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Moderator: What is ringworm, and do you find it to be seasonalin nature?

Q&A/ROSACEAAlbert Kligman, M.D., Ph.D., is a pioneer who continues to break new ground in dermatology. Dialogue with a Mentor is brought to you by an unrestricted educational grant from Galderma Laboratories, LP.

Washington - Etanercept can be safely administered to AIDS patients with difficult-to-treat inflammatory conditions, according to Robert Wallis, associate professor of medicine at UMDNJ-NJMS, who presented a poster at the February 2004 AAD meeting describing results of a Phase I trial conducted in Kampala, Uganda. "There does not appear to be a substantial risk that either opportunistic infections or HIV disease will be deleteriously affected by this treatment," said Dr. Wallis.

Washington - Sensitive skin is much more common among persons with rosacea compared to the general population, but even those rosacea patients with confirmed heightened skin sensitivity are likely to tolerate application of azelaic acid 15 percent gel (Finacea), according to the results of a prospective study undertaken by Zoe D. Draelos, M.D.

Washington, D.C. - Of the approximately 19 cases of linear atrophoderma of Moulin described in the literature; all of them presented in children or young adults less than 20 years of age -- until, perhaps, now. Gina C. Ang, M.D., and colleagues at Philadelphia's Jefferson Medical College, may have identified the first case of congenital linear atrophoderma, or at least the first one to come to the attention of the medical community.

Washington, D.C. - A unique case report of necrobiosis lipoidica (NL) within coronary artery bypass graft scars presents the dermatologist with the ongoing challenge of managing an ever-present skin disorder that denies therapy, according to Shannon Heck, M.D.

Washington, D.C. -- This year's AAD meeting included a presentation of the first reported success of etanercept in treating a particularly problematic case of palmoplantar psoriasis. The patient, a 59-year-old white woman, achieved almost total clearing of her hands, notable improvement of her feet, and resolution of her arthritic symptoms.

Q. In order to have more money available for my own personal investments, I first need to improve on our collections in the practice. Any suggestions?

The following article was reprinted with permission from Medical Economics magazine, another of Advanstar Medical Economics Healthcare publications. Weiss is senior editor of Medical Economics. For more information on the article, please visit Medical Economics MagazineYour receptionist lets you know that a Dr. Smith is on the phone, and he's checking the references of Jane Miller, a former staffer. You and your employees are thrilled that Jane no longer works for you. She was chronically late, sloppy, rude to patients, and was about to be fired when she quit, ostensibly for family reasons, about a year ago. "What should I tell him? Do you want to talk to him?"

I spend about two months a year away from my office attending meetings and vacationing. Often I am many time zones away, where I want to avoid the cost and inconvenience of phoning home to the office every day. Some of my staff are not regular users of e-mail, and it is not practical to train them for occasional use of my office email system.

Washington -- Not only do moisturizers with niacinamide provide temporary relief to patients with sensitive skin, they also appear to make sensitive skin less sensitive, said Tracy L. Grosick, principal researcher, skin care product development, Procter & Gamble, Cincinnati. Grosick presented these clinical trial findings at the annual American Academy of Dermatology meeting.

Washington - Much can be done to help patients who have any of the various types of alopecias, and dermatologists should be more willing to invest time and energy into diagnosing and treating the condition.

Q. What are the pros and cons of permanent cosmetics?

Washington - Sensitive skin is much more common among persons with rosacea compared to the general population, but even those rosacea patients with confirmed heightened skin sensitivity are likely to tolerate application of azelaic acid 15 percent gel (Finacea), according to the results of a prospective study undertaken by Zoe D. Draelos, M.D.

Human BioSystems (HBS), a Palo Alto, Calif., biomedical company conducting research to extend the shelf life of blood platelets and donor organs, announced that it finalized a purchase agreement to acquire all rights to a skin-cream product previously developed for severe burns.

Connetics Corp. has received notifications from the FDA that no user fee is required for the new drug application seeking marketing clearance for Extina (ketoconazole 2 percent) Foam. Previously, Connects announced positive results from its Phase III clinical trial with Extina versus Nizoral.

Dermik Laboratories has launched a medical information resource devoted to conditions involving the skin, hair, and nails. www.skinhealthsolutions.com offers direct and simple access to nearly 300 Web sites at no cost to the visitor. The portal contains an extensive range of targeted information about skin, hair, and nails provided by physician groups

A drug used to treat skin infections including athlete's foot, could help to slow the progression of Alzheimer's disease, scientists say.

