A medical student recently asked my advice on her decision to pursue a career in dermatology. It was about 25 years ago when my own parents encouraged me to pursue this specialty. What was their deal? Perhaps, they anticipated future developments in the field and were hoping for free Botox treatments? As readers know, I rejected the rarefied world of pustules and itchy skin rashes for the glamor of hemorrhoids, ...

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My patient suddenly leaned forward, swung her hair up, and began to push it this way and that, determined to find and show me the partitions that her hair made when rested in a new equilibrium. It was a warm Thursday afternoon and we were in dermatology clinic. This 20-something young professional had come to have her scalp examined. She'd noticed a sudden increase in the quantity of hair follicles that ...

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MedPage Today recently tackled a very controversial issue in medical practice.  The piece explored the ongoing battle between dermatologists and allied health professionals (AHPs) over the performance of dermatologic procedures.  As independent NPs and PAs begin to bill for more and more procedures (thus potentially talking revenue away from board certified dermatologists) specialists are beginning to argue that the AHPs are practicing beyond their scope of practice. According to the 
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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 59-year-old man is evaluated for a 3-month history of intermittent itching on the forearms. He describes the itch as deep, with a burning or tingling sensation. Scratching helps somewhat, but over-the-counter topical corticosteroids have not helped. Cooling the skin soothes the itch. He did not notice a rash until he started ...

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Top stories in health and medicine, August 18, 2014From MedPage Today:

  1. Feds to Withhold One-Third of Sunshine Act Data. Next month, when the federal government releases data about payments to physicians from pharmaceutical and medical device makers, one-third of the records will be withheld because of data inconsistencies.
  2. Derms Want NP/PA Practice Limits. NPs and PAs who bill Medicaid as ...

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Top stories in health and medicine, August 13, 2014From MedPage Today:

  1. CT Images Can Inform Clinical Decisions. The identification of high-risk plaque features using noninvasive CT imaging is a useful and independent predictor of acute coronary syndrome (ACS) in patients presenting to emergency departments with acute chest pain.
  2. Status of Spray Sunscreens Still Uncertain. The FDA has not reached a ...

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Top stories in health and medicine, August 11, 2014From MedPage Today:

  1. Psoriasis Ups Risk of Cancer, Serious Infection. Rates of malignancy among patients with psoriasis outpaced national averages, irrespective of therapy in most cases.
  2. Psoriasis: Screen for Fatty Liver Before MTX? What began as a case of chronic plaque psoriasis has evolved into consideration of routine testing for nonalcoholic steatohepatitis ...

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Today its time to say, Ultraviolet bad“Ultraviolet bad.” That was the core message that came out of the introduction this morning of the Surgeon General’s Call to Action to Prevent Skin Cancer at a meeting held at the National Press Club in Washington DC. There were some other messages that now raise skin cancer awareness and prevention high on the public health awareness list, such as ...

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I’ve always been good at pattern recognition and my visual-spatial orientation is excellent. Photography is my hobby, so it was only natural that as a medical student and internal medicine resident, I loved my dermatology electives.  Each day yielded up a new parade of interesting skin lesions and rashes, and by the end of my rotations I was confident in my diagnoses and recommendations. Contact dermatitis? Steroids!  Eczema? Steroids!  Psoriasis? ...

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I'm impressed by how much we struggle with seemingly simple health decisions when faced with sorting through too much information. Buying sunscreen: It's a simple task, right? Most of us do it every year about this time. And among actions we can take to reduce our risk of cancer in general and skin cancer specifically, this choice is fairly important. So my colleague was surprised to hear this snippet of conversation as she contemplated ...

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