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Traditional teaching for nail surgery proposes complete nail removal, but there are a variety of options - not just for total nail avulsion techniques, including the lateral nail plate curl and the trap-door avulsion - but also for partial nail avulsion, according to Nathaniel Jellinek, M.D.

Several risk factors can impair the wound-healing process in the elderly, such as poor nutrition, depression and the inappropriate use of medications. A focal point in wound healing is the investigation of drugs with the potential to limit scarring. Researchers are identifying targets, such as Transforming Growth Factor-beta3, to develop therapies aimed at minimizing scarring.

Untreated skin tears can become complex wounds and demand the care of a dermatologist. Up to 1.5 million skin tears occur annually in adults in healthcare facilities in the United States. Natural changes in the aging process, including diminished elasticity and decreased tensile strength, make the skin more susceptible to a tear.

Recent developments in pediatric atopic dermatitis include the discovery of filaggrin gene mutations and their possible role, a new appreciation of the epidermis' role in the immune system and renewed emphasis on patient education, an expert says.

Schools, sports programs, and day care centers provide ideal "breeding grounds" for methicillin-resistant Staphylococcus aureus infections. Any suspicious lesion should be cultured early. Comprehensive education is needed to minimize risk of transmission and to quell hysteria.

Ethyl chloride spray can be used to lessen the discomfort associated with Botox injections. The spray is available in pharmacies or through medical suppliers. Because the spray is highly flammable, it should not be used near electrodesiccation. It can be stored at room temperature.

National standards for ranking physicians may be on the horizon, but many dermatologists doubt that they can be implemented fairly and accurately. Insurance companies have proposed ranking physicians in tiers that could be used to determine levels of reimbursement or the amount of co-pays for patients to see the physician of their choosing.

Dr. C has been in practice for many years with Dr. W. They have an enormously successful dermatology practice and have a standard partnership agreement, the sole purpose of which is to protect the interests of their practice. The agreement has various paragraphs that deal with salaries, benefits, coverage and restrictive covenants.