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International volunteerism resources
Part of the Academy's mission, as enacted through the Education and Volunteers Abroad Committee (EVAC), is to improve dermatologic care to those in underserved areas through education and service. Browse AAD's international volunteer opportunities and resources below. ... SkinCare for Developing Countries Resident International Grant Contact us ... Questions about
If want to be a true leader, emulate the first president
By Warren R. Heymann, MD July 30, 2017 I recently had a discussion with our departing chief resident as he was about to embark on his academic career at UCLA. He was looking for sage advice — I focused on the need to maintain enthusiasm, wonder, curiosity, and dedication to
Is your margarita giving you a rash?
Dermatologist shines a light on the latest research in photocontact dermatitis SAN DIEGO (March 8, 2024) — Sun sensitivity and related skin conditions are often misunderstood. Foods, medications, and skincare products can trigger symptoms like itching, redness, blistering, or burning. One of the most common conditions is photocontact dermatitis, a
Where can I find updated guidance on teledermatology?
Asked and Answered ... May 1, 2022 The Academy has recently launched an updated teledermatology toolkit for AAD members, including more in-depth information on: ... Starting teledermatology ... Workflow advice for small practices ... How to prepare staff for offering teledermatology ... Up-to-date coding and reimbursement information ... Advice on
How aligned are Redditor-driven recommendations with the current AAD acne guidelines?
Clinical Applications ... Dr. Schwarzenberger is the physician editor of ... DermWorld . She interviews the author of a recent study each month. ... By Kathryn Schwarzenberger, MD, FAAD, October 1, 2024 In this month’s Clinical Applications column, DermWorld ... Physician Editor Kathryn Schwarzenberger, MD, FAAD, talks with Justin Marson,
Start the new year off with a fresh start (and skin)
Advice from a board-certified dermatologist on seeking cosmetic treatments ROSEMONT, Ill. (January 9, 2024) — With a rise in both public accessibility and visibility, cosmetic treatments are more popular than ever. Whether your New Year’s resolution is to improve your health or to look and feel your best, the most
A nail-biting commentary
By Warren R. Heymann, MD, FAAD Feb. 15, 2023 Vol. 5, No. 7 Reading advice columns has been a lifelong habit, having been enamored as a youth by the practical wisdom offered by "Dear Abby" (Pauline Esther Friedman Phillips) and her twin sister "Ann Landers" (Esther Pauline Friedman Lederer). Another
We all know.
From the Editor ... Dr. Schwarzenberger is the physician editor of ... DermWorld. By Kathryn Schwarzenberger, MD, FAAD, October 1, 2024 Ask any of us and we will confidently claim that no one knows more about skin, hair, and nails than a board-certified dermatologist. Unfortunately, social media offers an "open
Disaster strikes. Are you prepared?
Go to AAD Home ... Go to AAD Home ... Menu ... Experts offer advice on emergency preparedness planning. ... Experts offer advice on emergency preparedness planning. ... By Allison Evans, assistant managing editor “We went through hell after Hurricane Katrina. It was pandemonium. Talk about getting caught without any
From "slugging" to snail mucin
Dermatologists discuss popular social media trends impacting the skin. ... Feature ... By Emily Margosian, Assistant Editor, October 1, 2023 Social media and the skin have a long history together. For over 15 years, social media has been an ever-growing presence in nearly all facets of life: politics, commerce —
Five unsafe skin care trends to avoid
Advice from board-certified dermatologists to keep your skin healthy ROSEMONT, Ill. (Nov. 1, 2023) — Social media platforms are rife with skin care advice from a variety of sources, which can make it difficult to know how to approach the recommendations you find online. In recognition of National Healthy Skin
Start the presses!
