Some may think that being a dermatologist means taking care of the “superficial.” I beg to defer. We spend a great deal of time performing procedures and talking to patients. During our visits, patients share their truth, and open up their hearts to us in meaningful and vulnerable ways.  We hear about their relationships, their work, their fears, and their struggles. We become a part of their inner circle of ...

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Take one-half tablet three times per day with meals, increasing by half each week until reaching a maximum of three tablets three times per day. Did you get a new prescription from your doctor? If so, there is a 50 percent chance you will not adhere to label directions. Either the instructions are too complicated, the drugs are too expensive, you do not like the way the medicine makes you feel ...

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Here is some news about cancer that isn’t widely known and is hiding in plain sight: Deaths from melanoma -- a skin cancer that has lethal potential -- have declined dramatically over the past several years. And while that fact alone is surprising, so is the reason behind the drop. Let’s make something clear at the outset: too many people die from melanoma. It is not the ...

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Global climate change is reaching a critical mass. Since the advent of the industrial revolution, we have seen the global mean temperatures increase by 1°C (1.8°F), and significant steps must be taken by 2030 to mitigate an even larger global temperature increase of 1.5 to 3C as predicted by 2030. In other words, we are in dire need of change. This change is not only reliant on governmental policy change but is ...

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I didn't match dermatology the first time. It was a harrowing experience, and I had a chip on my shoulder until the day I opened my match envelope. The reality is that in the last ten years, dermatology has become the most competitive specialty in medicine. Hundreds of extremely qualified applicants are disappointed each year. Therefore, not matching is not a reflection of one's qualifications as a future ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 40-year-old man is evaluated for a new skin rash of 10 days' duration. The rash appeared abruptly and is not tender or pruritic. The patient has poorly controlled type 2 diabetes mellitus. His current medications include metformin and glyburide. Family history is unremarkable. On physical examination, vital signs are ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 32-year-old man is evaluated for an intermittent pruritic rash of 8 years' duration. Medical history is significant for mild persistent asthma. His only medications are an albuterol inhaler and an inhaled glucocorticoid. On physical examination, vital signs are normal. There is mild xerosis with erythematous plaques on the bilateral ...

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Quick quiz question: two people are diagnosed with melanoma -- Sarah Sunburn, an adamant sun-worshipper, and Paula Pale-All-The-Time, a fanatical sun-avoider. Who is more likely to die of the disease? The answer is pale-faced Paula. Surprised? Let me unpack this mystery and explain why sun exposure simultaneously kills people, while making the cancers they are diagnosed with appear to be less life-threatening. I will start with what you probably know already. Melanoma ...

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Long ago, and far away, I encountered a patient that changed the way I practice. I was with a medical student while examining a middle-aged woman who presented with a dramatic eruption that was probably DRESS syndrome (DRESS syndrome was not yet described). I prescribed prednisone and asked her to come in a few days later so I could assess her progress. She returned – I did not recognize her ...

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Informed consent is the cornerstone of medical ethics. And every physician must defend this sacred principle from every form of evil that would seek to dismantle, degrade and debase it. If informed consent is the sun, then privacy, confidentiality, dignity, and trust are planets that go around it. For without informed consent, the descent of health care into amorality is inevitable, and the doctor-patient relationship is doomed to ruination, oblivion, ...

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