of Medicine, Northwestern University.

The length of time to wait following sunscreen application before entering the sun is controversial.

There is not enough evidence to conclude that exposure to animals in childhood confers protection from atopic dermatitis or other atopic conditions, according to the chief of pediatric and adolescent dermatology, Rady Children's Hospital, San Diego.

Key cosmeceutical developments include the advent of safe, effective hand sanitizers, as well as a deeper understanding of the basic science of the human body, according to Zoe Draelos, M.D., who spoke on the topic at the 2012 summer meeting of the American Academy of Dermatology.

Options for topical treatment of actinic keratoses (AKs) are increasing, but in choosing a management approach, dermatologists should keep in mind that AKs are a premalignant condition, and the ultimate goal of therapy is prevention of squamous cell carcinoma (SCC). Field treatment is the key to managing the entire disease, says Neal Bhatia, M.D.

Even though dermatology is the oldest medical specialty, there are probably more unanswered questions in the field than in other specialties because we can visualize our organ of study 24/7. Thus, more observations can be made, allowing the formulation of more questions to answer. Patients probably ask more casual questions of spouses, family members and physicians regarding their skin than any other organ, as well.

Patients who undergo a solid organ transplant procedure have an alarmingly higher incidence of skin cancers compared to the general population. Special care and management strategies involving a multidisciplinary approach are warranted in this group, says Mich?l O'Donoghue, M.D., a dermatologist in private practice in Oak Brook, Ill.

Current strategies for minimizing bruising associated with filler injections include considering introducing cannulas in some areas, discontinuing certain vitamins and herbal remedies and potentially avoiding certain needle techniques, says Joel L. Cohen, M.D.

Many treatment regimens are available and customizable to meet the individualized needs of adult female patients with acne, according to Diane S. Berson, M.D., who practices in New York. And several key factors differentiate adult female acne patients from males.

As research and clinical experience continue to underscore differences between the three neuromodulators available in the United States, picking a product for a given clinical situation rests largely upon individual preference, according to Joel L. Cohen, M.D., who spoke earlier this year at MauiDerm 2012: Advances in Cosmetic and Medical Dermatology.

For common dermatologic conditions such as acne, warts and eczema, classical individualized homeopathic medicine can provide a safe, inexpensive and nontoxic alternative or adjunctive treatment, said Robert J. Signore, D.O., at the 2012 American Academy of Dermatology Summer Academy Meeting.

Regular serial screening by dermatologists may be the key to ensuring survival for patients at high risk of melanoma, according to a study. In the study, which is now in its 20th year, no melanoma deaths occurred in any higher-risk patients who underwent serial screening in the private practice of Ronald N. Shore, M.D.

The recent release of the Centers for Medicare and Medicaid Services Final Rule for Stage 2 of the Medicare and Medicaid Electronic Health Record (EHR) Incentive Program gives dermatologists a clear view of where the government initiative is steering you - and your patients. What lies ahead - eventually, even for those not participating in the program - is a new world of electronically connected practices and patients.

Preventing and addressing filler complications requires a thorough knowledge of the anatomy underlying the injection area, said Joel L. Cohen, M.D., earlier this year at MauiDerm 2012: Advances in Cosmetic and Medical Dermatology.

With the Nov. 6 election quickly approaching, dermatologists, issues involving the impact of the Affordable Care Act (ACA) and specific provisions (such as the establishment of the Independent Payment Advisory Board/IPAB) will be part of the decision-making process for many healthcare professionals. Dermatologists also should be aware that the Department of Health and Human Services has published a final rule that will directly affect their practices.

Carl R. Thornfeldt, M.D., has taken a fresh approach to an age-old dermatologic problem. "Where I practice in the high desert area, we have tremendous trouble with contact reactions to many skincare products and a lot of trouble with hyperpigmentation" in darker-skinned patients, who make up 30 percent of his practice. He is a Fruitland, Idaho, private practitioner and CEO and founder of Episciences.

Mary Maloney, M.D., says she believes everyone in dermatology is a leader. "We're the brightest and best," she says. "That's whether we lead our staff, our patients, our communities, choose to lobby in Washington, or serve a dermatology organization? we're all leaders."

A first-in-class cell-based therapy holds promise for better treatment of chronic venous ulcers. Surprisingly, the less intense regimen - fewer cells, administered less often - proved to be the more effective of the options studied, according to results published online Aug. 2 in The Lancet.

On Call asked dermatologists around the country whether they dispense prescription or over-the-counter products in their office, why they chose the course they did, what benefits they feel product sales have, and how they choose the products they sell. While the number of dermatologists who offer items for sale is growing, not all offices have gone the retail route.

Although contact dermatitis is more widely recognized in children, patch testing - the gold standard for identification of the condition - is underutilized in this population, says Sharon E. Jacob, M.D., associate clinical professor of medicine and pediatrics, University of California, San Diego.

A patient's immunodeficiency and/or sheer neglect of basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) tumors can result in very large, difficult-to-resect lesions, begging the need for higher vigilance and closer patient care, said Robert E. Clark, M.D., Ph.D., of the Cary Skin Center, Cary, N.C., at the 2012 meeting of Mastering Advances in Dermatology: Beyond Skin Deep in April.

These days, dermatologists have a lot to consider. Take, for example, the complexities surrounding implementation of electronic health records, as well as the looming and potentially drastic changes planned for healthcare delivery and reimbursement. So why would any dermatologist want to add learning leadership skills to their list of things to do?

A disgruntled employee went on Facebook and described a salary disagreement with his boss, Dr. Labor. Dr. Labor found out about this and promptly fired the employee for violating an office policy on not discussing office-related issues on social media. The now-former employee filed a lawsuit against him with the National Labor Relations Board (NLRB) alleging that his former boss violated his First Amendment rights.

Atopic dermatitis presents differently in children with skin of color, and dermatologists should be aware and culturally sensitive when managing the disease in these patients, says Adelaide A. Hebert, M.D., professor of dermatology and pediatrics, University of Texas Medical School at Houston.

Topical corticosteroid addiction may cause many patients' "red skin" syndrome, according to an expert in steroid-induced dermatitis.

Some of the most common surgical coding errors involve Medicare definition changes, physicians' erroneous assumptions or clinically ambiguous findings, says Howard W. Rogers, M.D., Ph.D., director of Advanced Dermatology, Norwich, Conn.

Successful repair and rejuvenation of the hand require a thorough knowledge of the subcutaneous anatomy and appropriate anesthetic techniques, says Emily J. Fisher, M.D., chief of cosmetic dermatology and laser dermatology, Lahey Clinic, Boston.

In treating children of color, promising breakthroughs include the discovery that nutritional deficiencies may have implications in vitiligo, said Nanette Silverberg, M.D., at the 2012 American Academy of Dermatology Summer Academy Meeting.