For S, to whom this article is dedicated by Valencia Long, MBBS Dermatology is graced by many French terms that resonate in everyday practice. Here are some examples, presented as a tribute to the great French teachers and pioneers of dermatology. May this note also serve as an expression of solidarity with the people of France in the aftermath of the recent terrorist attack in Paris, November 13, 2015. The term ‘plaque’ is an elevated, circumscribed lesion used to describe conditions such as psoriasis and sarcoidosis. It is also used in “parapsoriasis en plaque”, which may be considered related to patch stage mycosis fungoides. “Collarette” means small French collar and … Continue reading
Specialists in the Skins of the Rich and Famous
top doctors make a difference Castle Connolly – Top Doctors by Dr. A.R. Pito, FRCP Castle Connolly often buys a full-page ad in the New York Times listing preferred physicians (16 per page). “The mission of Castle Connolly Medical Ltd. is to help consumers find the best healthcare. The top doctors who are listed in our books and on this website’s directory were nominated by their peers in an extensive survey process of thousands of American doctors each year. Those doctors who are among the very best in their specialties and in their communities are selected for inclusion. Doctors do not and cannot pay to be included in any Castle … Continue reading
Expressions of Emotion in Dermatology
by Valencia Long, MBBS and Leonard J. Hoenig, M.D. The whole gamut of human emotion has found its way into the dermatologic lexicon. A rash looks “angry” when it is inflamed. Other times, a dermatitis that oozes and exudes fluid is described as “weeping. Cosmetic dermatology often deals with “frown lines” that are furrows that form over one’s brow as the skin ages and which remind us of scowling, a facial expression of displeasure. “Laugh lines”, also called “smile lines”, occur along the nasolabial folds and with aging can grow in length and depth. Perhaps the most common emotion that is expressed in dermatology concerns love. Pain, and the most … Continue reading
Psoriasis: A Poem
Psoriasis by Mara Feingold-Link PDF: Feingold Psoriasis The bronze plaque on Lake Champlain’s bridge is missing a nail. The empty pit in the top left corner is the only indication that it has seen countless cycles of pouring rain and flaring sun. On this dry afternoon it sits proudly above a school of mooneye fish swimming upstream toward clearer, cooler waters in early April. In their haste they scrape their flattened bellies along rock-lined riverbanks. To swim so fast is rash; beneath those silvery scales lie hundreds of miniscule eggs, pinpoints of new blood waiting to be born. The mooneye head toward a quiet inlet where patches of watermilfoil float … Continue reading
Welcome to The Cloud Clinic
by A.R. Pito and D.J. Elpern Sugata Mitra hit upon the idea of unsupervised learning by computers in an iconic study of slum children in India. This evolved into Self-Organised Learning Environments (SOLEs) where children search for answers to ‘big’ questions. Why not apply this idea to the medical environment? We envision a Consultative Cloud Clinic. The primary aim of Cloud Clinic is to enhance diagnosis and therapy in the interest of patient care and autonomy. Mitra’s School in the Cloud project enables small groups, to competently search for answers to ‘big questions’, drawing rational, logical conclusions. The concept can be usefully applied to ‘health questions.” Mitra and his colleagues … Continue reading
Robotic Accutane Prescribing
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
My Summer on Kauai
by James Foong In the summer of my third year as a medical student from Malaysia, I had the opportunity to shadow Dr Paul Esaki, a primary care physician who practices in Kapaa, Kauai, Hawaii. I arrived in Kauai late at night tired after a few hours of flying (but many hours of waiting after a last minute flight change). Dr Esaki picked me up in a weathered 4×4 truck (I was expecting a conservative sedan for some reason). Right off the bat, there was warm hospitality and he gave me a lively talking commentary of the island while on route to the beach house where I was to stay. … Continue reading
My Goals in Medicine
by James W. Foong I was asked to present this topic to a group of physicians and researchers at a medical conference in West Vancouver, British Columbia. What can I offer them that they do not already know? I felt that my talk could seem very self-centered, arrogant even. Such were my insecurities but out of sheer necessity, I began organizing my thoughts in an orderly manner for the presentation. What I realized was that the very reason we’re in this field gets lost amidst our hectic lives and the daily struggles that make us lose sight of our goals. Every once in a while, we may need a reminder … Continue reading
Skin Wars
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
The Dao of the Red Man
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
