itch scratch ache burn crack bleed toss turn wounds deep swollen red open cuts skin dead rash gash tender sore anguish pain scabs tore throb hurt sting weep ooze pus drain seep agony injury soak smear distress disease blisters tears dig rub gnaw claw rough dry scaly raw
Zen and Dermatology Practice
Zen Buddhism has a lot to teach us as physicians, as dermatologists. Consider these two quotes from respected roshi: The practice is the teacher. Your practice is your teacher. Maurine Stuart. Teaching is not difficult, Listening is not difficult either. What is truly difficult is to become conscious of what you have in yourself and be able to use it as your own. DT Suzuki, The Marvelous Cat
Loss and Found
Reflections on Skin Cancer and Solar Aging Band-Aid Generation I am one in the army of older people to wear a Band-Aid on my face. One skin cancer survivor who joyfully, happily, obliviously chose a chaise-sitting, oil-basting, body-rotating, reflector-using, get-a-tan- at-any-cost younger life. So now I’m a dues-paying member of a community I didn’t ask to join. The Reckoning I’m sitting on a park bench looking down at my hands, the backs shockingly old in the afternoon sun. The skin crinkles outward like a spider web or pieces of broken eggshells. On examination, the left hand appears more lined than the right. I wonder if the left one was … Continue reading
Music as Complement to Surgery
Dermatologists perform office surgery almost daily. Our awareness of the growing interest in, and literature on, music as an adjunct in the perioperative period led us to survey the use of music during 100 consecutive office procedures in a dermatology practice. We found that the effects of music were salutary for patients and the investigators. Music is a simple, inexpensive, safe and effective adjunct to office surgery. We hope that this report will be of help to physicians who wish to provide music to ease patients during office procedures. For full paper: Music and Surgery Appendix: Music Study Appendix Keywords: music, medicine, surgery, perioperative, playlists, dermatologist, dermatology
The Great God Fred
Once in a generation or so, there appears in our specialty, a charismatic individual whose creativity and intellect advance our knowledge and understanding in ways that were unanticipated. Dr. Frederic Sheldon Brandt was featured recently in a New York Times Style essay: The Man Behind the Face. His specialty is facial rejuvenation, and, if one believes the article, he and his associates are miracle workers. The Great God Fred and Associates’ website is worth visiting as well. This is dermatology for the rich and famous. After reading the article and visiting the website, you can draw your own conclusions.
GoodRx
Keywords: pharmceutical prices, drug prices, generics, savings A funny thing happened on the way to the pharmacy… I was robbed. It’s a strange reality in these United States, that the price of a pharmaceutical varies wildly from one drugstore to another. Patients on Medicaid and, or, those with insurance drug coverage usually do pretty well, but individuals who do not have some form of a prescription plan get it in the neck. Over the past few years, the price of some common drugs has gone through the roof. Doxycycline is an example. It used to be that 60, 100 mg capsules could be bought for four dollars at a Target … Continue reading
Shelley’s “Prayer of the Orphan Patient to the Doctor”
Listen to me Don’t be cynical, indifferent, or in a hurry. Ask me what makes my problem better or worse. Ask me what I think the cause is. Ask me to look for clues and teach me what they are. Think about me Think of my problem when you read those books, journals, and atlases. Think of my problem when you attend meetings. Think of asking your colleagues about me. Test me Order specific tests to help you decide on my diagnosis and treatment. Could I have AIDS, cancer, or lupus? Do I need a biopsy? A challenge with a medication? Do I need hospital help? Do I need to … Continue reading
Lessons from the Clinic
Yoon Cohen recently sent us an invaluable handout presented by Dr. William James at a meeting she attended. She wrote: “As an osteopathic resident, I attend our annual American Osteopathic College of Dermatology Conference every Fall. One of the highlights of the conference each year is a series of lectures from the Department of Dermatology at University of Pennsylvania. This year, Dr. William James has shared diagnostic and treatment lessons that he has learned over the years. He emphasized the importance of teamwork — sharing of our gifts freely with each other. Dr. James closed his talk with some final thoughts that resonate with Dr. Walter Shelley’s pearls of wisdom. … Continue reading
Skin Microbiome .Net
We may not see them, but we need them. An estimated one hundred trillion microorganisms inhabit the human body. This includes bacteria, fungi, viruses, protozoa and mites. There are gut, skin, respiratory, bone and even nervous system microbiomes – and this may be an incomplete list. We are only beginning to understand how these microbial communities impact health and disease. Dr. Yoon Cohen has started a web site called Skin Microbiome that will serve as a repository for the emerging literature on this subject. Disorders such as acne, atopic dermatitis, perioral dermatitis, psoriasis, rosacea, seborrhea, seborrheic dermatitis, skin ulcers and many more appear to be caused or exacerbated by an … Continue reading
Transmission of Scabies
Keywords: scabies, transmission, Mellanby, fomites, beds In the early 1940s, scabies was an important cause of morbidity in the troops. Kenneth Mellanby did important, but ethically questionable, experiments on conscientious objectors to determine how scabies spreads. Interestingly, fomites do not seems to be a serious risk for transmission. I’ve attached a link to Mellenby’s report in the British Medical Journal from 1941. Scabies Transmission by Kenneth Mellanby Kenneth Mellanby died in 1994. His obituary is interesting.
