Category Archives: Dermatology

Dermatology

Consequences of Lying on the Witness Stand: Are There Any for Dermatology Expert Witnesses? – Dermatology Times

Dr Derm is a nationally well-known academic researcher. Because of his expertise, he is commonly asked for expert testimony in a large number of medical malpractice cases. He recently testified and was asked about his background. He stated that he was a well-known dermatologist who lectures all over the world. This was true. When asked about his training, he states that he went to an Ivy League medical school. In fact, he went to medical school outside of the United States. After the trial is over, it is determined that he lied about his background. He admits this but contends that his lies as an expert on the stand had no material impact on the trial. His adversaries disagree and file a lawsuit against him. Soon thereafter he is arrested for perjury. He is in disbelief. Can this happen? The answer is yes!

Such an arrest is not a common headline. But it can happen. A decade ago, Melvyn Flye, a surgeon in St Louis, Missouri, testified in a medical malpractice case involving gallbladder surgery performed. Media reports noted that Flye allegedly lied under oath about his own surgical experience, how often he had been sued for malpractice, and the status of his surgical credentials at a St Louis hospital. He was arrested and subsequently released on $50,000 bond.1

Many physician defendants suggest that in their medical malpractice case, the physician expert witness lied and he or she committed perjury. In reality, expert witnesses are generally immune from civil litigation based on their opinions rendered in court. They cannot be sued for malicious prosecution, abuse of process, or defamation. The reason is simple. In most disputes, there are 2 sides, and if experts could be sued for their words by the adverse party, there would never be any end to litigation. Because of this, experts can make wild claims on the witness stand with essential civil impunity. For example, historically experts can testify that the defendant never received a medical degree, is a pedophile, or has been sued 25 times in the past. While each of these claims is factually false, a party often could not find a remedy in civil court against an adverse expert spouting such lies.

That said, if an expert makes factual claims that are demonstrably false, and these fictions are materially relevant to the outcome of a case, action can be taken criminally (alleging perjury). There, the action is propelled by the district attorney. The district attorney would need to be persuaded to take such a case. The bar is high, and most such prosecutors take a pass. The few times district attorneys have propelled such cases, they were based on an experts credentialsfor example, an expert misstating credentials such as board certification or how many procedures he had performed in the past.

With this in mind, preposterous opinions are not considered perjury. Fictional factual claims may be actionable as perjury. Dr Derm is entitled to his opinion. A defendant physician may not be happy about this but cannot do much about it. However, if Dr Derms testimony is clearly a lie, he can be arrested for perjury.

David J. Goldberg, MD, JD, is medical director of Skin Laser and Surgery Specialists of New York and New Jersey; director of cosmetic dermatology and clinical research at Schweiger Dermatology Group in New York, New York; and clinical professor of dermatology and past director of Mohs Surgery and Laser Research at the Icahn School of Medicine at Mount Sinai in New York, New York.

Reference

1. Dungan T. Missouri doctor charged in perjury case. Arkansas Democrat-Gazette. July 22, 2013. Accessed September 8, 2023. https://www.arkansasonline.com/news/2013/jul/22/missouri-doctor-charged-perjury-case-20130722/

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Consequences of Lying on the Witness Stand: Are There Any for Dermatology Expert Witnesses? - Dermatology Times

Dermatology

The Cutaneous Manifestations of Drug Reactions Can Mimic Traumatic Injuries: Case Reports and the Potential Role … – Cureus

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Please choose I'm not a medical professional. Allergy and Immunology Anatomy Anesthesiology Cardiac/Thoracic/Vascular Surgery Cardiology Critical Care Dentistry Dermatology Diabetes and Endocrinology Emergency Medicine Epidemiology and Public Health Family Medicine Forensic Medicine Gastroenterology General Practice Genetics Geriatrics Health Policy Hematology HIV/AIDS Hospital-based Medicine I'm not a medical professional. Infectious Disease Integrative/Complementary Medicine Internal Medicine Internal Medicine-Pediatrics Medical Education and Simulation Medical Physics Medical Student Nephrology Neurological Surgery Neurology Nuclear Medicine Nutrition Obstetrics and Gynecology Occupational Health Oncology Ophthalmology Optometry Oral Medicine Orthopaedics Osteopathic Medicine Otolaryngology Pain Management Palliative Care Pathology Pediatrics Pediatric Surgery Physical Medicine and Rehabilitation Plastic Surgery Podiatry Preventive Medicine Psychiatry Psychology Pulmonology Radiation Oncology Radiology Rheumatology Substance Use and Addiction Surgery Therapeutics Trauma Urology Miscellaneous

