Rash in a Patient with HIV Infection

A 50-year-old man presented  for the diagnosis and treatment of a rash on his legs and back for about 1 and 1/2 years. His past medical history was significant for HIV infection which had been treated with Highly Active Anti-Retroviral Therapy (HAART). He stated that his viral counts were undetectable and … Continue reading

Vaccinations for Childhood Diseases Is a Public Health Necessity

syringesI’m old enough to have acquired every childhood communicable disease except for smallpox and polio. The latter diseases were already practically eradicated from earth thanks to Jenner’s original vaccine and Jonas Salk’s … Continue reading

Gluten Sensitivity and Gluten-Free Diets in Dermatology

breadpastaGluten represents a group of proteins that are found in wheat, barley, and rye. Gluten is not present in rice and oats. Celiac disease, also know as “gluten-sensitive enteropathy,” is a type of … Continue reading

On Moving a Dermatology Practice: A Brief Work History

Moving is popular in the U.S. The average family moves about once every 5 years. But moving a Dermatology or any medical practice is far less common as you might expect. Patients prefer to keep the same doctor in familiar surroundings close to where they live. They expect to lose … Continue reading

Granuloma Annulare and Necrobiosis Lipoidica

Granuloma annulare (GA) is a skin disease commonly encountered in our clinic, either as an initial self-motivated visit or on consultation from another physician. The rash consists of small smooth bumps that may be skin-colored, pink, reddish-purple, brownish-orange. … Continue reading

How Efficient Is Your Dermatologist? Example from My Practice-Eczema or Ringworm

Dermatologists can be incredibly efficient and cost-effective in their practices because of their background and training in medicine and surgical procedures. We are not often acknowledged or appreciated for this by health insurance companies. The skin is the largest  organ in the body and plays an important role in immune … Continue reading

Accutane or Isotretinoin for Severe Acne: Update on Side-Effects

One of the most important drugs used in Dermatology today is Isotretinoin, also known as Accutane, for severe acne.  It is the only medication capable of curing the most severe forms of scarring cystic acne.  AccutaneBottles

Accutane is the brand … Continue reading

Vitamin D Analogues for Psoriasis

Vitamin D analogues are popular for the local treatment of psoriasis.  The first compound approved in the U.S. was calcipotriene (brand name Dovonex) available as cream, ointment, and lotion (for the scalp) for twice daily application.  It was modestly … Continue reading

When Should a Primary Care Doc Refer to a Dermatologist?

The answer to the question depends on the extent of training in dermatology and the individual physician’s comfort level in dealing with skin diseases.  Currently, the definition of “primary care providers” includes family practitioners, internists, pediatricians, and gynecologists, but may be expanded to include nurse practitioners.  The education of U.S. medical … Continue reading