Dermatology Times, May 1, 2005 - DermatologyTimes

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Dermatology Times
Dermatology Times, May 1, 2005
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Cigarette smoke impedes wound healing
By Bob Roehr
Riverside, Calif. — Fifty years after the negative effects of cigarette smoke first became broadly known, doctors are still discovering the magnitude of and mechanisms behind its toxic assault on the body. Dermatologists are particularly interested in discoveries over recent years that cigarette smoke results in premature aging of the skin and decreases blood flow to wound sites, resulting in retarded granulation tissue development and remodeling during wound healing and greater scarring.
Acne quality-of-life scores grow in importance
By John Jesitus
Vancouver, British Columbia — As the sophistication and the number of tools for measuring the impact of acne grow, so might the importance of quality-of-life scores to physicians, patients and policymakers.
Fillers beef-up botulinum results
By Rebecca Bryant
Combination therapy with botulinum toxin and fillers has another benefit: it produces much longer lasting results than either fillers or toxin used alone when used to treat folds and furrows of the glabella.
Acne myths still confuse patients
By Cheryl Guttman
New Orleans — Familiarity with popular beliefs about factors affecting acne is an integral part of managing patients presenting with that dermatologic disease, said Alexa Boer Kimball, M.D., M.P.H., at the 63rd Annual Meeting of the American Academy of Dermatology here.
Modifying your coding
By Inga Ellzey
Most dermatology billers are relatively comfortable (or should be) with the various modifiers commonly used by dermatologists (e.g., -24, -25, -26, -58, -59, -76, -79, -GA, GY, and -TC. Less familiar are modifiers -50 and -52.
Simple approach yields best results
By Bill Gillette
New Orleans — Facial reconstruction does not have to be as complicated a procedure as it might sound, according to Ken K. Lee, M.D., who presented a seminar on facial reconstruction at the 63rd Annual Meeting of the American Academy of Dermatology (AAD) here.
Practical considerations dog biologics
By John Jesitus
The fact that studies are frequently done at different locations, with different investigators and methodologies, further complicates matters.
Growth in cosmetic procedures signals paradigm shift
By John Jesitus
National report — With the number of cosmetic procedures performed nationally rising each year, the line between dermatology and plastic surgery continues to blur as dermatologists devote more time to cosmetic procedures and plastic surgeons embrace less invasive treatments.
What causes seborrheic dermatitis?
By Zoe Diana Draelos, M.D.
What is the cause of seborrheic dermatitis?
Electronic medical records
By Lisa B. Samalonis
New Orleans — Dermatologists can use electronic medical records (EMR) to streamline their office and make it more efficient. However, critical analysis of their individual practice and the selected system are needed to optimize EMR use, according to David L. Crosby, M.D., a dermatologist in practice in Waukesha, Wis.
Sebaceous gland targeting with photodynamic therapy
By Louise Gagnon
PDT involves light-activated drugs, or photosensitizers, to treat cancer, ocular and dermatological conditions.
Skin-healing powers of the Dead Sea
By Lisette Hilton
National report — Ironically, the very properties of the Dead Sea that kill fish and other wildlife offer psoriasis suffers and people with other chronic health conditions significant healing powers.
New class of UV absorbers emerging
By Patty Reiman
New Orleans — An emerging new class of organic, insoluble UV absorbers shows promise in providing improved broad-spectrum UVB and UVA sunscreen protection and meets the increasing demand of consumers and dermatologists, according to chemist Uli Osterwalder. He reports that the first representative of this UV absorber — bisoctrizole — has been used in sunscreens in European countries for five years and is now being submitted to the U.S. Food and Drug Administration (FDA) for approval.
Mosquito abatement, effective repellents key to eradicating West Nile Virus
By Laura Newman
Newport Beach, Calif. — The West Nile Virus outbreak in New York City in 1999 provided important lessons in prevention, abatement and repellent use. The New York area health departments quickly began public health programs, according to Tissa R. Hata, M.D., speaking at the Pacific Dermatology Meeting, here.
Clinical research centers require forethought
By John Jesitus
Scottsdale, Ariz. — In many ways, running a clinical research center is just like running any other business — those without a plan are likely to flounder.
Dermatologist links skin with psyche
By John Jesitus
New Orleans — It's no secret that psychosocial stressors can exacerbate many common skin disorders. So why aren't more dermatologists taking advantage of the mind-body link in their daily practices?