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The Cutaneous Manifestations of Drug Reactions Can Mimic Traumatic Injuries: Case Reports and the Potential Role ... - Cureus

Dermatology

How to Safely and Effectively Exfoliate Your Skin, According to Dermatologists – Allure

Exfoliators have undergone a remarkable transformation since the 90s. These days, the famous Saint Ives Apricot Fresh Skin Scrub has more competition, as exfoliators come in an array of textures and formats. (Some are gritty scrubs, while others are silky liquids youd never know are sloughing off the top layer of your skin.)

But before you pluck one from the shelf, it's worth reading this comprehensive guide to how to exfoliate your face and body properly. FYI, it's not a one-size-fits-all-deal like the once-prominent scrubs led us to believe. Ahead, six board-certified dermatologists answer your pressing questions about the skin-care ritual.

Meet the experts:

In this story:

Let's start with the obvious: It helps remove dead cells that can accumulate on the skin's surface, which when used correctly can help brighten and reveal fresher, softer skin underneath, says Alexis Stephens, MD, a board-certified dermatologist and founder of Parkland Dermatology and Cosmetic Surgery in Coral Springs, Florida. But that's not all. Below are benefits you might not know about.

It can help smooth fine lines.

As skin ages and becomes dehydrated, the enzymes on the outer layer of our skin lose their ability to function, says Jeannette Graf, MD, a board-certified dermatologist and assistant clinical professor of dermatology at Mount Sinai School of Medicine in New York City. "The result is a buildup of dead skin cells, which can make lines and wrinkles appear more prominent. Since exfoliation promotes cell renewal, it can increase how smooth and even your skin appears.

It can help your products work more effectively.

Dead skin cell buildup can hinder your skin's absorption of the skin-care products you so-diligently apply. Removing those cells can ultimately help your serums, lotions, and creams "penetrate deeper and work more effectively," says Dr. Stephens.

It can help prevent breakouts.

"A lesser-known benefit is that exfoliation can prevent acne by clearing pores," explains Dr. Stephens. But that's not to say you should rub a face scrub all over your breakouts. Perhaps try a chemical exfoliant.

Let's start by clarifying what a chemical exfoliant isn't: a scrub. Unlike products that manually remove dead skin cells, chemical exfoliation doesn't provide the immediate gratification of a physical exfoliant (sorry). However, they work gradually and gently, "breaking the bonds between skin cells, which leads to a peeling effect," explains Macrene Alexiades, MD, a board-certified dermatologist at Dermatology and Laser Surgery Center of New York in New York City.

Alpha-hydroxy acids (AHAs)

Chemical exfoliants fall under two categories: alpha-hydroxy acids (AHAs) and beta-hydroxy acids (BHAs). The major difference between the two comes down to their solubility. AHAs are water-soluble, meaning they work primarily on the skin's surface rather than penetrating deep into your pores like BHAs.

Popular AHAs you may have heard of include glycolic acid, lactic acid, and mandelic acid, though there are even more that arent used in skin-care products as frequently. Below youll find editor-approved products that contain three of the most popular AHAS, plus a quick rundown of what sets each apart.

Glycolic acid

Glycolic acid is arguably the most popular AHA. Scientists can create it synthetically in a lab, but it's also readily available naturally via sugarcane. Glycolic acid has the smallest molecule size compared to lactic acid and mandelic acid, meaning it can absorb into the skin more quickly, says Karan Lal, MD, a board-certified dermatologist and the director of cosmetic dermatology at Affiliated Dermatology in Scottsdale, Arizona. As you'll see below, there are glycolic acid treatments for both facial and body care.

