32nd Annual Hot Spots in Dermatology Turtle Bay Resort, Oahu, Hawaii August 16 – 18, 2019 Please consider joining us for our 2019 meeting. Hot Spots addresses clinical dermatology, emerging technologies and humane aspects of medicine. We keep the number of attendees small to assure meaningful informal sessions at which registrants and speakers have time to interact as colleagues. For more information please email Dave Elpern.
The question of whether to undergo a SLN biopsy for melanoma is a difficult one. It is clear that some experts recommend it while others don’t. If you live in Boston you will be told one thing. If you live in Montreal you’ll be told another. Where does that leave a patient? In England the National Institute for Clinical Excellence (NICE) provides decision aids for many conditions. Here is their SLN Decision Aid for melanoma. Please give it thought and discuss it with your dermatologist or surgeon. The decision is really up to you. It boils down to “What Matters To You.” Option-Grid-Sentinel-Node-Biopsy-yes-or-no
by Michael O. Memsah, M.D. I was in medical school when I learned that I did not matter in medicine. One particular day on service started uneventfully. However, after the team’s discussion of a patient, all attention turned toward me when a senior physician asked me a question about the rap music that had been playing in the background. “Help me understand something:” I recall the physician saying. The physician asked about word choice in rap lyrics, and then, pretending to quote a rap song, repeated the word “nigger” several times in rapid-fire succession. So begins this important “Viewpoint” article in JAMA Internal Medicine. Most of us will benefit from … Continue reading
This is the reference: Leuconychia in reflex sympathetic dystrophy: a chance association? Vanhooteghem O, et.al. Br J Dermatol. 1998 Aug;139(2):355-6. you can read at: BJD Leuconychia
The Business of Medicine: Old paradigm and new I wish I was a young buck looking for my first job. Recently, I received an email promoting a new position: Hi Dr. …, Hope this email finds you well! I’m contacting you regarding a Dermatology Opening in [a scenic rural area] Please see below for details and send CV if interested. Seeking a BE/BC Dermatologist to join its medical staff. Join the most trusted hospital in the area due to its highly trained physician staff and its arms-length affiliation with the University of [X] Hospital in {Y]. The community itself is an attractive university town located in the Foothills of the redacted … Continue reading
seen every day in medical offices Health Anxiety: lurking in plain sight All practitioners will learn useful information from this article. Excerpts “Many patients, despite how much they would like to, cannot do what we would like them to do: ‘stop worrying.’” As physicians, we see a few such people every day. Health Anxiety seems to be epidemic (perhaps, endemic) in our communities, yet it is poorly recognized. “People with health anxiety do not ask relief from somatic symptom, but rather only desire freedom from worry about disease. A key component of health anxiety is rumination, so that patients cannot stop thinking about a disease once the thought has come … Continue reading
Welcome to the Akamai Skin Clinic’s Robotic Accutane Centre. We recognize that many dermatologists do not want the hassle or liability of prescribing Accutane (a.k.a. isotretinoin) and so, we have developed a novel prescription system. Our certified realistic humanoid isotretinoin robotic paraprofessionals will make your office visit pleasant, entertaining and efficient. These Accu-Bots (ABs) have been programmed to care for people with severe acne since the clinician-patient interaction for this indication is structured and predictable. Our ABs have high-resolution scanners to grade your acne and compare your progress with previous visits. They also have the entire PUBMed database of isotretinoin articles in their memory to enhance patient care. Here is … Continue reading
by Mr. B. In 2014, I won an insidious lottery: contracting Pityriasis Rubra Pilaris (PRP), a rare skin disease that one in 400,000 people get. After accepting this horrific verdict, I discovered I had a major choice. Do I take high-risk drugs in hope for a cure, after assuming a drug had initially caused my PRP? During the challenge of being alone in my struggle, I fortuitously discovered a special dermatologist. Dr. K respected my concerns about a conventional physician-patient relationship, and he followed my lead in selecting my treatment. The communication and trust we developed led to a slow, minimal treatment that after one year resulted in remission without … Continue reading
by Dr. K. In September of 2014, I saw Mr. B., a 68 years old man, with a wide-spread dermatitis that turned out to be pityriasis rubra pilaris (PRP). He was miserable with generalized red skin, scaling and painfully thickened palms and soles. My essay, “The Dao of the Red Man” describes our long and complicated therapeutic journey. Mr. B. relates his personal PRP struggle in “Skin Wars.” The interested reader will learn much from reading and comparing both Mr. B. and my narratives. They speak to PRP, the physician-patient dyad, and shared-decision making. The Dao of the Red Man Skin Wars – Mr. B Also see: Skin Wars by … Continue reading
Anonymous My journey with Red Face Syndrome has been tough, especially as I am a high school student. It started with some type of rash, maybe an allergic reaction, under my nose and on my chin. It wouldn’t go away so I went to my doctor. She confirmed my suspicion that it was an allergic reaction and treated me with a pill, hydroxyzine, and triamcinolone ointment. I took the pills until they were gone and used the ointment. My rash cleared up so I stopped the medicines. I was so happy that the rash was gone and I could stop having uncomfortable sleepless nights with ointment covering my face. After … Continue reading
