Travels with Myself (and another)

Brian T. Maurer Abstract: After four decades of medical practice, a primary care clinician finds himself cast in the role of a patient in need of dermatological surgery for skin cancer from a former colleague he had never met face to face until the day of the surgical encounter. The night before the surgery I plowed through the Delia Owens novel “Where the Crawdads Sing.”  I hadn’t anticipated the ending and fitfully drifted in and out of sleep for a couple of hours, finally succumbing to exhaustion and the warmth of the bed.  Nonetheless, my eyes opened at 5:00 AM.  I got up to do my morning exercise routine, showered, … Continue reading

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The Evening Has Arrived

AQUI NO HAY VIEJOS SOLO NOS LLEGO LA TARDE The You Tube video of this poem is worth watching. This moving poem for elderly adults is recited by the vivacious 102-year-old lady: María Cristina Camilo. Dominican actress and broadcaster (b. 12.25.1918) Translated from the Spanish by Brian Maurer Here there are no old ones;It’s only that the evening has arrived for us:An evening weighted with experience—Experience to offer advice.Here there are no old ones;It’s only that the evening has arrived for us.Old is the sea,And it rises up like a giant;Old is the sun,And it warms us.Old is the moon,And it enlightens us;Old is the earth,And it gives us life.Love … Continue reading

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Nailing Down a Diagnosis

Onychomadesis is the spontaneous, complete shedding of the nail from its proximal side, without pain or inflammation, following nail matrix arrest. Brian Maurer, a pediatric practitioner, recently saw a 5-year-old boy with a two-week history of nail shedding.  The child had antecedent Hand, Foot and Mouth disease.  Nail shedding has been described as a sequela to HFM Disease. To access Mr. Maurer’s excellent case report please click “HFM Nails” References: 1. A Clinical Study of Nail Changes Occurring Secondary to Hand-Foot-Mouth Disease: Onychomadesis and Beau’s Lines.  Shin JY, Cho BK, Park HJ.  Ann Dermatol. 2014 Apr;26(2):280-3.  Free Open Access 2. From: Onychomadesis: A common sequalae and concern for patients after … Continue reading

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A Pain in the Bottom

 Bottom:  “Ready.  Name what part I am for, and proceed.” A Mid-Summer Night’s Dream, I, ii. Abstract: Over a one-month period a 17-year-old male presented with severe recurrent rectal discomfort clinically diagnosed as proctitis with anal fissure.  Both episodes responded to a course of antibiotics and topical steroid ointments.  On clinical examination the degree of rectal mucositis corresponded to that of his anterior oral mucosa, apparent side effects of oral isotretinoin therapy.  A history of constipation may have contributed to the finding of anal fissure.  Several similar cases have been documented in the medical literature.  Clinicians would do well to consider the possibility of isotretinoin-induced proctitis in patients on oral … Continue reading

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In Poor Taste: Terbinafine-induced dysgeusia in a 58-year-old man

Abstract:  This is a case report of dysgeusia and glossodynia in a 58-year-old man, which he developed during a 12-week course of oral Lamisil (terbinafine) prescribed as treatment for presumed onychomycosis.  Although these side effects are documented in the medical literature, many clinicians are either unaware of them or neglect to mention them to patients prior to prescribing the drug. The literature suggests that dysgeusia is more likely to develop in the older patient who has a low BMI.  There is no known treatment for the disorder, which may resolve on its own or become permanent. Keywords:  terbinafine, Lamisil, dysgeusia, ageusia, hypogeusia, altered sense of taste, medication side effects, onychomycosis, … Continue reading

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