Category Archives: Elpern, David J.

Same-old, Same-old Grand Rounds

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“The student begins with the patient, continues with the patient, and ends his studies with the patient, using books and lectures as tools, as means to an end.” — Sir William Osler, Aequanimitas, 1905 Keywords:  grand rounds, incontenentia pigmenti, VGRD, academic medicine, continuing medical education, CME I recently attended a regional Dermatology Grand Rounds held at an academic medical center.  The first such meeting I attended was over 45 years ago.  The recent program featured live patient viewing of around 20 people with a variety of unusual skin disorders.  Around 150 – 200 dermatologists were present.  It started with a 1.5-hour patient-viewing during which we all trooped around the clinic … Continue reading →

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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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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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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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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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Aloha

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The OJCPC-Dermatology is a new concept in medical periodicalss.   We will address all stakeholders in skin disease: patients, their families and caregivers.  We envision a level playing field, not top down from high-control professionals.  Please join us on this journey.  Write an article for us, read our pieces, visit our blogs.  Make Comments. LET THE GAMES BEGIN!

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