American Mohs

Brett W. Will, David J. Elpern, Roy C. Grekin, Douglas W. JohnsonCorresponding author, BWW Abstract Over 80 years ago, a medical student conceived of a novel approach to remove difficult-to-treat nonmelanoma skin cancers.  The procedure, called Mohs Micrographic Surgery (MMS), has been refined over the ensuing years and now large numbers of practitioners provide the service.  As the indications have continued to evolve and enlarge, the appropriate use of MMS needs to be addressed.  We look at the history of MMS since its inception and present questions that clinical dermatologists are asking. Most importantly, is MMS overused and if it is, should precautions be taken to temper its overuse? Introduction … Continue reading

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Cry the Beloved Specialty

by David J. Elpern, M.D. presented in shorter form at the Lown Institute Conference, Washington, D.C. April 9. 2018 Every peddler praises his needles. Portuguese proverb In November 2017, the NY Times published an expose about the current state of dermatology.1 It documented bizarre instances of over-diagnosis and over-treatment that are driven by ignorance and greed. Over the past 40 years, I have witnessed these changes in my specialty and am dismayed by the reluctance of my colleagues to address them. This trend began in the early 1980s when the Academy of Dermatology (AAD) assessed its members over 2 million dollars to hire a prominent New York advertising agency to … Continue reading

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Dermatology Mondays: On a Global Scale

“Find a job you enjoy doing, and you will never have to work a day in your life.” ― Mark Twain  Dermatology Mondays: On a Global Scale Omid Zargari, M.D.1, David J. Elpern, M.D.2, Gregor Jemec, M.D.3 Dana Clinic, Rasht, Iran, E-mail: ozargari@gmail.com The Skin Clinic, Williamstown, Massachusetts, USA Roskilde Hospital, University of Copenhagen, Denmark Key Words: Epidemiology, skin cancer, psoriasis, acne Funding source: None That’s when I first learned that it wasn’t enough to just do your job, you had to have an interest in it, even a passion for it. ― Charles Bukowski Each Monday, as physicians, we start our “work week.” If one happens to live in Iran, … Continue reading

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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

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