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As Internet authority Steve Litt has noted: Never get personal. Never say "you're an idiot" or "you're a hypocrite," and try to avoid saying "you're wrong." No matter how true the statement, it's almost guaranteed to generate a heavy-handed response that will just draw you into a potentially dangerous and unprofitable conflict.

If money grew on trees, if Sept. 11 and the recession hadn't happened, and if the federal budget wasn't in deficit once again, dermatologists and other physicians might see last year's 5.4 percent Medicare payment cut rescinded by a generally sympathetic Congress

Q. What is the benefit of the new facial cleansing cloths?A. The newest way to clean the face is use of a disposable single-use cleansing cloth impregnated with a cleanser. These cloths are made in two varieties for normal to oily skin and normal to dry skin, with designs particular to each ailment.

Q. What factors determine the SPF performance of a given sunscreen?A. The SPF is the sun protection factor afforded by a given sunscreen. It is determined by dividing the lower back of untanned individuals is into small test sites which are exposed to UVB light until a minimum amount of erythema develops, known as the MED. Lightproof barriers are placed around the test sites to prevent light contamination from one test site to another. Once the MED for the test subject has been determined, the subject is invited to return to the test site the next day for application of sunscreen. The sunscreen is placed on the test sites and allowed to dry. The skin is then exposed to UVB light at the expected SPF of the sunscreen product. The expected SPF is roughly determined by spectrophotometric absorption. The amount of UVB light required to obtain the same degree of erythema as the preceding day is determined and the SPF calculated.

New Orleans - Results from a single-center pilot study indicatethat I.V. alefacept (Amevive), the human LFA3-IgG1 fusion protein, may safelyand effectively improve the skin and joint manifestations of psoriatic arthritis,researchers from the Academic Medical Center, University of Amsterdam, TheNetherlands, reported at the annual meeting of the American Academy of Dermatology.

Jane, a very mature 17-year-old adolescent, presents to Dr. Jones forremoval of a facial nevus. Dr. Jones discusses the risk/benefit ratio ofsuch an excision. In the course of the discussion, he determines that sheis working a full-time job and lives with her boyfriend at home with herparents. She signs a standard consent form. Dr. Jones does not realize thatshe is 17; he did not ask. Ultimately she is not happy with the scar andwishes to sue her dermatologist. The basis of her suit is that at age 17she was not able to provide informed consent. Dr. Jones is aware that, asa general rule, a patient must be 18 years of age to provide informed consent.However, he contends that Jane was highly intelligent, articulate and hada better understanding of the procedure than some 19 year olds might have.Can Jane, as an adolescent, give informed consent?

New Orleans - Polymixin B sulfate/bacitracin zinc/neomycin applied either as a topical ointment or in an over-the-counter bandage effectively eliminates Staphylococcus aureus colonization in wounds,

New Orleans - Although the natural history and imaging characteristics of hemangiomas are well known, some new or relatively new observations have led to further sub-categorization, Patricia E. Burrows, M.D., said at the 60th annual meeting of the American Academy of Dermatology.

New Orleans - The experience of a teenage girl treated successfully with infliximab (Remicade) for severe, recalcitrant psoriasis of her hands and feet indicates the value of the TNF-alpha chimeric monoclonal antibody as a therapeutic option for psoriasis.

New Orleans - Second intention healing with a calcium alginate dressing can be a useful alternative for closing skin-cancer excision facial defects in select patients who might otherwise be managed with primary closure, local flaps, or skin grafts, Roger H. Weenig, M.D., M.P.H., said at the annual meeting of the American Academy of Dermatology.

Rockville, Md. - A three-drug combination for the treatment of melasma is available as a single formula after being used separately since the 1970s.

New Orleans - Dermatologists should maintain awareness that cutaneous lesions on the face or neck may have a dental origin, Julie L. Cantatore, said at the annual meeting of the American Academy of Dermatology.

New Orleans - Data from an open-label study suggest that the anticonvulsant drug gabapentin (Neurontin) added to antiviral treatment during acute herpes zoster infection may further reduce the duration and severity of postherpetic neuralgia, Mathijs H. Brentjens, M.S., M.D., reported at the annual meeting of the American Academy of Dermatology.

Miami Beach, Fla. - Isotretinoin (Accutane) causes depressionand mood changes but all cases can be managed for successful results, RonaldC. Hansen, M.D., said here at the annual Masters of Pediatrics meeting.

New Orleans - Just like the endothelial cells that proliferateand produce hemangiomas, the field of study that surrounds these benigntumors of infancy and childhood continues to be a work in progress, MoiseL. Levy, M.D., said at the 60th annual meeting of the American Academy ofDermatology.

Miami Beach, Fla. - The acne war chests of dermatologists haveexpanded with new devices, including azelaic acid, retinoids, and oral antibiotics.The FDA has even added oral contraceptives to the armamentarium.

Miami Beach, Fla. - The acne war chests of dermatologists haveexpanded with new devices, including azelaic acid, retinoids, and oral antibiotics.The FDA has even added oral contraceptives to the armamentarium.

Miami Beach, Fla. - Dermatologists and pediatricians often areafraid of learning the technicalities of the human genome. However, onlya basic knowledge, an understanding of how genetics might apply to practice,and a relationship with a geneticist who can answer your questions are necessaryto use the tools available today, Judith G. Hall, O.C., M.D., said.

* Never use the same product year-round. "Because skin isa living organ that's constantly affected by everything from hormones tohumidity, I use a variety of products - some only in certain seasons andothers just on certain days," says Susan Taylor, M.D., director, Skinof Color Center at St. Luke's Roosevelt Hospital, New York.

Money Matters

Q: I'm planning on buying a vacation home that ultimately willbe where we will live during retirement. Should I pay cash for the homeor apply for a mortgage?

Chicago - Oritavancin (InterMune), an investigational glycopeptidewith activity against a wide range of Gram-positive pathogens, has beenshown to cut the treatment time in half for complicated skin and skin structureinfections (CSSIs) compared to current standard therapy with vancomycinplus cephalexin, Margaret Wasilewski, M.D., said at the 41st InterscienceConference on Antimicrobial Agents & Chemotherapy.

Lobbyists for insurance companies, the managed care industry, and dozensof large trade associations are worried. Their old buddy, PresidentBush, has been talking to one of their biggest enemies, Sen. Ted Kennedy(D-MA), about, heaven forbid, managed care reform.

A few tips on relaying medical dataWe all have the experience of reading medical literature hoping thatthe articles will give new insights into skin disease and its management. There is often that vague discomfort that the data and their interpretationare not necessarily objective. This may be true for many reasons, includingconflicts of interest by the authors, optimistic spins from true believers,or honest misinterpretations of complex information. There are severalways that readers can be guided through this morass by the authors. Ifthe following footnotes were added at the end of scientific reports, itwould be a major assist to the readers: