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Dermatologists are increasingly turning to "extenders" - physician assistants and nurse practitioners - to combat a shortage of doctors in the specialty. These mid-level providers and the physicians who hire them say teamwork and training are among the keys for successful collaborations.

Body contouring is the next aesthetic frontier, and thanks to advances in noninvasive lipolysis, the future is very bright, says Mark S. Nestor, M.D., Ph.D.

Beginning in 2003, with approval of human collagen and in the following years the introduction of products containing hyaluronic acid, calcium hydroxylapatite, poly-L-lactic acid and more, it's no surprise that fillers have taken on an ever-increasing role in aesthetic dermatology. On Call wondered whether dermatologists' treatment techniques have changed as a result of the growing array of product options, and if so, how.

The p53 gene is very important in dermatology for the prevention of skin cancer. P53 is the gene that is activated when viable epidermal skin cells are damaged by UV radiation. UV radiation strikes the skin and is first transformed to heat by an organic sunscreen and possibly reflected by an inorganic sunscreen. If the sunscreen fails to diffuse all of the damaging UV radiation, keratinocytes function to reflect and scatter the radiation.

Born into an accomplished dermatology family, Ethan Lerner, M.D., has had to ask himself if he had any choice but to join the specialty. His father, the late Aaron B. Lerner, M.D., former professor and chairman of the Yale University dermatology department, discovered melatonin and developed transplantation therapy for vitiligo.

The unique needs of infants with severe atopic dermatitis require special attention. As such, says Mary Wu Chang, M.D., associate clinical professor of dermatology and pediatrics, University of Connecticut School of Medicine, "This is not something you can handle in a 15-minute visit."

Future management of actinic keratosis (AK) and nonmelanoma skin cancer (NMSC) will involve creative uses of conventional therapies, particularly in multimodal regimens, and it will be expanded by recent advances in chemotherapy, according to Theodore Rosen, M.D., who spoke at the 30th annual Fall Clinical Dermatology Conference.

Biosimilars are designed to mimic biologic agents, but they are not precise duplicates of these drugs. Biosimilars may prove useful for treating skin conditions such as psoriasis, but clinicians are waiting for guidance on the drugs from the Food and Drug Administration, which was still pending at press time.

Dr. Doe has practiced dermatology for more than three decades and has seen many of his patients become quite elderly. He is saddened by the senility of some of these patients, and he is worried about their ability to consent to various office-provided procedures. One of his patients with dementia has a brother who holds a power of attorney that becomes effective when the described patient is no longer able to make decisions for himself.

Photodynamic therapy (PDT) using a topically applied liposomal eosin hydrogel is an effective treatment for primary axillary hyperhidrosis, according to a study reported at the 31st annual meeting of the American Society for Laser Medicine and Surgery.

Neodymium is a crystal that is used as a lasing medium for some solid-state lasers. The 1,064 nm neodymium-doped yttrium aluminum garnet (Nd:YAG) laser emits monochromatic light in the near-infrared spectrum. Near-infrared lasers include other devices emitting wavelengths between 750 nm and 1,400 nm.

Clinical trial results suggest that natural supplement Pycnogenol (Horphag Research), an antioxidant plant extract from the bark of the French maritime pine tree, improves skin hydration and elasticity in women.

The Food and Drug Administration has approved Picato gel (ingenol mebutate, Leo Pharma) as a treatment for actinic keratoses on the face, scalp, trunk and extremities.

The Food and Drug Administration has approved the groundbreaking, first-in-class drug Erivedge (vismodegib, Genentech) to treat adult patients with advanced and metastatic basal cell cancers.

Results of a randomized, sham-controlled clinical trial including objective and subjective efficacy endpoints have established noninvasive high-intensity focused ultrasound (HIFU; LipoSonix/Solta Medical, cleared in September 2011 by the Food and Drug Administration for noninvasive waist circumference reduction) as an effective and well-tolerated option for body contouring.

Use of interactive teledermatology consultations leads to improved clinical outcomes for patients, according to a new study from the University of California, Davis, School of Medicine.

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At various times throughout my professional career, I have frequently asked many older physicians this question: What was the best thing about practicing medicine during your career? I have always been intrigued by their answers.

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Amgen has announced that a new patent has been granted that could protect its blockbuster drug Enbrel (etanercept) from generic competition for another 17 years - a move that could undermine some of the savings expected under federal healthcare reform, the New York Times reports.

Amgen has announced that a new patent has been granted that could protect its blockbuster drug Enbrel (etanercept) from generic competition for another 17 years - a move that could undermine some of the savings expected under federal healthcare reform, the New York Times reports.

Two new studies suggest that vitamin D supplementation is beneficial for patients with systemic lupus erythematosus (SLE) in that it modulates their T regulatory cells (Tregs), and that immunization with interferon-alpha-kinoid (IFN-alpha-K) is safe and shows positive results for such patients.

A new study suggests that less frequent post-treatment monitoring visits for melanoma patients makes only a small difference in the modeled delay of diagnosis of recurrence or new primaries.

The U.S. Preventive Services Task Force is urging physicians to appeal to vanity when counseling young people about the risks of overexposure to UV rays.

The Food and Drug Administration has approved the hyaluronic acid-based filler Belotero Balance (Merz Aesthetics) for the correction of moderate-to-severe facial wrinkles and folds, the company announced.

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Nails undergo a significant number of changes in elderly patients, including discoloration, increased curvature and a 40 percent reduction in the growth rate, according to Richard K. Scher, M.D., professor emeritus, dermatology, Columbia University, New York, and the University of North Carolina, Chapel Hill.

Many older women frequent the nail salon, undergoing gel nail manicures that are very popular now. For a gel nail manicure, a gel polish has to be heat ultraviolet-cured between each layer of polish. There are advantages and disadvantages to this relatively new type of polish.

Practicing physicians are allowed to exercise their professional judgment and prescribe approved drugs for unapproved, or off-label, purposes. Physicians have been judicially accorded broad and unconstrained prescribing authority for years; "off-label" simply means that a drug is being used or prescribed in a manner inconsistent with its FDA-approved indication.

As filler products change, so do the aesthetics that guide their use, says Heidi A. Waldorf, M.D., director of laser and cosmetic dermatology, Mount Sinai School of Medicine, New York. "The modern approach to soft-tissue augmentation is based on a three-dimensional approach rather than the old two-dimensional approach," Dr. Waldorf says.