On Infomercials and Experimercials

Dr. Bernard J. Carroll, an academic psychiatrist, died on September 10, 2018. His work demonstrated that the psychiatric drug literature had become so polluted as to be virtually meaningless, He called most drug trials “infomercials.” See his NY Times Obituary. Over the years, I have observed in my specialty, dermatology, the same is true. The Biologics are being aggressively and venally marketed. The result is that Humira, with sales of $18.5 billion in 2017, is the top selling drug in the world thanks to AbbVie’s multi-pronged marketing strategy. Where are the other Dr. Carrolls in medicine? Does dermatology have one? So many of our academic “stars” have been co-opted and feed … Continue reading

Medically Unexplained Dermatologic Symptoms (MUDS): Hiding in plain sight?

By David J. Elpern, M.D. J Eur Acad Dermatol Venereol. 2018 Jul;32(7):e265-e266 Keywords: medically unexplained symptoms, somatoform disorders, symptoms, illness, disease Illness is not the same as disease. Illness refers to “the innately human experience of symptoms and suffering.”1 Disease “is what the practitioner creates in recasting illness in terms of theories of disorder.” A person’s subjective experience of how she feels may not assume an underlying pathology. Illness can be organic, psychological or spiritual. A person can feel ill, but not have a disease. Consider Sara (not her real name), a 31-year-old social worker who sought dermatological care for a seven-year history of painful vulvodynia and generalized pruritus. Her … Continue reading

In Full Bloom

Anita Gade, BA; Cassandra Johnson, MS; Nikhil Anbarasan, BS; Matthew Apicella, MS Keywords: Art, Nature, Pleomorphic Lipoma, CTCL, dermatomyositis, IgA Pemphigus, Varicella, Tuberosclerosis, Pityriasis Rosea, Basal Cell Carcinoma, Erythema Gyratum Repens, SLE, Alopecia Areata, Melanoma, Pseudomonal Pyoderm Springtime evokes a sense of revitalization. Sprouting plants emerge from fertile soil nourished by rainfall and sunshine. Blades of grass sway in the cool breeze, synchronizing with the melody of birds chirping. The essence of spring, exquisitely captured by revolutionary American writer Harriet Ann Jacobs (1813-1897) in her autobiography Incidents in the Life of a Slave Girl1: The beautiful spring came; and when Nature resumes her loveliness, the human soul is apt to … Continue reading

My Illness Narrative: the Autopathography Project

You may have a complex health problem that doctors have not solved. When you enter a new doctor’s office, a perky young person at the reception area asks who referred you and then requests your insurance cards. Next, you will be given numerous forms to fill out. Then you are seen by an assistant who records your weight, blood pressure, pulse, and even the oxygen saturation from a fingertip. Finally, the physician or his “extender” sees you for 10 – 15 minutes, at least half of which time he is focused on your electronic medical record. After this ceremony, what does the medical professional know about whom you are and … Continue reading

A Pioneer of Dermatologic Literature

Jake Gibbons, B.S., Tyler Marion, B.S., M.B.A. Keywords: Geronimo Mercuriali; scabies; medical history; pharmacology; skin disease; humanities In 1572, Italian physician Geronimo Mercuriali, Hieronymus Mercurialis in Latin, published De morbis cutaneis.  This storied book, whose title translates to “On Diseases of the Skin,” is the first published manuscript dedicated to diseases of the skin.1 In this work, Mercuriali outlines various dermatologic diseases, describing the physical manifestations of such conditions and proposing various homemade, therapeutic concoctions. Born to a working-class family in Forli, Italy in 1530, Geronimo Mercuriali spent his early life learning Greek and philosophy. As a young man, he studied medicine in Padua, Italy before returning to his birthplace to … Continue reading