Go to AAD Home ... Go to AAD Home ... Menu ... Experts offer advice on how to successfully manage media relations ... Experts offer advice on how to successfully manage media relations ... By Victoria Houghton, assistant managing editor When Anne Chapas, MD, arrived in New York City and
DW Insights and Inquiries archive
... All content found on Dermatology World Insights and Inquiries, including: text, images, video, audio, or other formats, were created for informational purposes only. The content represents the opinions of the authors and should not be interpreted as the official AAD position on any topic addressed. It is not
Dermatology World Insights and Inquiries
... All content found on Dermatology World Insights and Inquiries, including: text, images, video, audio, or other formats, were created for informational purposes only. The content represents the opinions of the authors and should not be interpreted as the official AAD position on any topic addressed. It is not
2025 DW Insights and Inquiries archive
Explore ... DermWorld Insights and Inquiries articles by publication date. ... January ... Jan. 8 - The treatment of systemic juvenile xanthogranulomas matures ... ... All content found on Dermatology World Insights and Inquiries, including: text, images, video, audio, or other formats, were created for informational purposes only. The
Cutaneous green and E-A-G-L-E-S!
By Warren R. Heymann, MD Jan. 25, 2018 Dermatologists will be seeing a lot of green in their offices the next two weeks, especially here in the Delaware Valley, in anticipation of Super Bowl LII in Minneapolis on February 4th, 2018. ... May this serve as a reminder that some
Bad online review?
Go to AAD Home ... Go to AAD Home ... Menu ... Dermatology World explains why bad online reviews may not be so bad after all ... Dermatology World explains why bad online reviews may not be so bad after all ... By Ruth Carol, contributing writer Patients are increasingly
April
Issue ... April January February March April May June July August September October November December View digital flipbook In this issue ... From the Editor ... From the editor What's hot ... What's hot? Cracking the Code ... Coding and documentation clarity Acta Eruditorum ... Treating metastatic melanoma: Understanding a
How can I safely run my practice and limit potential exposures during COVID-19?
Asked and Answered ... February 1, 2021 The AAD offers a step-by-step guide on running a dermatology practice during COVID-19, including advice on how to: ... Assess your community’s COVID-19 prevalence and operate at an appropriate capacity ... Clean and disinfect your practice ... Reorganize your practice to minimize patient
Does the Academy offer any PPE resources?
Asked and Answered ... January 1, 2021 Yes. The Academy’s Coronavirus Resource Center offers dermatology practices a wide variety of clinical guidance on COVID-19, including resources relating to PPE and medical supplies. These include: ... Advice for medical workers on how to protect their skin while using PPE ... Conservation
Cutaneous T-cell lymphoma
Old stains leaving new marks in dermatology Paraneoplastic Sarcoidosis? A Proposal to Revise and Rename the "Sarcoidosis-Lymphoma Syndrome" Brentuximab vedotin update and the #MeToo saga of the Reed-Sternberg cell Attending the masquerade ball with CTCL and alopecia areata ... All content found on Dermatology World Insights and Inquiries, including:
August
Issue ... August January February March April May June July August September October November December View digital flipbook In this issue ... From the Editor ... From the editor What's hot ... What's hot? Clinical Applications ... Guidelines for the management of hidradenitis suppurativa Feature ... Disaster strikes. Are you
What is being recommended to patients on social media?
Facts at your Fingertips ... By Emily Margosian, Assistant Editor, October 1, 2023 Social media is abundant with skin care advice. A recent ... JAAD cross-sectional analysis of acne treatments on YouTube found that up to 91% of teens report using social media to access health information. However, who is
Dermatologic ergonomics: Straighten up and fly right
By Warren R. Heymann, MD, FAAD June 28, 2023 Vol. 5, No. 26 My posture has never been proper, having a proclivity to slouch. "Stand up straight, son!" my father would admonish. When I was young and supple, I would half-listen to the advice, usually reverting to my standard (incorrect)
Board of Directors
The Academy’s officers and board members lead the world’s largest dermatologic society, representing more than 20,000 physicians specializing in the diagnosis and medical, surgical, and cosmetic treatment of skin, hair, and nail conditions. ... Email the ... Board of Directors . ... Please note: The Academy cannot provide personalized medical
Not what the doctor ordered?
