Skin Wars

by Mr. B. In 2014, I won an insidious lottery: contracting Pityriasis Rubra Pilaris (PRP), a rare skin disease that one in 400,000 people get. After accepting this horrific verdict, I discovered I had a major choice. Do I take high-risk drugs in hope for a cure, after assuming a drug had initially caused my PRP? During the challenge of being alone in my struggle, I fortuitously discovered a special dermatologist. Dr. K respected my concerns about a conventional physician-patient relationship, and he followed my lead in selecting my treatment. The communication and trust we developed led to a slow, minimal treatment that after one year resulted in remission without … Continue reading

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The Dao of the Red Man

by Dr. K. In September of 2014, I saw Mr. B., a 68 years old man, with a wide-spread dermatitis that turned out to be pityriasis rubra pilaris (PRP).  He was miserable with generalized red skin, scaling and painfully thickened palms and soles.  My essay, “The Dao of the Red Man” describes our long and complicated therapeutic journey.  Mr. B. relates his personal PRP struggle  in “Skin Wars.”  The interested reader will learn much from reading and comparing  both Mr. B. and my narratives.  They speak to PRP, the physician-patient dyad, and shared-decision making. The Dao of the Red Man Skin Wars – Mr. B Also see: Skin Wars by … Continue reading

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ODEAR: Most-Favored Specialties

Hi, Dr. Elpern, I am contacting you in hopes that you may be able to assist me in attaining my goal of gaining acceptance to a Dermatology residency, and also to see if you had any advice on how to shine during my dermatology rotations, or any contacts at my away school who may assist me in research opportunities such as case reports/letters. I receive emails like this with regularity.  In the 1960s when I was in medical school, dermatologists were at, or near, the bottom of the physician feeding chain.  Internists, with their haughty demeanors, were the self-proclaimed real brains of medicine and lorded it over most other practitioners.  Radiologists … Continue reading

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Music as Complement to Surgery

Dermatologists perform office surgery almost daily. Our awareness of the growing interest in, and literature on, music as an adjunct in the perioperative period led us to survey the use of music during 100 consecutive office procedures in a dermatology practice.  We found that the effects of music were salutary for patients and the investigators.  Music is a simple, inexpensive, safe and effective adjunct to office surgery. We hope that this report will be of help to physicians who wish to provide music to ease patients during office procedures. For full paper:  Music and Surgery Appendix: Music Study Appendix Keywords: music, medicine, surgery, perioperative, playlists, dermatologist, dermatology

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Louis Chargin, M.D. (1879? – 1969)

Recollections of an Office Visit by, the then pre-teen, Barry Mayer, M.D., FACR My uncle had a dairy farm in Orange County, New York where I spent all summer and most of my vacations working and playing from the ages of about 7 to 11 years old. Our family primary care physician was a loyal referrer to Dr. Louis Chargin, a renown Bronx dermatologist. As a youngster I had seen him at least once for problems I can’t remember now. One summer, when I was around ten, I developed an annular eruption about 2-3 inches in diameter on the extensor surface of my right forearm.  It was a mystery to … Continue reading

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Hand of Angel

“I Want Too Hold Your Hand” by Corinne Viens. Abstract:  Dermatologists perform many minor surgical procedures on patients who are often anxious and/or needle-phobic.  The simple act of holding a patient’s hand during the injection of local anesthetic has a calming and therapeutic effect.  This essay is the personal experiences of a professional hand holder and her reflections on this service to the patient. Keywords: minor surgery, surgery, anxiety, needle phobia, hand holding, comfort, dermatology In the dermatology office where I have worked for nearly twenty years, I often hold the hands of patients while the doctor administers the local anesthesia prior to their procedures or, if they are exceptionally … Continue reading

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Observations on Cutting

by Christina Perron Abstract: Non-suicidal self-injury is thought of as a disordered emotional coping mechanism. This phenomenon is gaining increasing attention in the psychiatric and lay literature as it often is a harbinger of significant ongoing life stressors, a marker of adverse childhood experiences, and/or a manifestation of psychiatric disease. Dermatologists investigate and treat diseases of the skin and are therefore often privy to a patient’s closely guarded stigmata of self-harm. A fourth-year medical student questioned how best to care for this patient population in the outpatient dermatology clinic. A review of the current dermatologic literature proved largely silent on this subject. A dermatology clinic visit may represent an ideal, … Continue reading

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