Rhythmic changes influence female skin susceptibility
By Beth Kapes
Orlando, Fla. — Fluctuations in estrogen and progesterone during the menstrual cycle can cause changes to the reproductive system, yet little attention has been paid to how these variations may impact the body's largest organ, the skin.
Chemical peels still have role
By Paula Moyer
New Orleans — Although laser cosmetic procedures have captured popular attention, chemical peels continue to be appropriate for many patients, according to Suzan Obagi, M.D., at the annual cosmetic surgery symposium of the American College of Oral and Maxillofacial Surgeons.
Moist dressings accelerate healing, reduce infection, minimize scarring
By Fred Wilson
Wound care is a significant problem to dermatologists who perform abrasive cosmetic procedures such as dermabrasion, CO2 laser treatment or chemical peeling, according to Henry H. Roenigk, M.D.
Pilot trial: NB-UVB not enhanced by tacrolimus
By Cheryl Guttman
New Orleans — Concomitant topical treatment with tacrolimus 0.1 percent ointment (Protopic, Fujisawa) does not improve the response of generalized vitiligo to narrowband UVB phototherapy, according to the results of a randomized, double-blind, placebo-controlled, pilot study undertaken by researchers at the University of Texas Southwestern Medical Center.
Researchers: Swimming affects skin's hydration
By Lisette Hilton
National report — Recreational swimming in swimming pools results in short-term but significant changes to biophysical properties related to skin hydration, researchers report.
Avoiding Chemicals
By Karen Nash
National report — West Nile Virus caused nearly 10,000 illnesses and more than 250 deaths nationally in 2003, and in 2004 people were looking for ways to protect themselves from the most common mosquito-borne disease in this country. One problem some face is that safety concerns still exist about some of the chemicals designed to deter mosquitoes.
Topical niacinimide reduces sallowness
By Cheryl Guttman
Sallowness was assessed using a digital image analysis technique able to quantify yellow color.
Final phase 3b results demonstrate efalizumab long-term efficacy, safety
By Cheryl Guttman
Efalizumab was probably best administered as chronic therapy to maintain control of this chronic inflammatory disease.
Biologics gaining ground against psoriasis
By John Jesitus
New Orleans — Although some oral treatments for psoriasis have suffered setbacks, recent studies reveal encouraging news about biologic drugs' ability to battle this illness.
Skin regeneration through growth hormone factors
By Beth Kapes
Tokyo — Growth factors offer seemingly endless potential to skin wound repair and regeneration, yet there are several questions surrounding those that are exogenously applied to acute or chronic skin wounds, according to Xiaobing Fu, M.D., professor, Wound Healing and Cell Biology Laboratory, Burns Institute, The General Hospital of PLA, Beijing, China.
Proper asset allocation ensures successful portfolio performance
By William J. Lynott
Keep in mind that there are plenty of successful investors who never own more than a half dozen investments at one time, some even fewer.
Procedural laser knowledge crucial to patient, practice
By Paula Moyer
In order for laser surgery to be a successful component of a dermatology practice, Dr. Obagi encourages her colleagues to become more adept consumers.
Becoming a digital photography pro isn't difficult
By Melissa Heltzel
Creating a photo-friendly environment in each room is simple; all that's needed is proper lighting and background.
SD doxycycline: New rosacea therapeutic option
By Cheryl Guttman
New Orleans — Results of a multicenter phase 3, randomized, double-blind, placebo-controlled trial demonstrate the safety and efficacy of a subantimicrobial-dose (SD) of doxycycline for the treatment of rosacea, said Diane M. Thiboutot, M.D., at the 63rd Annual Meeting of the American Academy of Dermatology here.
No better time to protect AR from malpractice claims
By Fred Johnson, C.L.U. , David B. Mandell, J.D., M.B.A.
Most physicians have significant AR balances that sit on the practice's balance sheet as an exposed asset.
Tacrolimus, UVB therapy synergistic duo
By Cheryl Guttman
Nice, France — Results of a comparative, prospective, randomized study undertaken by French dermatologists indicate that topical tacrolimus ointment 0.1 percent (Protopic, Fujisawa) plus phototherapy with a 308-nm excimer laser can be a highly effective combination for the treatment of recalcitrant, localized vitiligo.
Make URL short, memorable
By Kevin C. Smith, M.D.
My advice to most doctors is to use a domain name ending in .com or .net — these are recognized by almost all members of the public as being proper domain names.