Go to AAD Home ... Go to AAD Home ... Menu ... Pharmacists assume greater role in dermatology patient care ... Pharmacists assume greater role in dermatology patient care ... By Jan Bowers, contributing writer A critical member of the health care team, the pharmacist not only dispenses medication, but
Race, equity, and the impact of COVID-19 on African Americans
Derm World Weekly - A Publication of the American Academy of Dermatology | Association ... Dermatology World Weekly talked to Sacharitha Bowers, MD, vice chair of the Diversity, Inclusion, Community Engagement and Equity (DICE) Council for the Department of Internal Medicine at Southern Illinois University School of Medicine, about the
The meaning of community
Former camper Kaitlyn Wannall, now 18, loved her time at Camp Discovery. Kaitlyn’s story ... Kaitlyn Wannall is looking forward to starting college in the fall of 2022. ... The community of people with skin diseases is present everywhere. I became a part of this community when I was nine
Mentorship helps the dermatologic career
AAD member Mariam Mafee, MD, FAAD, loved her time in the Academic Dermatology Leadership Program. Dr. Mafee’s story ... Mariam Mafee, MD, FAAD ... I became interested in the Academic Dermatology Leadership Program (ADLP) when I had made a switch from private practice into academics. I was looking for some
San Francisco dermatologist advances innovative treatment on FDA committee
American Academy of Dermatology honors Dr. Kenneth Katz as National "Patient Care Hero" ROSEMONT, Ill. (April 11, 2022) - San Francisco board-certified dermatologist Kenneth Katz, MD, MSc, MSCE, FAAD, was named an American Academy of Dermatology ... Patient Care Hero for his work leading a national advisory committee at the
Pathways: Inclusivity in Dermatology
Pathways: Inclusivity in Dermatology ... The American Academy of Dermatology (AAD) and American Academy of Dermatology Association (AADA), in collaboration with Johnson & Johnson and Kenvue, are launching "Pathways: Inclusivity in Dermatology" to increase the number of practicing dermatologists who are underrepresented minorities (URiM) in medicine over the next five
A cold abscess remains a cold case: Multiple neonatal staphylococcal cold abscesses of the large folds
By Warren R. Heymann, MD, FAAD Jan. 17, 2024 Vol. 6, No. 3 Graduating residents will usually ask me for parting words of wisdom. If I had to choose one morsel of advice, it would be to read and study throughout their career. I still marvel at reports of entities
Full disclosure
From the Editor ... Dr. Schwarzenberger is the physician editor of ... DermWorld. By Kathryn Schwarzenberger, MD, FAAD, June 1, 2023 Many of you know that I am married to an ob-gyn, so treating pregnant patients has always been easy for me. Even in the middle of the night, I
iPLEDGE changes
Ask the Expert ... By Victoria Houghton, Managing Editor, July 1, 2023 DermWorld ... spoke to Stephanie Croney, JD, assistant director of regulatory policy for the American Academy of Dermatology Association (AADA), about the recent FDA advisory committee meeting on recommended changes to the iPLEDGE REMS program. DermWorld : Recently,
Who do you turn to?
From the President ... Dr. Cronin served as Academy president from March 2023 to March 2024. ... By Terrence A. Cronin Jr., MD, FAAD, June 1, 2023 Dr. Cronin speaking at the Plenary at the 2023 Annual Meeting in New Orleans. ... When you need financial advice where do you
How to treat acne
Board-certified dermatologist offers skin care advice to help you get the best results from your acne treatment ROSEMONT, Ill. (November 17, 2022) — Acne is the most common skin condition in the United States, affecting up to 50 million Americans annually. As your body’s largest organ, it’s important to take
Pathways: Inclusivity in Dermatology to increase number of Black, Latino, and Indigenous physicians in dermatology
American Academy of Dermatology collaboration with Johnson & Johnson Consumer Health and the Janssen Pharmaceutical Companies of Johnson & Johnson will double representation in next 5 years. ROSEMONT, Ill. (March 23, 2022) — People of color often face unequal access to health care and experience poorer outcomes across the health
From the editor
From the Editor ... Dr. Schwarzenberger is the physician editor of ... DermWorld. By Kathryn Schwarzenberger, MD, March 1, 2019 Learning to say no. For some of us, this is one of the hardest things we do. However, it is a skill needed by those of us who chronically long
Telemedicine coding basics: What you need to know now
Teledermatology visits ... Teledermatology services are performed using virtual technology in one of the two ways: ... Live-interactive (synchronous): A real-time, two-way interaction between the physician and the patient. For example, the patient initiates a video chat with the physician to discuss a rash. The video can be performed through
Good advice?
