Monthly Archives: October 2012

Imaging Ioxides II

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Nancy Piatczyc commented on Imaging Ioxides Scapularis and we thought her words and images were prescient and compelling.  You will enjoy reading her comments and seeing more images. “Both images in the previous post are of ticks found here in Williamstown.  Regarding the bottom image that looks like a flower we are guessing it shows the spiracles that the tick uses for respiration.  There is one on either side of the bottom of the tick. Recently, a tick friend of mine brought in a live tick.  It was from somewhere in Berkshire County, and was crawling up her arm, but not attached.  So she brought it in still alive and … Continue reading →

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Imaging Ixodes Scapularis

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Williams College Biology Professor, Hank Art, sent us these fine electron microscopic photographs of a deer tick taken by Nancy Piatczyc, Williams’ electron micrcroscope technician. Ticks, in the Northeast, are dreaded carriers of Lyme Disease, Babesiosis and Ehrlichiosis. The beauty and complexity of this troublesome critter is depicted well here. Ioxides’ fearful majesty calls to mind William Blake’s poem. The Tyger Tyger! Tyger! burning bright In the forests of the night, What immortal hand or eye Dare frame thy fearful symmetry? Nancy Piatczyc sent us a comment on this post as well as some dramatic additional images:  Imaging Ixodes II.  Pleasant dreams!

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Mirror Amputation for Acne Excoriee de Jeunes Filles

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Casual Comments by DJ Elpern Abstract: Many young women habitually pick facial lesions which in reality may be rather minor.  These are some informal thoughts on excoriated acne with a suggestion of a simple behavioral technique called “mirror amputation” that may help some of these persons. Keywords: acne, excoriations, acne excorie de jeunes filles, dermatotillomania, mirror amputation, skinorexic Dermatologists see women with excoriated acne regularly.  The typical patient is a young to middle-aged woman with scattered excoriations on the face.  There is a surprisingly scant literature on this common disorder which has also been called acne excoriee de jeunne filles (AEJF), Dermatotillomania, and Skinorexia. A recent post on AEJF on … Continue reading →

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Observations on Cutting

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by Christina Perron Abstract: Non-suicidal self-injury is thought of as a disordered emotional coping mechanism. This phenomenon is gaining increasing attention in the psychiatric and lay literature as it often is a harbinger of significant ongoing life stressors, a marker of adverse childhood experiences, and/or a manifestation of psychiatric disease. Dermatologists investigate and treat diseases of the skin and are therefore often privy to a patient’s closely guarded stigmata of self-harm. A fourth-year medical student questioned how best to care for this patient population in the outpatient dermatology clinic. A review of the current dermatologic literature proved largely silent on this subject. A dermatology clinic visit may represent an ideal, … Continue reading →

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Magic and Medicine by Felix Sun

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Felix is a fourth years student at Williams College where he is an accomplished tennis player, song writer, magician and chemistry major. Felix.S.Sun@williams.edu Abstract:  Felix Sun did a medical elective during January of 2012 in a dermatology office.  He drew on his experiences performing magic tricks for children and applied them to the clinical setting.  It became clear that sleight of hand goes a long ways towards making children (and some adults, too!) more comfortable in the clinical setting. Keywords:  magic, patients, student elective, Williams College. Magic. Is it real? That’s hard to say, but what it can create seems as “real” as it gets. That special moment when time … Continue reading →

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The Power of Hugs

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The Power of Hugs By Nicholas Kristof NY Times, October 21, 2012 Nicholas Kristof’s “Sunday column looks at the recent research into the importance of early childhood interventions to reduce poverty and social problems. It’s something I’ve been interested in for some time, originally through the work of Dr. Jack Shonkoff at Harvard, and now a new book by Paul Tough beautifully assembles the evidence for what might be called the brain biochemical element of poverty — and the strategies to address it.” The Op-Ed piece is a great summary of some of the points made by Paul Tough in “How Children Succeed,” a book which I, too, found really … Continue reading →

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Relative Risk – A Near Fatal Case of Acne

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By Richard Sontheimer Professor, Department of Dermatology, University of Utah School of Medicine, richard.sontheimer@hsc.utah.edu Keywords:  Acne, isotretinoin, Accutane, depression, suicide He was an intense young man who interacted with me differently than other patients. Each time I entered the exam room, he welcomed me by using my first name.  Unusual, as he was 40 years my junior and not a personal acquaintance prior to his first clinic visit. He had presented for scarring cystic facial acne. Five months later, he had completed a course of oral isotretinoin (Accutane®) with complete clearing of all inflammation from his face. While winding up my last clinic visit with him, I asked the required … Continue reading →

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Thoughts about brachioradial pruritus

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Brachioradial pruritus is a common condition that is not well-recognized by most practitioners. I saw my first patient with brachioradial pruritus (BRP) in 1983 when I practiced dermatology in Hawaii.  She was a middle-aged woman with intractable pruritus over the dorsolateral (brachioradial) aspect of her left arm proximal and distal to the elbow.  I remember her well since an article on the subject had recently appeared in the Archives of Dermatology1.  Her general doctor had told her it was “nerves” and prescribed amytriptylene, which at the time was primarily an antidepressant. BRP is more commonly encountered in tropical and sub-tropical areas, and over the next few years I saw a fair … Continue reading →

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Book Review: Room for Examination

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Reviewed by: Dr. David Elpern I have had an interest in books about medical training for many years and have read a score or so on this topic.  Those that stand out are, William Nolan’s “The Making of a Surgeon1,” Perri Klass’ “A Not Entirely Benign Procedure2” and Fitz Mullan’s “White Coat, Clenched Fist.”  To this exclusive canon, I now add James Channing Shaw’s new book, “Room for Examination: True Tales of a Disillusioned Dermatologist” which chronicles the path from naïf to dermatologist. It is wise, philosophical, honest, poignant, humorous, engagingly written, never self-serving and riveting.  Shaw is Division Head of Dermatology at the Women’s College Hospital, University of Toronto, Canada. … Continue reading →

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