The Inkey List Glycolic Acid Exfoliating Toner

Naturium The Smoother Glycolic Acid Body Wash

The Inkey List Glycolic Acid Exfoliating Toner not only comes at an affordable price point but also delivers a potent dose of glycolic acid, containing the maximum concentration permitted in an over-the-counter product, which is 10 percent.

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How to Safely and Effectively Exfoliate Your Skin, According to Dermatologists - Allure

Dermatology

Robyn Siperstein, MD, FAAD: Initiating a Patient-First Dialogue in … – Dermatology Times

Robyn Siperstein, MD, FAAD, is a board-certified dermatologist practicing at Siperstein Dermatology Group in Boynton Beach and Boca Raton, Florida.

Siperstein sat down with Dermatology Times at the 2023 Society of Dermatology Physician Assistants (SDPA) Annual Fall Dermatology Conference in Nashville, TN, to discuss key highlights and takeaways from her sessions, "How to Choose a Cosmetic Plan for a Patient," and "Contrary to Popular Belief: Thought Changing Research in Cosmetic Dermatology."

"People often remember how they feel but not exactly what is said," Siperstein said. "And so I often ask people to discuss their favorite feature, not just what they want to fix."

Transcript

Robyn Siperstein, MD, FAAD: I am Dr. Robyn Siperstein. I'm a board-certified cosmetic dermatologist from Florida, and today I'm going to be talking about how to choose a cosmetic plan for your patient. I think it's really important not to just go from the top of the face to the bottom, but also to go from the inside out. The analogy that I use is a 5-layer cake. So the bottom of our cake is the plate which is like our bone, and then a 2-layer of yellow fluffy cake. The bottom yellow flap is the deep fat, he top is a superficial fat, and in between, we have some red icing, which is an analogy for the muscle. Icing on top, as well, is our skin. I talked how we need different modalities for each. So for instance, on the top of the skin, we would use things like IPL, laser resurfacing, ablative procedures to help smooth out. For our superficial fat layer, that creates our contours, so a soft, non structural filler is great there, whereas deeper down on the plate or the bone or the deep fat, we need very strong structural fillers. Kind of think of it as the base building blocks of a house.

So depending on where you are, we'll guide you in what you're going to recommend from a step-by-step perspective from inside out. I also give some tips on how to make the patient feel their best during the consult and creating the plan. People often remember how they feel but not exactly what is said, and so I often ask people to discuss their favorite feature, not just what they want to fix. When I am discussing things that might be negative, such as asymmetries or lines that they have at rest, to warn them what will or will not go away and proper expectations, I have famous people pictures of, for instance, Taylor Swift with 1 eyebrow higher than the other, chins different lengths, so that they know even the most beautiful people do have asymmetries and that it's okay.

My second talk is Contrary to Popular Belief, and that is one of my favorite talks to give. Unfortunately, in all aspects of life, we're often taught things, and we don't think to question them. So the whole idea behind this is to question things that were taught from generation to generation and really analyze where we get our knowledge from and make sure that it's evidence-based. I review different studies and how to analyze a study and then go through some specific examples. The 3 examples I give, one is around neuromodulators, such as Botox, not bending our heads or resting for 4 hours, and where this myth actually came from, and what is much more likely given some of my research and literature review.

I also discuss filler longevity. We thought for a long time on-label indications anywhere from 6 months to up to 2 years. But we're now getting MRI studies showing that it can last up to 15 years in certain areas, and so this is important to use this knowledge in our consults and consents.

Lastly, was my most recent research project which is on cannulas, and it is showing that even 27 and 30- gauge cannulas can be safe and often better for certain really delicate areas like the undereye area. I go into my research and actually some videos using cadavers showing why cannulas are so much safer because their coefficient of friction helps to glide over and under the vessel, and also that they have less arterial penetration force than a needle.

[Transcript has been edited for clarity.]