Go to AAD Home ... Go to AAD Home ... Menu ... What is the USPSTF and what do its skin cancer counseling recommendations mean for the specialty and its patients? ... What is the USPSTF and what do its skin cancer counseling recommendations mean for the specialty and its
Caring for their own
Derm World Weekly - A Publication of the American Academy of Dermatology | Association ... Brooklyn, New York, was particularly hard hit by the pandemic. The New York State Governor quickly mandated that SUNY Downstate Medical Center become a designated coronavirus referral center, one of only three in the tristate
Academic leadership in dermatology: Heeding to advice from surgical chairs
By Warren R. Heymann, MD April 23, 2016 It is irrelevant that the "good old days" of the omniscient chairs of hierarchical departments are a relic of the past. While I will acknowledge that life may have been simpler decades ago, perhaps it was not better (except for the chief!).
American Academy of Dermatology survey shows Gen Z adults at risk for skin cancer due to increasing rates of tanning and burning
Board-certified dermatologist urges sun protection to prevent skin cancer ROSEMONT, Ill. (May 14, 2024) — A new survey from the American Academy of Dermatology revealed that Generation Z adults, ages 18-26, are at risk for skin cancer due to increasing rates of tanning and burning. To encourage safe sun habits,
2025 AAD Annual Meeting: Session spotlight
Expand your knowledge at the AAD Annual Meeting! ... Join us for an unparalleled educational experience at the AAD Annual Meeting, where you’ll have access to a wealth of knowledge from leading experts in dermatology. This year’s program features an exciting lineup of new and highly attended sessions that promise
Skin care for developing countries
The Academy offers grants to individuals and organizations to fund international volunteer and humanitarian projects under the Skin Care for Developing Countries program. ... Grants available ... Grants vary between $2,500 and $5,000 depending on the proposal, scope of the project, and availability of funds. ... Application timeline ... To
Free skin cancer screenings at a shelter for displaced and unhoused veterans
Stephanie Choi, a medical student at UMass Memorial Medical Center, sought to bring dermatology care to the underserved. Stephanie Choi's story ... Stephanie Choi (medical student) and others from UMass Memorial Dermatology participated in this skin cancer screening event. ... Homelessness is a pervasive and widespread problem in the United
Your Dermatologist Knows media wins 2024
A key part of Your Dermatologist Knows is pitching stories to media outlets in hopes they’ll run news stories sharing information about the wide breadth of knowledge dermatologists have to their readership. We consider every new story published as a result of our pitches as a win, regardless of whether
What’s new and what can I expect from the 2025 Annual Meeting?
Asked and Answered ... December 1, 2024 Get ready to register for a magical experience in Orlando, Florida! ... 2025 AAD Annual Meeting attendees can expect some exciting new offerings alongside the top-tier education you expect from the AAD. ... What’s new ... Opening Ceremony, Friday, March 7 from 5:00
PDF of skin care developing countries past recipients
Freeman, MD, PhD Expanding Store and Forward Teledermatology in Tajikistan Ali Lotfizadeh, MD Skincare
Neil S. Sadick, MD, FAAD CV
increase access/uptake of treatments ACADEMY INVOLVEMENT to individuals that qualify, and for free skincare
Career case study archives
The career case study archives provide residents with information to help them choose a subspecialty, with insider tips from dermatologists. Select any of the images below to download a PDF of guidance on that subspecialty. ... Cosmetic Pediatric Medical Academic Dermatopathology Hospital Surgery Mohs Help and Chat
PDF of Fall DIR
Ho, and I started reaching out to skincare companies to help procure gentle skincare products that would
June 19, 2024
Derm World Weekly - A Publication of the American Academy of Dermatology | Association ... IN THIS ISSUE / June 19, 2024 ... Neuropsychiatric diagnoses after isotretinoin initiation in pediatric acne patients DermWorld Insights and Inquiries : Advances in pruritus therapeutics — It’s Greek to us Efficacy of treatment options
Albinism awareness gets a makeover
In Practice ... Victoria Williams, MD, is an assistant professor of clinical dermatology at the University of Pennsylvania. ... By Emily Margosian, assistant editor, May 1, 2019 "What really struck me was that there were no dermatologists on the ground there," recalls Victoria Williams, MD, assistant professor of clinical dermatology
EHR use cases: Streamline operations and improve practice efficiency
Are you thinking about transitioning your paper-based practice to start using an electronic health record (EHR)? Or have you recently implemented an EHR and feeling overwhelmed with all the features? According to the American Academy of Dermatology 2020 Practice Profile Survey, 8 in 10 practices have adopted EHRs and while
The AAD and the international arena
From the President ... Dr. Tomecki served as Academy president from March 2021 to March 2022. ... By Kenneth Tomecki, MD, FAAD, October 1, 2021 The Academy is clearly a national organization, but it has appreciable international reach and influence in other countries. The Academy has more than 16,000 U.S.
