American Mohs: A Critical Review

Authors: Brett M. Will1, David J. Elpern2 MD; Roy Grekin3, MD; Douglas W. Johnson4, MD Affiliations: 1 Medical Student, Georgetown University School of Medicine, Washington, DC; 2Practicing Clinical Dermatologist, Williamstown, Massachusetts; 3Department of Dermatology, Clinical Professor, University of California San Francisco School of Medicine, San Francisco, California; 4Department of Dermatology, The Queen’s Medical Center, Honolulu, HI Keywords: Mohs Surgery, Health Care Costs, History of Medicine, Practice Guidelines as a Topic, Skin Neoplasms Abstract Over 80 years ago, a medical student conceived of a novel approach to remove difficult-to-treat nonmelanoma skin cancers. The procedure, called Mohs Micrographic Surgery (MMS), has been refined over the ensuing years and now large numbers of … Continue reading

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Implicit Bias in Medicine: Case Report and Literature Review

by Kory M. Johnson, Emma Fixen, David J. Elpern, Douglas W. Johnson Mount Sinai Health System, New York, NY John A. Burns School of Medicine, PGY1, Honolulu, HI David Elpern MD: The Skin Clinic, Williamstown, MA University of Hawaii School of Medicine, Honolulu, HI Keywords: implicit bias, explicit bias, immigrant, indigent, psoriasis, lymphoma, healthcare A 46-year-old Micronesian woman with history of severe disabling psoriasis and psoriatic arthritis had been our patient for many years (Figures 1 and 2). Her psoriasis started as an adolescent and had been treated with numerous therapies including topical steroids, phototherapy (sunlight exposure in Micronesia), methotrexate, cyclosporine, acitretin, apremilast, etanercept, infliximab, ustekinumab, secukinumab, ixekizumab, IL-23 blocker, … Continue reading

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