Monthly Archives: November 2012

Human Microbiome (Introduction)

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The human microbiome is the collection of microorganisms (such as bacteria viruses and fungi) which live on and inside humans (on the skin, in the saliva and mouth, in the eyes, and in the gut and the rest of the gastrointestinal tract). Foreign microbes outnumber human cells in the body a wide margin; humans have about 100 trillion cells, and carry ten times as many microorganisms in the intestines alone. We know that some of these organisms are useful for humans. However, most have no known effect; they are just symbionts and are referred to as the normal ‘flora.’ Studies in 2009 asked whether our health is damaged if we reduce this biota (collection of … Continue reading →

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Hunting for Bear: A Melanoma Postscript

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Hunting for Bear: A Melanoma Postscript by Tim Guetti  Abstract:  A 62 year-old man relates his experiences after being diagnosed with an acrolentiginous melanoma on his foot.   The surgery interferes with his plans to go on a father-son bear hunt.  We hear and read many stories about the diagnosis and treatment of melanoma, but few relate what is important to the patient with the disease. Keywords: hunting, bear, melanoma, foot, acrolentiginous, melanoma, father, son My story begins a few years back when my son Scott, now 39, said to me “Dad, we need to go on a hunt.” It had been many years since we had been on a “hunt” … Continue reading →

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The Rudolph Sign

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The Rudolph Sign: Red Nose as a Sign of Nasal Infection [Dahle and Sontheimer reported a case of what they dubbed “nasal vestibular folliculitis” (NVF) in the Dermatology Online Journal1 in March of 2012.  We saw a similar patient in November 20122.  Our patient has provided his history here, to add to the literature on NVF.  With each new case, we will learn more about this emerging disorder.] “I’m an 81 years old man, and if I remember correctly, I initially noticed tiny growth(s) in my nostrils. They were annoying more than painful.  After a few days, my nose and face became swollen and painful (7 on the pain scale3).  That … Continue reading →

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Quilted

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Clara Luu’s poem is the most eloquent description of  severe atopic dermatitis ( often called S.A.D.)  that I have come across in a long dermatological career.  If you read it, you don’t need all the textbooks or review articles.  It speaks to what we are trying to do with the OJCPCD. Persistent scratches ripping through the tranquility of the night, and bedsheets dusty with flaked skin, mingled with dried blood in the mornings. Her skin stained with the purple sting of potassium permanganate, burning from the relentless scorch of tea tree oil, smothered in topical corticosteroids. Bandaged to retain moisture. Unbandaged to promote air flow. A blur of diagnoses and … Continue reading →

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Hand of Angel

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“I Want Too Hold Your Hand” by Corinne Viens. Abstract:  Dermatologists perform many minor surgical procedures on patients who are often anxious and/or needle-phobic.  The simple act of holding a patient’s hand during the injection of local anesthetic has a calming and therapeutic effect.  This essay is the personal experiences of a professional hand holder and her reflections on this service to the patient. Keywords: minor surgery, surgery, anxiety, needle phobia, hand holding, comfort, dermatology In the dermatology office where I have worked for nearly twenty years, I often hold the hands of patients while the doctor administers the local anesthesia prior to their procedures or, if they are exceptionally … Continue reading →

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Chronic Telogen Effluvium?

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Chronic Telogen Effluvium Hope never dies.  Having lived with chronic telogen effluvium for 14 years, I still find myself hopeful that  the current shedding that I am experiencing will be my last, that the new ¼ inch hairs that are now sprouting on my scalp will be the real thing – that they will live out the normal cycle of hair growth and shedding.  Yet, I know realistically that this is not what will happen.  I continually shed and grow hair, but the cycle is such that by the time new ¼-inch hairs reach a length of two inches, the old two inch hairs shed.  Consequently, my hair is always … Continue reading →

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Micrographic Surgery: A Patient’s Experience

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My Mohs Experience Abstract: This is the personal account of a 70 year old man who underwent micrographic surgery for an ill-defined basal cell skin cancer on his temple.  It is intended to inform patients and physicians about the personal experiences and perceptions of Mohs patients.  A micrographic surgeon has added a coda. Keywords:  micrographic surgery, Mohs surgery, Mohs micrographic surgery, MMS, nonmelanoma skincancer, basal cell carcinoma, squamous cell carcinoma, illness narrative Who knows/ whose nose/ needs Mohs?  E. Dorinda Shelley Introduction:  Dermatologists see patients with nonmelanoma skin cancer on a daily basis.  Certain tumors, especially those around the nose, ears, and eyes are best handled with micrographic surgery (aka, … Continue reading →

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