This month’s news from across the specialty
What’s hot ... August 1, 2023 In this monthly column, members of the ... DermWorld Editorial Advisory Workgroup identify exciting news from across the specialty. ... Craig Burkhart, MD, MS, MPH, FAAD SARMs is a growing and dangerous social media trend. ... The U.S. Food and Drug Administration (FDA)
Eye-opening news about oxymetazoline
By Warren R. Heymann, MD, FAAD April 27, 2022 Vol. 4, No. 17 Certain articles have a "wow" factor that immediately impacts practice. In 2007, I recall being impressed by the 2 cases of erythematotelangiectatic rosacea reported by Shanler and Ondo that dramatically improved with the application of oxymetazoline hydrochloride
Providing free skin cancer screenings and advice on sun safety and skin cancer prevention
AAD member Susan Boiko, MD, FAAD, FAAP, volunteered to screen patients during Skin Cancer Awareness Month. Dr. Boiko's story ... Susan Boiko, MD, FAAD screens a participant while (right to left) Estela Chami, volunteer Community Health Worker, VCC; and Deysi Merino-Gonzalez and Alla Valdespino, VCC staff, look on. ... I
May 29
Derm World Weekly - A Publication of the American Academy of Dermatology | Association ... IN THIS ISSUE / May 29, 2019 ... Academy issues statement on sunscreen safety DW Insights and Inquiries : Life is just a bowl of cherry angiomas AccessDerm: Serving the underserved Anthem enforces modifier 25
June 8, 2022
Derm World Weekly - A Publication of the American Academy of Dermatology | Association ... IN THIS ISSUE / June 8, 2022 ... The administrative burden of prescribing isotretinoin DermWorld Insights and Inquiries : Sweating over acquired idiopathic generalized anhidrosis AADA counters IPMG objections to iPLEDGE improvements Actinic keratosis guidelines
IL-36 and generalized pustular psoriasis: L’chaim!
By Warren R. Heymann, MD, FAAD March 9, 2022 Vol. 4, No. 10 In 1910, Leo Ritter von Zumbusch meticulously detailed the clinical course of "psoriasis pustulosa generalisata" (referred to herein as generalized pustular psoriasis, GPP) in a brother and sister, pondering if this was a variant of psoriasis or
PDF of Diagnosis and associations
Erythema marginatum Rheumatic fever Migratory polyarthritis, carditis, Sydenham’s chorea, fever, SkinCare
Tarrying for tapinarof
By Warren R. Heymann, MD, FAAD January 12, 2022 Vol. 4, No. 2 Today we held our first round of interviews for our dermatology residency program for 2023. Meeting dermatology resident applicants is a delight — they are brilliant, engaging, and a source of pride for our discipline. We started
ChatGPT enters the chat
Dermatologists discuss the possibilities — and pitfalls — of ChatGPT in clinical practice. ... Feature ... By Emily Margosian, Assistant Editor, April 1, 2024 Design a webpage. Make a content strategy. Answer medical questions. Write an essay about trickle-down economics in the style of a Taylor Swift song. The possibilities
PDF of Disclosure of Interests
Stock options for Armis Scientific Shares in Mercer Strategies LLC (no longer affiliated) Owner of T2 skincare
#DermTwitter @ a glance
Go to AAD Home ... Go to AAD Home ... Menu ... Dermatologists harness the twittersphere for clinical discussion, patient education, and more ... Dermatologists harness the twittersphere for clinical discussion, patient education, and more ... By Emily Margosian, assistant editor Among the now 321 million Twitter users currently on
PDF of Taylor DOI
Owner of T2 skincare (currently inactive) Partial owner in a soon to be formed company currently named
Supplements and the skin
Are nutritional supplements aimed at skin care helpful, harmful, or simply a placebo for patients? ... Feature ... By Heidi Splete, Contributing Writer, July 1, 2023 Nutritional supplements appeal to many individuals as an alternative or additive treatment for skin and hair ailments, but evidence to support the effectiveness of
PDF of Supplementary tables for treating psoriasis patients with systemic non-biologics
information provided does not, and is not, intended to constitute consultative, coding, medical, or legal advice
I was scammed into registering for a fake meeting. How can I verify an Academy meeting is legitimate?