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Robyn Siperstein, MD, FAAD: Initiating a Patient-First Dialogue in ... - Dermatology Times

Dermatology

Enhancing the Patient Experience Through Addressing Pain Points … – Dermatology Times

Joe Cari, MPAS, PA-C, currently practices as a physician assistant in Highlands Ranch, Colorado. Previously, Cari worked in advertising and marketing before making a career pivot and becoming a dermatology PA in 2014.

At the 2023 Society of Dermatology Physician Assistants (SDPA) Annual Fall Dermatology Conference in Nashville, TN, Cari presented a session titled, From The Parking Lot to Check Out: Tips For a Great Patient Experience,1 detailing advice for approaching the patient experience from an advertising, marketing, and health care professional perspective.

These are ways to identify those pain points yourself and maybe make suggestions, or even maybe you can bring it to the higher ups to sort of bring yourself a little bit forward in the leadership conversation, Cari said.

Caris main advice for PAs revolves around what he calls being extra, or going above and beyond in each and every area of the patient journey mapping.

Arrival

Check-in

Cari believes that in the next 5 to 10 years, health care and medicine may see artificial intelligence booming in the latter.

Waiting room

Cari frequently recommended virtual reality availability in clinics and practices as a means to improve the patient experience. This, he said, may represent the future of anxiety relief in patients.

Consultation and treatment

Procedure fear and anxiety

Check out and follow up

The positive patient-centric dermatology experience is what we're all looking for. Identifying pain points along your entire patient journey is going to be very, very important to not only yourself, mitigate those, but correct those deficiencies within the clinic, Cari said. It's going to encourage teamwork and communication with your leadership and among the medical providers and professionals, and its going to help staff enhance patient care and want to change.

Cari referenced a UK patient complaint study wherein almost 70% of all complaints reported by patients have the potential to be addressed or mitigated with a health care professional or a PAs involvement and carefulness. 22.1% of complaints were related to treatment, 16.8% to communication, 15% to skills and conduct, and 13.9% to respect. Perceived experiences, Cari said, make up the largest proportion of patient complaints and concerns in a practice.

If you choose to listen, to change, it not only helps you and your understanding of the patient's perspective, but also your understanding and perspective, which makes for a better patient experience, better patient care, and that's going to make you a better provider, Cari said.

Reference

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Enhancing the Patient Experience Through Addressing Pain Points ... - Dermatology Times

Dermatology

Global Dermatology Collaboration and Licensing Deals and Agreements Analysis Report 2023 with Directory of Dermatology Deal Records Signed Since 2016…

Global Dermatology Collaboration and Licensing Deals and Agreements Analysis Report 2023 with Directory of Dermatology Deal Records Signed Since 2016  Yahoo Finance

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Global Dermatology Collaboration and Licensing Deals and Agreements Analysis Report 2023 with Directory of Dermatology Deal Records Signed Since 2016...

Dermatology

UNION therapeutics to present at 7th Annual Dermatology Drug … – PR Newswire

HELLERUP, Denmark, Oct. 25, 2023 /PRNewswire/ -- UNION therapeutics A/S (UNION), a privately held, clinical stage, pharmaceutical development company focused on immunology and infectious disease, today announced that Dr. Kim D.Kjller, CEO of UNION therapeutics will present at the seminar on clinical trials at the 7thAnnual Dermatology Drug Development Summit on October 31 - November 2, 2023, in Boston, US.

Dr. Kjller will discuss recent challenges and progress in assessing efficacy in clinical trials of hidradenitis suppurativa (HS) and how novel endpoints may improve the approach. To perspectivize the discussion, data from the OSIRIS, proof-of-concept study of oral orismilast in HS presented at the European Academy of Dermatology and Venerology (EADV) Congress 2023 will be presented.

7thAnnual Dermatology Drug Development Summit

Presentation: Demonstrating efficacy in clinical trials with novel and meaningful endpoints Presenter:Dr. Kim D. Kjller, CEO, UNION therapeutics Date and time:Wednesday November 1, 2023, at 10:40am EST.

