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Outbreak Breaker

San Francisco - Daily antiviral therapy with valacyclovir (Valtrex) reduces not only genital herpes outbreaks and their severity but also reduces shedding, which, in turn, reduces transmission of the virus, according to a new study.

Minocycline Syndrome

New York City - Citing a small but growing number of patients who have been diagnosed with minocycline hypersensitivity syndrome, Colleen Crandell, D.O., advises dermatologists to become familiar with this recently emerging entity.

A 24-year-old woman has excelled at her receptionist job at a prominent cosmetic dermatology office. She is an employee at will; that is, she has no employment contract. She has recently attended a conference at which Basal Cell Nevus Syndrome is discussed. At that time she discloses that, although she has no stigmata for the disease, she has a strong family history for this genetically transmitted disease. Shortly thereafter she is terminated from her job. She is not given a reason for the termination but suspects it is related to her genetic predisposition.

Trust vs. Training

While driving home from work on a two-lane road one dark night last week, it suddenly occurred to me that I was taking for granted, without any thought or apprehension, the fact that the drivers of the oncoming cars were paying attention to their driving and not impaired in any way. Of course, once I started to think about the potential problems of inattentiveness or possible impairment of the older drivers, I immediately began recalling the numerous accounts on television and in the newspaper of horrific automobile accidents resulting in extensive injuries and sometimes even death.

There's probably no area of medicine that has received more hype, misinformation, and confusion than the Internet and practice Web pages. There are hundreds and perhaps thousands of our physician colleagues who have created Web pages only to have a bad taste concerning the time, money, and effort spent on a medium that does not appear to generate more patients or improve the efficiency of the practice.

Thin Is In

Once you (or your staff) have experienced a liquid crystal display (LCD) monitor, you will never want to go back to a bulky, energy-hogging cathode-ray tube (CRT) display. I purchased one 17-inch LCD monitor for my front-desk staff - it was such an improvement and was so popular that I went back and immediately purchased a second, identical monitor for their other workstation!

Thinning the Risks

Chicago - Incorporating a few straightforward screening questions and some simple intraoperative techniques can translate into significant benefits for enhancing the success and safety of liposuction surgery, Naomi Lawrence, M.D., said at the annual meeting of the American Society for Dermatologic Surgery.

Birmingham, Ala. - In a rare occurrence, superficial punctate keratitis developed after injections of botulinum toxin type A to the glabellar area, a difficult diagnosis arrived at through the combined consultation of a dermatologist and an ophthalmologist.

Dear general practitioners: Botox isn't an easy road to riches. You need to get very good and deliver consistent, high-quality results throughout the entire transaction - from the first phone call to the next follow-up appointment. You are looking at investing at least $10,000 (more commonly $20,000) after all is said and done, plus probably a hundred hours (or more) of your time.

Woundcare Clinic

Akron, Ohio - Chronic wounds benefit from a multidisciplinary treatment strategy, according to Eliot N. Mostow, M.D., of Wound Care Associates, Akron. Dr. Mostow has a multidisciplinary approach, known as the four Ps' of woundcare. "This means getting the right people, the right place, the right products, and the right protocol together," he said.

Wasted Potential

Boston ?? Wound bed preparation is essential to obtaining the maximum benefits from bioengineered skin and other advanced wound therapies, according to Vincent Falanga, M.D.

Keeping it Simple

Rootstown, Ohio -- Although dermatologists were instrumental in the development of complex procedures such as Mohs micrographic surgery, dermatologic surgeons are better known for their use of simple and quick procedures that are associated with minimal complications, Robert T. Brodell, M.D., professor of medicine, Northeastern Ohio Universities College of Medicine, Rootstown, said.

Ear Reconstruction

Lubbock, Texas - Dermatologists are now at the point where they like to repair and reconstruct the wounds they create in the treatment of skin cancer, according to David F. Butler, M.D.

Heading Off HPV-16

The recent news that a human papillomavirus (HPV) vaccine is well on its way to being a reality has dermatologists pricking up their ears. The vaccine, which is in development by Merck & Co. to target HPV-16, could facilitate a 40-percent reduction of intraepithelial cancer of the cervix within 10 years of widespread distribution to women and men, according to Ulrich R. Hengge, M.D., department of dermatology, University of Essen, Germany. More importantly to dermatologists who see histologically benign recalcitrant vaginal warts every day, the science behind the HPV-16 vaccine is virtually the same as that behind similar investigational therapeutic and prophylactic vaccines for condylomata.