Asked and Answered ... April 1, 2020 Most meeting fraud can be avoided by verifying the authenticity of a registration site before providing any personal or financial information. ... Registration for official AAD/A meetings should only be done through the Academy’s website and the AAD’s legitimate registration and housing partner,
Refusal of medical treatment
Legally Speaking ... Clifford Warren Lober, MD, JD, presents legal dilemmas in dermatology every other month. He is a dermatologist in practice in Florida and a partner in the law firm Lober, Brown, and Lober. ... By Clifford Warren Lober, MD, October 1, 2019 Question: When can a patient refuse
PDF of psoriasis phototherapy guideline supplemental tables
, and is not, intended to constitute consultative, aad.org/guidelines coding, medical, or legal advice
Curbside consult or formal medical consultation?
Legally Speaking ... Robert M. Portman, JD, MPP, is a health care attorney with Powers Pyles Sutter & Verville, in Washington, DC, and serves as legal counsel for the AAD and AADA. ... By Megan La Suer, JD, MHA, and Rob Portman, JD, MPP, December 1, 2020 Every month, DermWorld
Leadership succession: Sunrise, sunset
Please note that next week DermWorld Insights & Inquiries will be discussing the terbinafine-resistant infections that have now come to the United States . By Warren R. Heymann, MD, FAAD May 17, 2023 Vol. 5, No. 20 Topol’s recent passing unleashed an avalanche of emotion. I watched ... Fiddler on
Vicarious liability
Legally Speaking ... Every month, DW covers legal issues in "Legally Speaking." Clifford Warren Lober, MD, JD, presents legal dilemmas in dermatology every other month. He is a dermatologist in practice in Florida and a partner in the law firm Lober, Brown, and Lober. ... By Clifford Warren Lober, MD,
Minimizing the risk of medical malpractice liability related to COVID-19 public health emergency
Legally Speaking ... Robert M. Portman, JD, MPP, is a health care attorney with Powers Pyles Sutter & Verville, in Washington, DC, and serves as legal counsel for the AAD and AADA. ... By Megan La Suer, JD, MHA, and Rob Portman, JD, MPP, August 1, 2020 Every month, Dermatology
A new spin
Go to AAD Home ... Go to AAD Home ... Menu ... Examining the theory behind the use of platelet rich plasma for dermatologic procedures ... Examining the theory behind the use of platelet rich plasma for dermatologic procedures ... By Victoria Houghton, assistant managing editor Professional football players, world-renowned
Patient preference in dermatologist attire: A lesson from “Annie”
By Warren R. Heymann, MD June 5, 2016 The physician-patient relationship is predicated on trust and confidence. Impressions form rapidly and physician attire is an important component on how patients perceive their physician(s). ... Fox et al surveyed 255 patients (with 63% from a medical dermatology clinic, 24% a dermatologic
One less headache to worry about: Using Isotretinoin in patients with a history of pseudotumor cerebri
By Warren R. Heymann, MD May 13, 2016 I have been prescribing isotretinoin since it was first introduced over thirty years ago, having encountered just a few patients with truly suspect pseudotumor cerebri (PTC). This was manifested by severe headaches and papilledema on ophthalmologic examination. Considering discretion the better part
Step 2: Learn the MIPS categories
Learn more about the MIPS reporting categories before you determine your level of participation. The weights and requirements of the categories change each year. ... Report with DataDerm ... The Academy’s Qualified Clinical Data Registry DataDerm allows streamlined reporting on MIPS categories, including dermatology-specific measures available nowhere else. ... Learn
Direct-to-consumer telemedicine websites: Caveat emptor, a prediction, and proposal
By Warren R. Heymann, MD ... July 17, 2016 ... Two weeks ago, I experienced pain extending from my right groin to my buttock to the degree that I almost could not bear weight. I felt as though I was 90, and if anyone saw my gait, they would have
Mea culpa: The truth about Grover Cleveland’s cancer!