Contacts

Morten Boesen, Chief Financial Officer, UNION therapeutics A/S +45 2381 5487 [emailprotected]

Sarah Toft-Jrgensen, Director of Communications and IR, UNION therapeutics A/S +45 5385 3044 [emailprotected]

About UNION therapeutics

UNION therapeutics is a privately held, mid- to late-stage, pharmaceutical development company advancing novel treatment options within immunology and infectious diseases. UNION is headquartered in Hellerup, Denmark, and led by an international team combining biotech entrepreneurs and seasoned pharma executives, with a track record of developing and launching more than fifteen marketed drugs. Read more at http://www.uniontherapeutics.com

SOURCE UNION therapeutics

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UNION therapeutics to present at 7th Annual Dermatology Drug ... - PR Newswire

Dermatology

4 Tips and Considerations for Selecting a Systemic Treatment for … – Dermatology Times

/Adobe Stock

At the 2023 Society of Dermatology Physician Assistants (SDPA) Annual Fall Dermatology Conference in Nashville, TN, Douglas DiRuggiero, DMSc, PA-C, presented a session titled, Psoriasis: How to Choose the Best Systemic Treatment for your Patient,1 where he discussed considerations and best practices for determining an appropriate systemic treatment for patients with psoriatic disease.

Make sure you know what you're diagnosing because youll never have the right treatment if you've got the wrong diagnosis, DiRuggiero said. Always put the patient first, because while we have 12 biologicscreams, 2 orals, multiple topicals, and a lot of other treatments: The best treatment for your patient is the thing that fits their needs best.

There are several factors involved in determining an appropriate treatment path for a patient with psoriasis. DiRuggiero notes that these include severity of disease, body surface area, involvement in sensitive areas, pre-existing or comorbid conditions, patient quality of life, and most importantly, patient choice.

Psoriasis by itself is its own black box warning, DiRuggiero said.

DiRuggiero went on to note that for patients with psoriasis, the risk of developing conditions such as fatty liver disease, metabolic syndrome, and cardiac disease, for example, are greater than in patients without psoriasis or psoriatic disease.

Psoriasis is a part of an umbrella known as the psoriasis-associated autoimmunity spectrum. DiRuggiero said that because of this, there is a considerable amount of overlap between cutaneous psoriasis and numerous other autoimmune conditions. For example, approximately 2% to 6% of patients with psoriasis, DiRuggiero noted, will develop irritable bowel disease (IBD). Patients may even have IDB at the time of their diagnosis with psoriasis and not even know it. This background is important to consider when deciding how to best manage or treat a patients psoriasis.

Psoriasis does not present equally in all patients, particularly in patients with skin of color and more darkly-pigmented skin types.

DiRuggiero said that it is important for health care providers to develop differential diagnoses for their patients and to consider that while something may appear to be psoriasis, it does not always make it psoriasis.

Never assume its a slam dunk case, he said.

Shared decision making is a little bit of a difficult venture, DiRuggiero said. I call it controlled decision making.

When a patient comes into a practice with potential drug names in mind that they may have heard of or previously researched, it is important to acknowledge that while the particular treatment may be effective and a great choice for another patient, not every patient is created equally.

I dont think PASI is the thing to drive all decisions, DiRuggiero said.

Instead, he suggests guiding patients through acknowledgment of their input while also ensuring they are aware that a full examination of their medical history may mean their preferred treatment option is not the best fit for them.

[Patients] need to hear that there's hope, that there's positivity to a disease. The fact is that if someone develops liver dysfunction, or liver failure, or develops macular degeneration and becomes blind, to the public, that brings a sense of sympathy and empathy, DiRuggiero said. But when someone develops a disease of the largest organ in the body and its invisible, it doesnt earn sympathy. It brings repulsion.

He went on to describe the present treatment landscape and era for psoriasis as a great time to be living with the condition, simply due to the wide variety of treatment options available for patients and their respective, individualized needs.

I'd never dreamed I have 20 new approved products for psoriasis in my prescribing career, DiRuggiero said. Don't lose the fact that we are prescribing hope, and we have a chance to put on a cape every day and become someone's hero."

Reference

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4 Tips and Considerations for Selecting a Systemic Treatment for ... - Dermatology Times