To view the questionnaire we used, click What Matters To Me Questionnaire We are trying to create a tool to help patients communicate with their physicians and other care providers about what really matters to them in their relationships with the health care system. Although one may not always get everything wishes for, this is a chance to share your preferences and values with regards to the healthcare you receive. When answering the questions it may be helpful to think of times you felt that your medical care needs were not met. Please rate choices in the order of importance to you. All information is confidential. No one’s identity will … Continue reading
Marius Rademaker Hot Spots 2018 Very Low-Dose Isotretinoin
Very low-dose isotretinoin in mild to moderate papulopustular rosacea; a retrospective review of 52 patients. ABSTRACT BACKGROUND/OBJECTIVES: Rosacea is a chronic inflammatory disorder that affects up to 10% of the population. Standard treatments include topical azelaic acid and metronidazole or systemic tetracyclines. Isotretinoin has generally been restricted to severe disease, often at a dose of 0.5-1.0 mg/kg/day. METHOD: Retrospective review of open-label isotretinoin (initial dose 20 mg/day, with dose adjustments according to response), in patients with mild to moderate papulopustular rosacea. RESULTS: Altogether 52 patients (33 women), mean age 48 years (range 18-86) were treated with isotretinoin over a 5-year period. All patients were commenced on 20-mg isotretinoin/day which was reduced to 10-20 mg once to five times a week (equivalent to 5 mg/day) … Continue reading
Metastatic Basal Cell Carcinoma
Case Presentation Metastatic BCC 2018 Hot Spots in Dermatology Presenters: Marianna F. Karewicz, NP Roman W. Glamb, MD Straub Medical Center Download Fyll Presentation: Metastatic Basal Cell Abstract Basal Cell Carcinoma (BCC) is deemed as one of the most frequent types of skin cancer. Typically, it is regarded as localized in nature and there is a tendency to view the condition as non-malignant because the tumor rarely metastasizes (Habif, 2016). However, what if the condition became aggressive? If left untreated, BCC has the capability to spread through direct extension, destroying normal tissue and large portions of the body; even penetrating the subcutaneous tissue to bone and/or the brain. This case … Continue reading
Dr. Edmund Ing—Expertise and Community Service in Hawaii
Presented by his son, Malcolm Ing, M.D. Hot Spots in Dermatology, August 17 – 19, 2018 Dr.Edmund Ing succeeded despite the odds and challenges he had to face while obtaining a medical degree and establish a practice and expertise in urology in Hawaii. Poverty –Despite being born to an impoverished family, Dr.Ing was able to obtain excellent training in medicine and surgery and in his specialty—Urology. He was the first residency–trained Urologist in Hawaii after obtaining a Master of Medical Science at the University of Pennsylvania, which required a thesis to graduate from the program. There were no student loan programs, Medicare or Medicaid in those days. Prejudice- Being of … Continue reading
Illness Narrative – Long Form
My Illness Narrative: the Autopathography Project (If you want this in a printable form, please email D.J. Elpern djelpern@gmail.com) You may have a complex health problem that doctors have not solved. When you enter the new doctor’s office, a perky young person asks who referred you and then requests your insurance cards. Next, there are numerous forms to fill out. Then, you are seen by an assistant who records your weight, blood pressure, pulse, and even the oxygen saturation from a fingertip. Finally, the physician or his “extender” sees you for 10 – 15 minutes, at least half of which time he is focused on your electronic medical record. After … Continue reading
Darkness Visible: A Life of Chaos
a chaos of hard clay. Byron, Darkness Darkness Visible: A Life in Chaos It takes almost a decade to train a physician: at least seven years for a family practitioner and up to ten for cardiac- and neurosurgeons. We become technically proficient in treating diseases, but are not as adept at treating the illnesses that people present with. How often do we get, or make, the time to really get to know our patients? Physicians are comfortable with disorders that are clear-cut: diabetes, skin cancer, hypertension, and on and on. Yet, there is a subset of humanity with medically unexplained symptoms (MUS). Thirty to 50% of people seen by primary … Continue reading
The Church Spire Sign in Dermatopathology
Raagini Suresh, B.S. Keywords: church spire sign, dermatology, dermatopathology, pathology, biopsy Abstract: Dermatopathologists often use key phrases to describe histopathological findings. This piece takes a look at the origin of the phrase “church spire sign,” and explains the symbolic meaning behind the addition of spires to church buildings. Dermatology is an extremely visual field. While the physical exam is often a key component of establishing a diagnosis, histopathology can be used to provide a microscopic look at clinical findings. Most dermatologists are well versed in performing biopsies to better characterize their patients’ skin lesions, often sending biopsy specimens to dermatopathologists for interpretation. The language dermatopathologists use in their reports includes … Continue reading
An Astute Observer
Priscilla Ly, BS Keywords:William Osler, smallpox, tuberculosis verrucosa cutis, hereditary telangiectasia, Osler nodes, Osler-Weber-Rendu William Osler was the best known physician of his time with an insatiable interest in all fields of medicine. He was not only a pathologist and an internist, but he was also a multispecialist who contributed greatly to the field of dermatology. As an astute observer, William Osler naturally reported many of his cutaneous observations. He was meticulous in his attention to detail and authored nearly 100 publications describing cutaneous conditions. He brought clinical teaching to the bedside of patients and taught his students the power of observation. If the light were not good, he was … Continue reading
Medical Nemesis: The Expropriation of Health (1975)
From the Introduction: full notes at:Medical Nemesis Illich Ivan Illich, 1926-2002 (http://en.wikipedia.org/wiki/Ivan_Illich) Introduction: The medical establishment has become a major threat to health. The disabling impact of professional control over medicine has reached the proportions of an epidemic. Thoughtful public discussion of the iatrogenic [“physician caused”, iatros=physician & genus=birth] pandemic, beginning with an insistence upon demystification of all medical matters, will not be dangerous to the commonweal. Indeed, what is dangerous is a passive public that has come to rely on superficial medical housecleaning. My argument is that the layman, not the physician, has the potential perspective and effective power to stop the current iatrogenic pandemic. During the last generations … Continue reading
Why so serious?
Tyler Marion, B.S., M.B.A., Kevin Cao, B.S., Jorge Roman, M.D. Keywords: Chlorotrichosis; Pseudochromhidrosis; Copper toxicity; Green hair; Mercury, Contact dermatitis; Perioral erythema; Erethism; Joker. Notoriously known as Batman’s ultimate adversary, the Joker is considered as one of the most iconic villains in comic book history. He is easily recognized by his trademark green hair, bleached white skin, and cherry red lips; as well as his cynical smile. These traits have remained consistent through the many adaptations and portrayals of the character. Appearing in several films including the Batman (1989), The Dark Knight (2008), and Suicide Squad (2016), the villain’s famous features have a fascinating origin ripe for speculation. The most … Continue reading
