Health Anxiety in Dermatology

Patients see doctors with varying degrees of concern regarding their health. While some require tests or treatments, a subset has severe health anxiety and cannot be reassured by tests, procedures, or pharmaceuticals but may be helped, at least temporarily, by a sympathetic listening face and reassurance. Hence, we designed a questionnaire to investigate health anxiety in patients recruited from a general dermatology clinic. The study was reported in the International Journal of Dermatology and can be accessed at this pdf: Health Anxiety in Dermatology

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MUDS: In Search of Medically Unexplained Dermatological Symptoms

by David J. Elpern, M.D. Medically unexplained symptoms (MUS) are relatively well-known in the literature but not discussed in any dermatology journal. A recent book, Is It All In Your Head?: True Stories of Imaginary Illness, by by the neurologist Suzanne O”Sullivan is a readable and accessible resource. While studied in primary care, neurology and rheumatology, our PubMed review found no mention of medically unexplained symptoms in a major dermatology journal. Yet two surveys conducted in my office, each of of 100 consecutive dermatology clinic patients, found that ~ 20% had some form of MUDS. This rate is congruent with the estimated prevalence of MUS.  It appears that MUDS are … Continue reading

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Spirituality in Dermatology

by Jorge Ramon and David J. Elpern This article was published in the July 2017 Archives of Dermatology Excerpts: Spirituality is difficult to define, but a recent consensus conference defined it as the aspect of humanity that refers to the way individuals seek and express meaning and purpose. Spirituality is understood by many as a means by which one copes with chronic or life threatening illnesses. While some people may not believe in a specific faith, many are interested in spirituality. Coming to grips with each individual patient’s spirituality requires a broad understanding of the person’s beliefs and values. Christina Puchalski’s FICA Spirituality History Tool1 can be a guide to … Continue reading

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Towards Continuous ‘Medical’ Inspiration

by David J. Elpern, M.D. Abstract: Physicians waste too much time mired in our pedantic and mediocre professional literature. There is no way one can keep up with it and most of the articles are forgettable and sadly will prove to be inaccurate. It is better to spend time with the arts (literature, music, fine art, film) that are more important to one’s personal and professional development. They provide the Continuous Medical Inspiration that trumps Continuing Medical Education. Keywords: medical education, canon, personal canon, literature, fine art, music, William Osler, medical literature, CME Each week physicians and other caregivers peruse their professional literature.   We also gather regularly at Grand Rounds … Continue reading

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Isotretinoin on a Global Scale

In the end, we are dependent on creatures we have made. Goethe  Isotretinoin and iPledge  on the Global Stage by Ava Atri, B.A. and David J. Elpern, M.D. Keywords: isotretinoin, regulation, iPledge program, teratogen Introduction Isotretinoin has revolutionized the treatment of acne since it was approved by the U.S. Federal Drug Administration in 1982. Because it is teratogenic, some countries rigorously regulate its prescriptions.  In the United States, prescribers and patients must comply with the iPledge Program in order to write or fill isotretinoin prescriptions.1  A chance discussion with a colleague from Iran, where isotretinoin can now be purchased without a prescription, led us to survey a number of other … Continue reading

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Dermatology Mondays: On a Global Scale

“Find a job you enjoy doing, and you will never have to work a day in your life.” ― Mark Twain  Dermatology Mondays: On a Global Scale Omid Zargari, M.D.1, David J. Elpern, M.D.2, Gregor Jemec, M.D.3 Dana Clinic, Rasht, Iran, E-mail: ozargari@gmail.com The Skin Clinic, Williamstown, Massachusetts, USA Roskilde Hospital, University of Copenhagen, Denmark Key Words: Epidemiology, skin cancer, psoriasis, acne Funding source: None That’s when I first learned that it wasn’t enough to just do your job, you had to have an interest in it, even a passion for it. ― Charles Bukowski Each Monday, as physicians, we start our “work week.” If one happens to live in Iran, … Continue reading

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Notes from Cushing’s Life of Osler

Some years ago, a friend gave me a copy of Harvey Cushing’s The Life of Sir William Osler. He knew I admired Osler but had read little of his work. My colleague had sought the tome out in a used bookstore, for it has been out of print for many years. Somewhat reluctantly, because of its forbidding length, I waded into the volume and was swept away by the elegance of both Cushing and Osler’s writings. You may be interested in perusing the For the document, go to From Cushing’s Osler

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