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Skin side effects from anticancer treatments can be a special burden for patients already suffering the extreme pressures of a cancer diagnosis. Treatments must be customized for patients based on the type of cancer and treatment, as well as the patient’s personal goals. Close and active relationships with patients are vital to assure the best possible outcome.

Extracorporeal photopheresis is underused for early-stage mycosis fungoides. ECP is capable of correcting the cytokine imbalance seen in patients with MF and results in an increase of Th1 cytokines. Clinicians should consider more frequent use in select patients

Laser for melanoma in situ (MIS) should generally be reserved for nonsurgical, usually elderly patients. When indicated, MIS may be treated with CO2 laser or with combined Q-switched Nd:YAG and imiquimod. Any atypical-appearing lesion should be biopsied prior to the start of a laser treatment.

Dr. Derm recently performed a fairly simple excision, discussed blood thinners, but failed to ask his patient about “natural” herbal intake. The patient did not take any prescription blood thinners, but did take high daily dosages of garlic and ginkgo. A lawsuit was brought against Dr. Derm. Can he really have liability for all the things people ingest these days?

The feminine mystique

Surgical and nonsurgical options provide effective treatment for the growing number of women seeking vaginal rejuvenation, experts say.

All surgical management of melanoma is defined by Breslow thickness. For melanoma less than 1 mm in thickness, typically a SLNB is not required. Future imaging devices may better delineate the extent and depth of the tumor in vivo.

Genetic profiling is valuable in both diagnosis and prognosis of skin cancer. Hedgehog inhibitors and (superficial radiation therapy) SRT are strong contenders for treating nonmelanoma skin cancer. Advances in targeted therapies and biologics are part of the new wave of melanoma treatments.

The big squeeze

Limited provider networks are cutting more than costs; these narrow networks are cutting dermatologists. One expert shares insight on what derms need to know.

Norman Levine, M.D., notes that being a physician is not easy. A large part of the difficulty centers on the patient-doctor relationship and how one maximizes the benefits that the patient accrues by the care he receives.

Instructional handouts help caregivers stick to complicated treatment plans for pediatric AD patients. Historically effective AD treatments are being augmented with new phosphodiesterase inhibitors and biologics. Gentler approaches such as massage, light therapy, and melatonin may also be of value for children with AD.

Drugs to treat atopic dermatitis are at the top of the FDA’s dermatology list. Biologics and PDE4 inhibitors show promise in the treatment of AD. Approval is still needed for the use of biologics to treat AD in pediatric patients.