News

A new study suggests that less frequent post-treatment monitoring visits for melanoma patients makes only a small difference in the modeled delay of diagnosis of recurrence or new primaries.

The U.S. Preventive Services Task Force is urging physicians to appeal to vanity when counseling young people about the risks of overexposure to UV rays.

The Food and Drug Administration has approved the hyaluronic acid-based filler Belotero Balance (Merz Aesthetics) for the correction of moderate-to-severe facial wrinkles and folds, the company announced.

On The Web : Online scheduling, payment options offer convenience, ease paperwork Viral Villain : HPV strain plays role in SCCs; research suggests vaccine possibility Special Report : The aging patient

Nails undergo a significant number of changes in elderly patients, including discoloration, increased curvature and a 40 percent reduction in the growth rate, according to Richard K. Scher, M.D., professor emeritus, dermatology, Columbia University, New York, and the University of North Carolina, Chapel Hill.

Many older women frequent the nail salon, undergoing gel nail manicures that are very popular now. For a gel nail manicure, a gel polish has to be heat ultraviolet-cured between each layer of polish. There are advantages and disadvantages to this relatively new type of polish.

Practicing physicians are allowed to exercise their professional judgment and prescribe approved drugs for unapproved, or off-label, purposes. Physicians have been judicially accorded broad and unconstrained prescribing authority for years; "off-label" simply means that a drug is being used or prescribed in a manner inconsistent with its FDA-approved indication.

As filler products change, so do the aesthetics that guide their use, says Heidi A. Waldorf, M.D., director of laser and cosmetic dermatology, Mount Sinai School of Medicine, New York. "The modern approach to soft-tissue augmentation is based on a three-dimensional approach rather than the old two-dimensional approach," Dr. Waldorf says.

Razor blade design is a carefully studied science. There is no substitute for a well-designed blade in obtaining the optimal shave. Old razor blades or blades that have been dropped or exposed to solvents are permanently damaged and cannot deliver a quality shave.

Preliminary results of a study evaluating biopsy specimens obtained from mature burn scars pre- and postfractional CO2 laser resurfacing show histologic changes that are consistent with the clinical improvement achieved, but further data is needed to understand the mechanisms leading to normal skin regeneration, reported David M. Ozog, M.D., at the 2011 annual meeting of the American Society for Laser Medicine and Surgery.

Botulinum toxins, fillers and lasers are all powerful Aesthetic tools commonly used for rejuvenation. These modalities may also have use in some cases where reconstruction of postsurgical scarring is desired, according to a Denver dermatologist.

Venous leg ulcers are fairly common in the elderly population - 5 to 10 percent of seniors will experience them - but dermatologists can take steps to better diagnose, treat, manage and even prevent them, according to one expert.

Analyses of data from two large, prospective, phase 3 studies investigating ustekinumab (Stelara, Janssen Biotech) for the treatment of moderate-to-severe plaque psoriasis are consistent in demonstrating the safety and efficacy of restarting the biologic if treatment is temporarily interrupted.

The good news is that the battle over the budget in Washington has opened the door to serious consideration for reforming the formula used to pay physicians under Medicare. The bad news? Proposals being considered to pay the tab could bring considerable pain.

I have always looked for evidence of volunteerism on the applications of every candidate seeking a residency training position in dermatology. I've found that medical students who make the effort to volunteer their time to help someone in need truly make the best residents. They are generally caring, thoughtful individuals who recognize that the special gifts they have been given deserve to be "paid back" to society in some way.

Injectables do not replace rhinoplasty, but they offer a viable alternative for those interested in nasal reshaping who are unwilling to undergo surgery, say Vince Bertucci, M.D., and Jean-Fran?ois Tremblay, M.D.

A new experimental oral medication known as Purpurex (New Vitality) is effective in improving and even clearing the appearance of senile purpura, while helping to prevent new lesions from occurring, according to a recent study.

Thinning hair is often a result of the aging process, and it affects both men and women in their later decades, usually around age 60, according to Vera Price, M.D., F.R.C.P.C., professor of dermatology, University of California, San Francisco.

A survey by Merritt Hawkins found that patients wait 22.1 days on average to see a dermatologist, with waits ranging from 3.4 to 104.4 days, depending on the geographical location. Physician assistants and nurse practitioners offer dermatologists an excellent way to expand their availability to more patients, but the value of these advanced practice providers goes well beyond scheduling.

The surgical removal of the lymph nodes in patients who are found to have positive nodes after undergoing sentinel lymph node biopsy (SLNB) improves survival, compared to patients who have melanoma spread to lymph nodes when the disease is large enough to be felt with a physical examination, according to a surgical oncologist.

Research in transgenic mice has demonstrated that expression of oncogenes E6 and E7 from a cutaneous beta human papillomavirus (HPV38), coupled with UVB exposure, results in high rates of nonmelanoma skin cancer. Neither factor by itself was sufficient to generate tumors in the animals.

Solar lentigines are common in the aging patient, with 90 percent of Caucasians over age 60 having the condition. Even those who diligently used sunscreen may experience lentigines, because most sunscreens don't block all UV waves.

Nonsurgical treatments offer an alternative approach when surgical options are not optimal for treating certain cases of nonmelanoma skin cancer in elderly patients, according to an expert. Topical and oral medications are useful if skin cancer is in a delicate area, enabling clinicians to eliminate the tumor or shrink it so it can be removed surgically.

The CellSearch system (Veridex LLC) is an in vitro circulating-tumor-cell test that has shown to be of use in the management and treatment of patients with breast, colorectal and prostate cancers. Now, the system is finding its way into dermatology and may prove useful in the treatment and prognosis of melanoma.

Jessica J. Krant, M.D., M.P.H., says one of her goals at her Fifth Avenue, New York, dermatology practice is to go totally paperless. So she has implemented several online options - including appointment booking - that not only eliminate paper, but also help streamline the office's workload. "Patients love it," she says.

Superior service doesn't just happen. Experts say it requires having a proactive plan for an element of medical practice that many physicians unfortunately overlook. As physicians, says Victor J. Marks, M.D., "Service is what we do. We don't make or grow anything. We serve other people."

The Department of Health and Human Services is proposing a new rule that would allow patients to have direct access to their lab test results. The tests that dermatologists send, such as biopsies, can indicate serious medical conditions. On Call asked dermatologists around the country what they think about patients being able to access their lab results directly, without the benefit of the physician's knowledge and experience to interpret their meaning.

Findings from a study examining an association between dermatologist density and melanoma mortality suggest that better workforce distribution may lead to a population-level improvement in mortality related to this malignancy, reported researchers at the 2011 annual meeting of the Society for Investigative Dermatology.

In the elderly population, the sources of itching are the same as those affecting anyone else, but the causes of their discomfort are usually exacerbated by age, according to Jeffrey Bernhard, M.D., a dermatologist who practices in Worcester, Mass.

Tanya Kormeili, M.D., was 3 years old when the Iranian Revolution began to unravel her family's life. As pro-democracy Jews living in Tehran, the Kormeilis experienced an erosion of their freedoms with each year of the Ayatollah Khomeini's reign.