The Melanoma Epidemic: Reflections on a Creature We Have Made

In the end, we are dependent on the creatures we have made. Goethe By David J. Elpern Abstract: I believe that the current melanoma epidemic is mostly an artifact of aggressive promotion by dermatologists, dermatopathologists and oncologists. For decades the death rate from melanoma has stayed constant, while the rate of diagnosis has soared. Promoted screenings, diagnostic drift, and the dermatoscope are causing physicians to pick up indolent lesions that are unlikely to kill. These, in turn, cause unwarranted, anxiety in the public and providers. When the dermatological establishment started the war on melanoma in the 1980s it had no idea where it would lead and at present we are … Continue reading

Preprint Opportunities: Dermatology and Medical Humanities

Preprints and Post-Publication Peer Review by David J. Elpern We are creating two Preprint Repositories that will help some authors. dermatolRxiv.com and medhumRxiv are free online archives for finished but unpublished manuscripts (preprints) in dermatology and the medical humanities. Preprints are preliminary reports of works that have not been certified by peer review.1 The so-called major dermatology journals are the domain of academic dermatologists, some of who are bedfellows of pharmaceutical companies (PhRMA).   These major American dermatology journals, in particular, are heavily dependent on lucrative PhRMA ads. We envision dermatolRxiv.com and medhumRxiv as resources for clinical dermatologists and others who are not vassals of PhRMA or academic medicine to publish … Continue reading

Dr. Arrieta’s Lesson: Have We Lost Something in the Gain?

by Ariana Shaari* A global pandemic transformed the way medical care is delivered nearly overnight. Telemedicine, generally defined as healthcare delivery without face to face contact, has crucial applications in the fight against Coronavirus – facilitating social distancing, easing the burden on physicians, and increasing accessibility to care, especially for providers and patients without adequate personal protective equipment (Luz, 2019). Telemedicine had a robust foundation before the pandemic and was quickly adopted to preserve crucial aspects of healthcare delivery. It’s roots are in the 19th century, when a physician first conveyed electrocardiographs over the telephone (Ryu, 2010). In the 1920s, radio consultations were used to provide medical care to patients … Continue reading

Skin, Social Media, and the Psyche of Kids

Emily Burns, BA1* Pauline Berens, BA, BS1 1Baylor College of Medicine, Houston, Texas *Corresponding author: Emily.burns@bcm.edu Keywords: skin harm, pediatrics, social media, psychosocial, adolescence, skin disease, acne Conflict of Interest: None Informed consent: Not applicable Abstract: Most U.S. teenagers use at least one form of social media. Social media usage in children has been associated with both positive and negative psychological effects. One contributor to the negative psychological impact of social media is cyberbullying. Children with skin conditions are more likely to be bullied by their peers. Consequently, children with skin conditions could be disproportionately impacted by increased social media use and the potential psychosocial sequelae. Further research is needed … Continue reading

The Preprint Revolution

When we established OJCPCD in 2012, we rejected the concept of peer review.  “Peer review, as it exists today, is an impediment to creativity and keeps many authors away from scientific publication while it serves as a filter to allow Editorial Boards’ gate-keepers to facilitate their academic cronies in getting their work into print.  We, at the Online Journal of Community and Person-Centered Dermatology are embracing a “post-publication ‘peer review’ model that is fair to all and will give voice to a more interesting and varied collection of articles.” (1) “The ultimate goal should be: free, instant scientific publishing Free instant publishing: Once open post-publication peer review provides the critical … Continue reading

A Case of Aphantasia

By Dustin Grinnell In this short story, a fictional technology gives a man the ability to visualize anything in his mind’s eye. With an increasingly stronger imagination, the man struggles to stay in the real world and must rely on family to free him from the grips of his own mind. A few years ago, I began treating a thirty-five-year-old man, whom I will refer to as Theodore. Theodore had a rare and only recently discovered condition known as aphantasia, which left him unable to visualize images in his mind. For example, if Theodore closed his eyes to visualize a sunset, he saw only blackness. About two percent of the … Continue reading

Tattoo

a poem by Nat Mulkey* Sharp pain greets my shoulder My shoulder sighs, This again. Your hand has a flag, Of your country The IV at the center, poorly placed Covers it in blood. I wince, breathless Skin getting red and raw This one is bigger than the last Only halfway done. Near your ribs in calligraphy Names of your children Pulsating above your Nervous heart. Hours pass The outline is complete. Shading and color still to do Anticipation My hand trembles. A finger drags along your abdomen That is where they will cut And enter your body. Your hand reaches I needed this To stay, feel alive My voice … Continue reading

The Doctor Gets a Skin Biopsy

by Tabor  Flickenger That’s me burning, that smell A touch of cautery here and here to halt the blood I have wielded the needle and knife Now it’s my turn to receive I wash my hair kneeling In mute supplication Remove the dressing later, as instructed. A little dried blood. Three neat blue sutures. Not so bad. Not so bad. I almost forget with my eyes closed Till my fingers brush the prickly alien patch Worry repressed is not banished But descended, pushed down into the bowels Frayed nerve ending pulse, twist, shudder I work like all is normal. I tell no one. I care for others’ pain and push … Continue reading

Melanocytic

by Rebecca D. Hamburger A mole appeared on my back a few years ago, in my early twenties. I cannot be sure exactly when as it is only visualized by mirror and neck contortion. It has been evaluated numerous times by a trusted dermatologist as a benign melanocytic nevus, and I was advised to keep a watchful eye on it. The anxiety which surrounds this decidedly harmless lesion, exaggerated in the painting, morphs into a physical symbol of all the other anxieties in my life. The green hills of jealousy toward others’ achievements as I navigate medical school, the flowery pattern symbolizing the positivity and happiness which I often mask … Continue reading

A Night in a Canadian Emergency Room

by James Channing Shaw, MD* Key words: Single-payer, Canadian Healthcare, Medicare-for-All, U.S. Healthcare, Medicare, 2020 After practicing medicine in the United States for over twenty years, I moved to Toronto for professional reasons. One summer evening two years after our arrival in Canada, I developed chest pain, and being an experienced doctor, I ignored my own symptoms, thinking that certainly I was too young to be having heart disease. By 1:00 a.m. the pain had worsened and was travelling down my left arm so I figured it would be unwise to delay any longer. At 2:00 a.m. my wife and I arrived at a modern emergency department in the center … Continue reading

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