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 …

Cyclosporine, Psoriasis, and Grapefruit Juice

Cyclosporine (CS), a potent immunosuppressive peptide, was discovered by Sandoz in 1975.  Clinical testing showed that it was very effective for preventing rejection of life-saving organ transplants such as kidney, heart, liver, and bone marrow.  Investigators also noted the impressive ability of CS to clear up any psoriasis on the …

What Are Dysplastic Moles? Opinion and Advice

To better understand the concept of “dysplastic moles,” we must agree on definitions of terms.  Dysplastic from dysplasia  means abnormal development of  tissue.  A mole in this context usually refers to a growth in skin that may be pigmented, flesh-colored, flat or raised, hairy or non-hairy. A mole, also called a nevus, usually consists of …

Importance of the Second Opinion: Editorial with Illustrative Cases

When I worked as a Dermatologist at the Cleveland Clinic, we encountered many patients    who were either referred by an outside Dermatologist, or self-referred, for a second opinion on their diagnosis or treatment or both.  Most patients would bring copies of their records for us to review, and invariably, …

Vascular Birthmarks

Birthmarks are common.  They occur in one out of 10 newborns.  One of the most disfiguring types is the vascular birthmark, which is composed of blood vessels in the skin giving it a red or purple appearance.  The larger tumor-like birthmarks, called hemangiomas, enlarge during the first few months of life …

Why Does It Take So Long to Get an Appointment With a Dermatologist? (Part II)

Dermatologists may seem to be in short supply or just difficult to see because of the increased demand for specialty care, particularly in the arenas of skin cancer and skin rejuvenation.  There is certainly an epidemic of both skin cancer and ageing in the United States.  This phenomenon is more …

Why Does It Take So Long to Get an Appointment With a Dermatologist? (Part I)

Before I begin to answer this question, let us review the definition of a Dermatologist. A Dermatologist is a licensed physician, MD or DO in the U.S. who has completed at least 3 years of post-graduate residency training in Dermatology. A Dermatologist specializes on the diagnosis and treatment of diseases …