Connecting the Dots

Acne, eczema, psoriasis, rosacea, hyperhidrosis, trichotillomania, onychotillomania, neurotic excoriations ... Even as connections between isotretinoin (Accutane) and depression in teens was hotly debated in the media spotlight last year, no one denies the powerful connection between the health of the psyche and that of the skin.

Multifaceted Topical

Pittsburgh -Topical tacrolimus ointment 0.1 percent (Protopic) may be a viable addition to the current therapeutic armamentarium for early-stage cutaneous T-cell lymphoma (CTCL), Larisa Geskin, M.D., said.

Asni?ress, France - The amount of ultraviolet A radiation (UVA) filtering is as important as labeled sun protection factor (SPF) levels in determining the effectiveness of sunscreens, according to Andr?ougier, Ph.D. However the UVA blocker he prefers most, Mexoryl, remains unavailable in the United States as it awaits FDA approval.

Pusan, South Korea -- Intralesional interferon alfa-2b (Intron-A) can be a useful option for the treatment of rapidly growing keratoacanthomas, Chang-Keun Oh, M.D., Ph.D., said.

So Far, So Good

Paris - Citing ease of application and time savings as the key advantages, Jean-Marie Lachapelle, M.D., characterized Allerderm's T.R.U.E. Test as "a step forward in the technology of patch testing that ensures an optimal penetration and delivery of allergens through the skin."

Steroid Sparing

Baltimore -- The immunosuppressant agent mycophenolate mofetil (CellCept) should be considered the steroid-sparing drug of choice in the management of pemphigus, according to Daniel Mimouni, M.D.

GA Subset Served

Sandusky, Ohio - Tacrolimus 0.1 percent ointment can treat a subset of patients with granuloma annulare (GA), according to a study conducted at Northern Ohio Dermatology Research in Sandusky, Ohio. The phase IV, open-label, single-center, clinical trial was conducted by Mandi R. Motter, R.N., clinical research coordinator, Thomas E. Fleming, M.D., principal investigator, and colleagues.

Stanford, Calif. - Conjugation of cyclosporin A to arginine oligomer protein transduction sequences provides a promising method for delivery of the peptide immunosuppressant agent into psoriatic skin. However, further study is needed to characterize the cutaneous bioavailability achieved with that novel delivery platform and to answer the larger question of whether topical cyclosporin A offers a viable therapeutic modality for psoriasis, according to David F. Fiorentino, M.D., Ph.D.

Azelaic Hailed

Birmingham, Ala. - Topical azelaic acid 15 percent gel (Finacea) is more effective than metronidazole gel 0.75 percent for improving erythema and reducing inflammatory lesion counts in patients with mild to moderate papulopustular facial rosacea, according to the results of a multicenter, double-blind, randomized, parallel comparative trial.

New Rosacea Fighter

Louisville, Ky. - A drug indicated for the treatment of periodontal disease appears to have efficacy equivalent to conventional oral therapy for rosacea but with virtually none of the side effects.

Trailing the Toxin

Chicago - Many dermatologists believe botulinum toxin works to relieve headaches, but the jury is still out on the toxin's true therapeutic benefits.

Filler Flack

Washington -- Artecoll, a new item in the increasingly broad array of permanent and semipermanent nonsurgical wrinkle-reduction options, on Feb. 28 took a big step toward FDA approval.

Introduction

As the number of new dermatologic procedures and laser treatments grows, more and more patients are seeking out the rewards of cosmetic dermatology. With these technological advances comes an increasing need for effective topical anesthesia. Recently, two esteemed cosmetic dermatologists, Ch?rie Ditre, MD, and Mark G. Rubin, MD, participated in a teleconference to discuss the merits of pain mitigation in the procedures they perform.

Uplifting News for Men

San Francisco - Most recipients of botulinum toxin type A (Botox Cosmetic) injections to soften or even remove facial wrinkles are currently women. But according to University of California-San Francisco dermatologist Christopher B. Zachary, M.D., males also benefit from this therapy, and removing certain facial wrinkles and furrows may provide benefits beyond just a handsome face.