DermHelpCentral

European Suncreens

There has been a long wait in the U.S. for available and better UVA blockers.  The U.S. Federal Drug Administration (FDA) does not approve Tinosorb M, an effective UVA blocker.  The sunscreens we have in the States block UVB and many dermatologists feel this is not enough.  Yet, there is gridlock at the FDA in approving the use of newer UVA blockers which afford better protection.  Many consumers are getting these from Europe of Canada.  The lack of approval is not based on science, but is felt to be the result of lobbying by the makers of the sunscreens we have!  To learn more about this see:  UVA Reform in the NY Times (June 23, 2010).

Tanning Addiction

Jane Brody had a recent column in the NY Times on new studies which indicate that some people may actually be addicted to natural or artificial tanning.  The focus is on tanning salons which are more easily accessible to the public.

Here's an excerpt.
"Dermatologists express great frustration with their seeming inability to deter tanning behavior, particularly among adolescents and young adults, who are most at risk for the ill effects from these otherwise life-giving rays. There are many explanations for this failure, including the widespread belief that people look better (read healthier and perhaps thinner) when they are tan. This notion has helped to foster the multibillion-dollar indoor tanning industry, supported by some young patrons as often as 20 times a month.  But in recent years, another explanation has emerged for which there is now considerable scientific support: the idea that exposing one’s skin to UV radiation has addictive potential. As with alcohol, not everyone who is exposed becomes dependent on the sun. But there are enough UV abusers — one in five college students, perhaps half of beach habitués and 70 percent of indoor tanners, according to various studies — to warrant a new medical diagnostic category: tanning addiction.

The full article is worth reading.

Can't Swallow Pills?

If you or your child have trouble swallowing pills, here is a solution.

ORALFLO; PILL SWALLOWING CUP

This is a cup to Help Swallow Pills & Medications.  "The Oralflo Pill Swallowing cup was designed to help you swallow pills without stress. Don't let a pill-swallowing problem keep you from taking the medication that you need. Helps all ages - children, adults and seniors."

It sells for ~ $15.00 online.

Overview of Acne Therapy

This fine article was co-authored by James Shaw from the University of Toronto.  There have been no substantial advances since it appeared.  If you are interested in the approaches we use in acne management, you may want to read this lucid article.

Treatment of Acne Vulgaris  (Full Text Link)

Aamir Haider, MD, PharmD; James C. Shaw, MD, FRCPC

JAMA. 2004;292:726-735.

Context  Management of acne vulgaris by nondermatologists is increasing. Current understanding of the different presentations of acne allows for individualized treatments and improved outcomes.

Objective  To review the best evidence available for individualized treatment of acne.

Data Sources  Search of MEDLINE, EMBASE, and the Cochrane database to search for all English-language articles on acne treatment from 1966 to 2004.

Study Selection  Well-designed randomized controlled trials, meta-analyses, and other systematic reviews are the focus of this article.

Data Extraction  Acne literature is characterized by a lack of standardization with respect to outcome measures and methods used to grade disease severity.

Data Synthesis  Main outcome measures of 29 randomized double-blind trials that were evaluated included reductions in inflammatory, noninflammatory, and total acne lesion counts. Topical retinoids reduce the number of comedones and inflammatory lesions in the range of 40% to 70%. These agents are the mainstay of therapy in patients with comedones only. Other agents, including topical antimicrobials, oral antibiotics, hormonal therapy (in women), and isotretinoin all yield high response rates. Patients with mild to moderate severity inflammatory acne with papules and pustules should be treated with topical antibiotics combined with retinoids. Oral antibiotics are first-line therapy in patients with moderate to severe inflammatory acne while oral isotretinoin is indicated for severe nodular acne, treatment failures, scarring, frequent relapses, or in cases of severe psychological distress. Long-term topical or oral antibiotic therapy should be avoided when feasible to minimize occurrence of bacterial resistance. Isotretinoin is a powerful teratogen mandating strict precautions for use among women of childbearing age.

Conclusions  Acne responses to treatment vary considerably. Frequently more than 1 treatment modality is used concomitantly. Best results are seen when treatments are individualized on the basis of clinical presentation.

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Digital Photography in Dermatology

Feroze Kaliyadan is a dermatologist and accomplished photographer in Kerala, India.  This article is an excellent introduction to skin photography and it's available free Full Text!

Basic digital photography in dermatology. Kaliyadan F, Manoj J, Venkitakrishnan S, Dharmaratnam AD.

Indian J Dermatol Venereol Leprol. 2008 Sep-Oct;74(5):532-6.

Dr. Kaliyadan's photo near Cochin International Airport

Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala -682 026, India.

Abstract
Digital photography has virtually replaced conventional film photography as far as clinical imaging is concerned. Though most dermatologists are familiar with digital cameras, there is room for improvement in the quality of clinical images. We aim to give an overview of the basics of digital photography in relation to dermatology, which would be useful to a dermatologist in his or her future clinical practice.