DermHelpCentral

How to Use this Site

Dermatology Central is a resource for persons who have skin disorders and/or who have visited a dermatologist.  We hope it will be interactive.  You can find the area you are interested in the Categories Section which is located on the right hand column of this page.  We hope you will find DermCentral useful.  Your suggestions will be of value.

The most comprehensive web site that gives information about skin disorders is: DermNet NZ. It is the brain-child of Dr. Amanda Oakley, a dermatologist from Hamilton, New Zealand..  If you have any questions about almost any skin problem, you will find basic unbiased information there.  DermCentral does not try to duplicate DermNet, but provides a different type of information: treatment protocols, controversies, news aricles, the latest research findings.  Both sites are complimentary and will enable people who want to be managers of their own care to help direct their physicians. 

Seeking the Best Medical Care Prices

by Walencia Konrad, NY Times, November 28, 2009

"Can you really shop for doctors and hospitals the way you would for airfares and flat-screen TVs?

Health care consumers are encouraged to comparison-shop on things like doctor’s fees and heart surgery rates. But unfortunately, most of us have little clear or useful information to go shopping with.

This is an important and helpful article in the NY Times. If you want to find the lowest rate for a procedure or learn what is usual and customary, check it out. It documents that your insurance company gets a better rate for a procedure than a non-insured person does.

Full Article.

Helpful resources:

PriceDoc.com

HealthcareBlueBook.com .

These sites are still a bit primitive and not many options.  It's a great idea and hopefully they will offer more options in future. .

Melanoma on the Rise -- or is it being overdiagnosed?

An important article in the NY Times addresses a recent study on melanoma published from England.  It is important to read the Times piece and come to your own conclusions. Sadly, one of the American dermatologists who is quoted and who "pooh-poohs" the study is in the pay of sunscreen companies and a founder of the Skin Cancer Foundation which takes large sums from industry.

In recent years there has been a sharp rise in reported cases of malignant melanoma, the deadliest form of skin cancer. But a British study has found evidence that the epidemic may be due at least in part to “diagnostic drift,” a growing tendency to identify and treat benign lesions as malignant cancers. The findings may raise the temperature in an already-heated controversy.  Full Times article. 

Concerns Regarding Birth Control Pills

"The oral contraceptives Yaz and Yasmin are top-selling products, largely as a result of marketing that presents them as much more than mere pregnancy prevention. [Since they are commonly recommended to women with acne, it is in a patient's best interests to familiarize herself with the risks, even if they are small.]

Yaz, in particular, the top-selling birth control pill in the United States, owes much of its popularity to multimillion-dollar ad campaigns that have promoted the drug as a quality-of-life treatment to combat acne and severe premenstrual depression.

While the risk of blood clots is small, a patient needs to be aware of the data and make her own informed decision."  Reading this fine article:  Health Concerns Over Popular Contraceptives. 

For comparison of similar OCPs, click on image below:

Melanoma - Genetic Testing

It appears that routine genetic testing for persons at risk for melanoma is not, at present, the standard of care and may pose more uncertainties than help.  Things may change, but in 2009, this still appears to be valid.

Kefford RF, Mann GJ.  Is there a role for genetic testing in patients with melanoma?  Curr Opin Oncol. 2003 Mar;15(2):157-61.

Department of Medicine, Melanoma Genetics Research, Westmead Millennium Institute
for Cancer Research, University of Sydney at Westmead Hospital, Westmead, NSW,
2145, Australia. rick_kefford@wmi.usyd.edu.au

Autosomal dominant inheritance of mutations in the locus or the gene may confer a high risk of cutaneous melanoma development. The penetrance of mutations is influenced by UV exposure. Inherited variants in the melanocortin-1 receptor also confer increased risk of cutaneous melanoma. Features associated with increased genetic susceptibility to cutaneous melanoma include the presence of multiple affected first-degree relatives on one side of the family, multiple primary melanomas in the same individual, earlier age of onset, and the presence of multiple atypical nevi, but none of these factors reliably predicts for the presence of mutations. It is currently premature to offer predictive DNA testing  for melanoma outside of defined research protocols. This is because of (1). the low likelihood of finding mutations in known melanoma susceptibility genes, even in more than 60% of melanoma- prone kindreds; (2). the broad confidence limits on  current estimates of lifetime penetrance of mutations and the wide variation in this penetrance with locality; (3). a high "background" incidence of melanoma in non-mutation carriers in melanoma-prone families; (4). current uncertainties about the factors determining the functionality and phenotypic expression of the  trait among carriers of these mutations (penetrance), even if found; and (5). the lack of proved efficacy of melanoma prevention and surveillance strategies, even  for mutation carriers. Rather than singling out those deemed to be at high risk because of family history, all patients carrying risk factors for cutaneous melanoma should be subject to stringent programs of sun protection and skin surveillance.

Black Hair, Good Hair

Here's an informative overview of "Black Hair" for women.  It makes some good points and is a great introduction to this topic.  Important for dermatologists and the public to read.  The article refers to a new documentary produced by Chris Rock called "Good Hair."

Don't miss the Multimedia section!

Maladies in Musicians

This is a good article that appeared in the Southern Medical Journal in 2002.  Maladies in Musicians.

<a href="http://www.thefreelibrary.com/Maladies+in+musicians.+(Review+Article)-a089830777">Maladies in musicians. (Review ArticleABSTRACT: Certain medical ailments occur with increased frequency among musicians and can affect musicians of all ages and ability. These maladies range in severity from incidental, asymptomatic findings among casual and occasional players to serious injuries that significantly disable professional musicians from practicing or performing. The most prevalent problems involve overuse of muscles resulting from repetitive movements of playing, often in combination with prolonged weight bearing in an awkward position. Other common problems include dermatologic irritation, peripheral neuropathies, focal dystonias, and otolaryngologic disorders. This review organizes the musical maladies according to section of the orchestra with further subclassification by pathologic process. By becoming familiar with the disorders associated with specific instruments, physicians will be better able to make the correct diagnosis in musicians with medical complaints.

Chemo Fog

Jane Brody for the New York Times, August 3, 2009:  The Fog That Follows Chemotherapy.  "As more people with cancer survive and try to return to their former lives, a side effect of chemotherrapy is getting more and more attention. Its name is apt, if unappealing: chemo brain.

Nearly every chemotherapy patient experiences short-term problems with memory and concentration. But about 15 percent suffer prolonged effects of what is known medically as chemotherapy-induced cognitive impairment."

This piece may help you, a family member or a friend.

Hormonal Acne in Women

by James Channing Shaw, MD

It is common for women to get acne in their 20s or 30s for the first time. The cause usually centers around hormonal issues.

See Dr. Shaw's valuable post.

James Channing Shaw aka James C. Shaw, MD is an American-trained physician and writer who currently lives in Toronto.  A fuller bio is on his blog.

Scabies Slide Show

This is a well-done and informative slide show on scabies.  It is well worth viewing and answers most questions.

It's an example of how multimedia can teach better than straight text.  Lindane (Kwell) for all practical purposes is not used any more because it is difficult to obtain.  This piece grossly overestimates the risk (which was only seen in premature infants!)

How to Remove a Tick

eHow has a good section on Tick Removal.