By Warren R. Heymann, MD April 17, 2016 The authors briefly note conditions from Lincoln’s presumed bout with smallpox to Ronald Reagan’s BCCs. You might think I’m bringing this up because she omitted George W Bush’s BCC (for that story please visit our office), but no. The real reason I’m
PDF of patient consent for telehealth
The dermatologist will then give you advice about your dermatologic condition and how to treat and take
Scratching from A Hard Day’s Night? Meet the beetles!
By Warren R. Heymann, MD May 17, 2016 One of my least favorite encounters in dermatology is telling patients that it looks like they have insect bites. The usual responses are: "From what?" "I haven’t been outside," "My vet says my dog doesn’t have fleas," "My wife doesn’t have any
2024 exemption reweighting
Exemption reweighting is unchanged in 2024. Below is the breakdown of the 2024 MIPS category weights and how the weights will be redistributed if various exemptions are applied. ... As a refresher, here are the baseline weights for 2024: ... Quality: 30% ... Cost: 30% ... Promoting Interoperability (PI): 25%
Step 1: Check participation requirements
MIPS 2024 Reporting Snapshots ... Access our ... 2024 MIPS reporting options (PDF), with guidance tailored to your practice size and needs. ... First, determine if you are exempt from MIPS reporting. ... Use the tool below to check whether you are required to participate in MIPS. CMS uses your
The Academy has something for everyone
From the President ... Dr. Thiers served as Academy president from March 2020 to March 2021. ... By Bruce Thiers, MD, January 1, 2021 Welcome, 2021! January always brings the inevitable questions about New Year’s resolutions and change, so what’s in store for you this year? Are you considering retirement?
Dermatology Match Day: The ecstasy and the agony
By Warren R. Heymann, MD March 15, 2018 In February, 1979, one month prior to matching in internal medicine at NYU/Bellevue Hospital, I took a dermatology elective under the tutelage of Dr. Michael Fisher at the Albert Einstein College of Medicine. What an epiphany — a fascinating discipline that
Say it ain’t so: Dark chocolate exacerbates acne!
By Warren R. Heymann, MD May 5, 2016 Diet and acne has always been controversial. When I was a child I heard that pizza and chocolate could lead to break-outs; over time that was relegated to be a myth (thank goodness). ... The latest foods that have may possibly lead
New Medicare cards
In Practice ... Rachna Chaudhari is the AAD's practice management manager. Her column offers tips in response to common member questions. ... By Rachna Chaudhari, MPH, director of practice management, April 2, 2018 ... The Centers for Medicare and Medicaid Services (CMS) recently announced that it would be changing your
Holy dermatology, Batman!
Balance in practice ... By Emily Margosian, assistant editor, August 1, 2020 Each month, Dermatology World ... addresses issues "in practice" for dermatologists. This month, Philip Latham, MD, talks about his passion for Batman-inspired car remodels. "You can’t just go down and tell the guy at the auto store that
Physicians love to be recognized
From the Editor ... Dr. Schwarzenberger is the physician editor of ... DermWorld. By Kathryn Schwarzenberger, MD, FAAD, April 1, 2023 Unless it is for the wrong reason. Our colleagues who have received the dreaded "outlier" letter from insurers almost certainly would agree. The growing trend for insurers to analyze
Nails
Breaking the terbinafine laboratory habit for onychomycosis Biting my nails worrying about atypical presentations of nail unit melanomas Dyeing for a "new" topical agent for psoriasis? Think indigo Clawing to understand lichen nitidus Cutaneous green and E-A-G-L-E-S! Nailing the diagnosis of psoriatic arthritis ... All content found on Dermatology
Evolution of mentorship in medicine
Experts discuss a recent paradigm shift in the look and feel of mentorships. ... Feature ... By Ruth Carol, Contributing Writer, July 1, 2023 What are your core values? It’s not the typical question mentees would have been asked years ago but one they may be asked now as mentorships
PDF of Fall 2021 DIR
careful to avoid giving medical advice online that might create a physician- 2.