Chemicals from underarm deodorants and other cosmetics can build up inside the body, according to a study. British researchers have found traces of chemicals called parabens in tissue taken from women with breast cancer.

Akron, Ohio - Maggot debridement therapy (MDT), a controversial, but reportedly effective wound-healing technique, has attracted a following abroad in recent years, and is now gaining interest in the United States, as well. MDT is the medical use of live maggots or fly larvae for cleaning non-healing wounds. "MDT has been around for centuries -- so it's certainly not new, but there has been a resurgence of interest," said dermatologist and wound-care specialist Elliot N. Mostow, M.D., of Wound Care Associates of Akron (Ohio).

Waikoloa, Hawaii - Topical treatments for actinic keratosis can attack the problem internally and externally because of varying mechanisms of action, said James Del Rosso, D.O., as he reviewed advances in AK therapies Hawaii Dermatology Seminar.

Washington, D.C. - There are several clinical variants of Kaposi's sarcoma (KS), and appropriate treatment and response to treatment differ according to the clinical variant, according to Katie Pang, M.D., a clinical research fellow working with Dr. Stephen Tyring at the Center for Clinical Studies in Houston, Texas. The four major clinical variants are classic KS, KS in iatrogenically immunosuppressed patients, AIDS-related epidemic KS, and African endemic KS. HHV-8 is the etiological agent of all of the clinical types of KS.

Washington - A novel thermophobic foam containing three active ingredients to fight dandruff is at least as effective as standard anti-dandruff treatment, and offers the advantages of a non-greasy formulation that is fast-acting and not irritating to the hair or scalp, according to Massimo Milani, M.D., the medical director and head of technology and development at Mipharm SpA in Milan, Italy.

Waikoloa, Hawaii- When counseling rosacea patients on routine skincare products, the dermatologist's main mission is to keep the skincare simple and thus avoid the irritation that triggers an exacerbation of rosacea, according to Zoe D. Draelos, M.D.

Waikoloa, Hawaii - Psoriasis patients report a dramatic improvement in their quality of life when they are treated with a biologic therapy, according to Alexandra B. Kimball, M.D., M.P.H.

Miami - Atopic dermatitis (AD) can be challenging to diagnose even for the seasoned dermatologist because it mimics other common skin diseases in the pediatric population. It also can be challenging to treat, with the addition of new agents on the market. There are key points to consider when making the diagnosis and tried-and-true methods of treatment to keep in mind when recommending therapies to parents and their children, according to Bernice Krafchik, M.D., dermatologist, and professor emeritus at the University of Toronto.

Boutique. Concierge. Express service. There are a variety of names but the end result is the same: patients pay an annual retainer, and for that money - usually between $1000 to $2000 - patients receive a variety of special services: a smaller patient base which allows for no-wait appointments, longer appointments, and quicker return phone calls. It probably can not be called a trend yet, but a number of physicians around the country have dropped Medicare and others have stopped accepting managed care. Now, this new twist is being added - personalized medical care - for a fee.

Washington - The standard multi-drug therapy for multi-bacillary leprosy (MDT-MB) recommended by the World Health Organization proved effective in treating patients with Lucio's phenomenon, a rare necrotizing reaction sometimes seen in patients with Lucio's leprosy, according to Luna Azulay-Abulafia, assistant professor of dermatology at the Universidade do Estado do Rio de Janeiro and at the Universidade Gama Filho, Brazil. At the February American Academy of Dermatology annual meeting, Dr. Azulay-Abulafia described two cases of Lucio's phenomenon in Brazilian patients with Lucio's leprosy successfully treated with MDT-MB, with no need for systemic therapy with corticosteroids or thalidomide.

Washington - Langerhans cell sarcoma is a rare neoplasm that can involve multiple organs, including lymph nodes, bone, lung, bone marrow, skin, and brain. A single, cutaneous tumor is an unusual primary presentation, said Tammie Ferringer, M.D., dermatopathology fellow at the Medical University of South Carolina.

Washington - Cryosurgery should be offered as a treatment option for a variety of skin cancers because it is an effective modality with numerous advantages, said Gloria F. Graham, M.D., at the annual meeting of the American Academy of Dermatology.