The Rudolph Sign: Red Nose as a Sign of Nasal Infection [Dahle and Sontheimer reported a case of what they dubbed “nasal vestibular folliculitis” (NVF) in the Dermatology Online Journal1 in March of 2012. We saw a similar patient in November 20122. Our patient has provided his history here, to add to the literature on NVF. With each new case, we will learn more about this emerging disorder.] “I’m an 81 years old man, and if I remember correctly, I initially noticed tiny growth(s) in my nostrils. They were annoying more than painful. After a few days, my nose and face became swollen and painful (7 on the pain scale3). That … Continue reading
Quilted
Clara Luu’s poem is the most eloquent description of severe atopic dermatitis ( often called S.A.D.) that I have come across in a long dermatological career. If you read it, you don’t need all the textbooks or review articles. It speaks to what we are trying to do with the OJCPCD. Persistent scratches ripping through the tranquility of the night, and bedsheets dusty with flaked skin, mingled with dried blood in the mornings. Her skin stained with the purple sting of potassium permanganate, burning from the relentless scorch of tea tree oil, smothered in topical corticosteroids. Bandaged to retain moisture. Unbandaged to promote air flow. A blur of diagnoses and … Continue reading
Hand of Angel
“I Want Too Hold Your Hand” by Corinne Viens. Abstract: Dermatologists perform many minor surgical procedures on patients who are often anxious and/or needle-phobic. The simple act of holding a patient’s hand during the injection of local anesthetic has a calming and therapeutic effect. This essay is the personal experiences of a professional hand holder and her reflections on this service to the patient. Keywords: minor surgery, surgery, anxiety, needle phobia, hand holding, comfort, dermatology In the dermatology office where I have worked for nearly twenty years, I often hold the hands of patients while the doctor administers the local anesthesia prior to their procedures or, if they are exceptionally … Continue reading
Chronic Telogen Effluvium?
Chronic Telogen Effluvium Hope never dies. Having lived with chronic telogen effluvium for 14 years, I still find myself hopeful that the current shedding that I am experiencing will be my last, that the new ¼ inch hairs that are now sprouting on my scalp will be the real thing – that they will live out the normal cycle of hair growth and shedding. Yet, I know realistically that this is not what will happen. I continually shed and grow hair, but the cycle is such that by the time new ¼-inch hairs reach a length of two inches, the old two inch hairs shed. Consequently, my hair is always … Continue reading
Review: Under My Skin
Under My Skin: A dermatologist looks at his profession and his patients by Alan Rockoff, M.D. joins a small, but growing, collection of memoirs by dermatologists. Continue reading
Micrographic Surgery: A Patient’s Experience
My Mohs Experience Abstract: This is the personal account of a 70 year old man who underwent micrographic surgery for an ill-defined basal cell skin cancer on his temple. It is intended to inform patients and physicians about the personal experiences and perceptions of Mohs patients. A micrographic surgeon has added a coda. Keywords: micrographic surgery, Mohs surgery, Mohs micrographic surgery, MMS, nonmelanoma skincancer, basal cell carcinoma, squamous cell carcinoma, illness narrative Who knows/ whose nose/ needs Mohs? E. Dorinda Shelley Introduction: Dermatologists see patients with nonmelanoma skin cancer on a daily basis. Certain tumors, especially those around the nose, ears, and eyes are best handled with micrographic surgery (aka, … Continue reading
Imaging Ioxides II
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
Imaging Ixodes Scapularis
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!
Mirror Amputation for Acne Excoriee de Jeunes Filles
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
Observations on Cutting
by Christina Perron Abstract: Non-suicidal self-injury is thought of as a disordered emotional coping mechanism. This phenomenon is gaining increasing attention in the psychiatric and lay literature as it often is a harbinger of significant ongoing life stressors, a marker of adverse childhood experiences, and/or a manifestation of psychiatric disease. Dermatologists investigate and treat diseases of the skin and are therefore often privy to a patient’s closely guarded stigmata of self-harm. A fourth-year medical student questioned how best to care for this patient population in the outpatient dermatology clinic. A review of the current dermatologic literature proved largely silent on this subject. A dermatology clinic visit may represent an ideal, … Continue reading
