Staying current with medical dermatology research

San Francisco - Keeping up with new developments in medical dermatology requires vigilance and time, especially because study results are published in so many different journals. To help dermatologists stay abreast of research, John H. Epstein, M.D., presented at the Pacific Dermatologic Association meeting in Newport Beach, Calif. He synopsized various papers that have been published in the last two years in journals other than the Archives of Dermatology, the Journal of the American Academy of Dermatology and the Journal of Investigative Dermatology.

Dr. Epstein, a clinical professor of dermatology at the University of California at San Francisco, says, "We talked primarily about medications: the good, the bad and the ugly."

"Six patients developed heparin thrombocytopenia and then were either given warfarin at the same time or shortly after developing thrombocytopenia. They developed warfarin-induced necrosis of the skin.

"This is rare, but you shouldn't give warfarin when you have the presence of heparin thrombocytopenia. You have to wait until the thrombocytopenia has subsided," Dr. Epstein says.

"So, the report says you should only give aspirin to people at high risk of colorectal adenomas who are also at low risk of developing aspirin-induced adverse effects, such as cerebral vascular accidents, gastrointestinal bleeding and ulceration."

"Although Seldane and Hismanal are off the market, we still have some drugs we use in dermatology that can do the same thing in high doses: erythromycin, clarithromycin, pimozid and chlorpromazine," Dr. Epstein says.

"We prevent herpes simplex virus better than we treat it. In other words, acyclovir, which is very cheap - just $73 a year - 400 mg of acyclovir twice a day or 500 mg of valacyclovir can help prevent the activity and transfer of the infection.

"When you treat HSV, you only shorten the course by about one day - which isn't very good."

Androgenetic alopecia usually starts at age 14 in girls and age 15 in boys, but can start as early as age 7.