Comparing biologics for psoriasis
By Rebecca Bryant
Making the appropriate choice ... requires having a clear understanding of the benefits and disadvantages of each drug.
Column
Overuse of black box warnings is scare tactic
By Mark G. Lebwohl, MD
As the Vioxx/Celebrex scandal lays waste to the American healthcare landscape as we know it, the U.S. Food and Drug Administration (FDA) finds itself under relentless pressure to get things right. Congress is demanding more stringent safety standards and even threatening to create a new federal agency to take safety approvals and monitoring out of the FDA's hands.
Cosmetic surgery patients: Easy tax targets
By Norman Levine M.D.
The act of taxing a single group of patients who are seeking cosmetic surgery simply because they are easy targets is unfair, injudicious, potentially sexist and wrong.
Derms respond to cosmetic tax proposals
By Karen Nash
The New Jersey legislature instituted a 6 percent sales tax on cosmetic procedures so quickly last fall that doctors say organized opposition had little time to form. The state has been collecting the levy for several months.
Practice blends tradition, innovation
By Lisette Hilton
Patricia K. Farris, M.D., likes the mix that dermatology offers: traditional clinical work, new-fangled cosmetic options and marketing opportunities for services and products.
Will medicare beneficiaries suffer as payments drop?
By Bob Gatty
Washington — Dermatologists and other physicians, as well as Medicare beneficiaries, are in for a shock next year, according to government officials, who announced in late March that Medicare will slash physician payments by 4.3 percent on average in 2006 and impose an $11-per-month premium increase on beneficiaries.
'I am importing cheaper medications from Canada. How can I be in trouble?'
By David J. Goldberg, M.D., J.D.
There is still a natural desire to get the same medications from a cheaper source. Dr. Sue turned to Canada. Other physicians have turned to Europe and South America. But whatever the source, Dr. Sue's actions are illegal.
Cover Story
Breakthrough: scientists put melanoma cells into coma-like state
By Rebecca Bryant
If this research trajectory proves fruitful, he estimates that it will be at least 10 years before dermatologists will be able to use senescence drugs to treat melanoma in a typical practice setting.
News
Environment influences genetic diseases
By John Jesitus
New Orleans — When it comes to studying genetic diseases of the skin, the popular mantra that "It's all in the DNA" doesn't tell the whole story.
UV-filtering contact lenses not protective
By Jane Schwanke
The recent influx of contact lenses containing ultraviolet (UV) filters has prompted some patients to inquire about using these as protection after PUVA therapy, rather than coated prescription glasses, sunglasses or UV opaque protective goggles. But as Suliman Otman, M.D., M.S., a clinical research fellow at the Welsh Institute of Dermatology at Cardiff University, England, discovered, UV-blocking contact lenses are not suitable eye protection for people receiving Psoralen in combination with UVA light.
Emergencies: Be prepared for inevitable
By Beth Kapes
New Orleans — Whether it is serious intraoperative bleeding, the presence of a life-threatening disease or a lethal drug reaction, the dermatologist's office should be prepared for the emergent crisis that can happen at any time and anywhere, Glenn D. Goldman, M.D., says.
New directory at Skin Cancer Foundation
New York — Mary Stine has been named executive director of the Skin Cancer Foundation.
Can CME, experience offset doctors' age-related decline?
By John Jesitus
National report — Does practice make perfect? A recent Harvard Medical School review suggests that as physicians age, the quality of care they provide decreases — the plethora of continuing medical education (CME) options available and the presumed benefits of wisdom notwithstanding.
Artificial skin could mimic normal skin
By John Jesitus
Potsdam, N.Y. — Researchers at Clarkson University are working on a skin substitute that they hope one day will heal and function like normal skin. As such, physicians could use it successfully to treat large burns or areas of surgical reconstruction.
West Nile virus skin symptoms documented
By John Jesitus
New Orleans — Scientific literature rarely portrays cutaneous manifestations of West Nile virus (WNV) because these manifestations are, by nature, transient. However, a recent case report contains what is only the second publication of these symptoms.
Performance pay issue still in infancy
By John Jesitus
Key features of the plan, which the division has been refining over the past four to five years, include sharing profits — and risks.
Conducting clinical trials comes under greater scrutiny
By Lisette Hilton
National report — Clinical research investigators need to be aware of their numerous responsibilities to sponsors, patients, the public and, sometimes, the government. Complying with rules might be more important than ever, given the recent media attention focused on problems surfacing with some medications years after they have been approved and on the market.

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