Skin Stretching

Tyler Marion, B.S., M.B.A., Kevin Cao, B.S., Jorge Roman, M.D. Keywords: Skin stretching; Lip plates; Skin modification; lip stretching; beauty; Mursi. Skin stretching, as a form of body modification, has been used for centuries across many different cultures. Ear lobe stretching in particular dates back roughly to 1500 BC in ancient Egypt, Central America, and South America.1 The stretching of earlobes has been seen in many different tribes including the Aztecs, Mayans, and Asian Hill tribes. This form of skin stretching was even used by King Tutankhamen, an ancient Egyptian pharaoh.2 A unique variation of skin stretching can be observed in Africa amongst the Mursi, Chai, and Tirma tribes in the form … Continue reading

What Matters to Me: Investigations in a Dermatology Practice

Nothing about me without me.  What Matters to Me: Investigations in a Dermatology Practice By Hope Mendez and David Elpern, M.D. The Skin Clinic, 12 Meadow St. Williamstown, MA 01267 Corresponding author: David Elpern djelpern@gmail.com Abstract: We surveyed 125 consecutive patients in a dermatology clinic in rural Massachusetts in the attempt to learn what matters most to them in their interactions with providers and the health care system. Keywords: patient-doctor communication, patients’ rights Introduction: We were first made aware of to this subject by a prescient article in the British Medical Journal by Sosena Kebede.1 When patients see providers they are rarely given the opportunity to communicate what they they … Continue reading

Delusions of Infestation/Morgellons

Presented at Hot Spots in Dermatologgy Kahuku, Hawaii August 18, 2018 by Lauren Claypoole, MS1, John A Burns School of Medicine (University of Hawaii) My presentation is called “Delusions of Parasitosis/Morgellons>  When I was at college, I was able to shadow a dermatologist for a month. He suggested I present two once-in-a-blue-moon cases that I observed at the clinic. Both patients taught me about the intricate crossover between the fields of dermatology and psychiatry, that I believe contributed significantly to my choice to be a psychology and neuroscience major shortly thereafter. Full Talk: Delusions of Parasitosis/Morgellons

Hot Spots Presentations

    Kahuku, Hawaii August 17 – 19, 2018 Presentations in Alpha order by Speaker Where Column # 4 has a “Y” the handout is at www.ojcpcd.com Bintliff, Shay surfdoc@aloha.net On Retirement Y Claypoole, Lauren claypoole.lauren@gmail.com A Student’s Introduction to Delusional Parasitosis Dann, Frank zitdoc@hotmail.com As I’ve Seen it over Four Decades Elpern, Dave djelpern@gmail.com Who Was Michael Balint? Y Esaki, Paul paulesaki@gmail.com Flying solo with a complex patient Glamb, Roman rglamb@straub.net Paraneoplastic Pemphigus a Platform to Bloviate Goo, Alana alanagoo@hawaii.edu Flying solo with a complex patient Ing, Malcolm malcolmingmd@hotmail.com Dr.Edmund  Ing: Expertise and Community Service In Hawaii Y Johnson, Douglas dwj808@gmail.com Western Samoa, 2018 Johnson, Evan ewjohn127@gmail.com Navigating the … Continue reading

Hot Spots in Dermatology 2018 Syllabus

August 17 – 19, 2018 Turtle Bay Resort Kahuku, Hawaii   Thursday, August 16: 6:00 pm.  Get together at The Johnson’s Cabana 6:00 Friday, August 17: 8:00 am Registration and Breakfast 8:30 a.m. – 12:30 p.m.  Plenary Sessions 8:30 – 9:20 a.m.  Clinical Pathological Cases (Marianna Karewicz, Kumar, Rademaker, and others) 9:20 – 9:30 Michael Webster. Radiotherapy Update 2018 9:30 – 10:00: Marius Rademaker.  “How I use isotretinoin” 10:00 – 10:30 Bhushan Kumar. “Non-venereal genital dermatoses” 10:30 – 10:45 Refreshment Break 10:45 – 11:15  Malcolm Ing. “Dr.Edmund  Ing: Expertise and Community Service In Hawaii” 11:15 – 11:45  Alan Katz “Antibiotic resistant N. gonorrhoeae: an urgent public health threat.” 11:45 – … Continue reading

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