A summary of guidance from OSHA about handling the COVID-19 pandemic.
This material should not be construed as legal or tax advice and members should consult with their personal
Five myths about HIPAA
Legally Speaking ... Daniel F. Shay, Esq., is a health care attorney at Alice G. Gosfield and Associates, P.C. ... By Daniel F. Shay, Esq., November 1, 2022 DermWorld ... covers legal issues in "Legally Speaking." This month’s author, Daniel F. Shay, Esq. is a health care attorney at Alice
Fifty shades of black salve
By Warren R. Heymann, MD May 4, 2016 Diet and acne has always been controversial. When I was a child I heard that pizza and chocolate could lead to break-outs; over time that was relegated to be a myth (thank goodness). ... The latest foods that have may possibly lead
From the editor
From the Editor ... Dr. Schwarzenberger is the physician editor of ... DermWorld. By Kathryn Schwarzenberger, MD, April 1, 2019 A lot has changed in medicine over the past 20 years. We have new diseases, new understanding of old diseases, and innumerable new medications with which to practice our craft.
Leadership story by Kelly M. Cordoro, MD, FAAD
Leadership Development Steering Committee chair Kelly M. Cordoro, MD, FAAD, finds it an incredible privilege to strengthen and expand the programs and offerings of the Leadership Institute. Dr. Cordoro’s story ... Kelly M. Cordoro, MD, FAAD, chair of the AAD’s Leadership Development Steering Committee. ... Leadership training has influenced every
Fighting for truth in advertising in Indiana
Ask the Expert ... By Victoria Houghton, Managing Editor, August 1, 2022 DermWorld ... spoke to Carrie Davis, MD, FAAD, former chair of the Government Affairs and Advocacy Committee at the Indiana Academy of Dermatology, about efforts with the American Academy of Dermatology Association (AADA) to advocate for truth in
Dermatologic surgery
Transplantation dermatology: Race matters Breaking up (with habits) is hard to do: The role of platelet transfusions when performing skin biopsies on profoundly thrombocytopenic patients Angiosarcomas and morbid obesity: An enormous problem Nom de plume: Affaire risquée A surgical pearl (in waiting) for the medical dermatologist Patients’ (mis)understanding of their
DW Insights and Inquiries archive
Explore hundreds of ... DermWorld Insights and Inquiries articles by clinical area, specific condition, or medical journal source. ... Access articles by publication date ... 2024 2023 2022 2021 2020 2019 Access articles by clinical area ... Dermatologic surgery Dermatopathology Medical dermatology Pediatric dermatology Access articles by condition or medical
Acne/rosacea
Putting muscle into isotretinoin laboratory testing isn’t chopped liver! Stress2 + Hormones2 = Acne2 The rosy reality of coffee Why we do what we do Scarred by dogma: Revising recommendations for surgery and isotretinoin use A novel sebum inhibitor for acne vulgaris: A slick maneuver Got milk? Got acne? Low
41’s gracious contribution to skin cancer awareness
By Warren R. Heymann, MD Dec. 1, 2018 Skin lesions are observed on photographs, television, and in the movies. Whether it is Bill Clinton’s rosacea, Richard Gere’s Becker’s nevus, or Mikhail Gorbachev’s port wine stain, I have to consciously ignore these conditions to concentrate on why I am watching them
Joining the “fold”: Squamous cell carcinoma complicating porokeratosis ptychotropica
By Warren R. Heymann, MD June 26, 2017 Coalescent erythematous papules involving bilateral buttocks. ... Credit: ... JAAD I know the variants of porokeratoses and can recite them as though I am the very model of a modern major general — Mibelli, linear, punctate, palmoplantar, DSAP, superficial disseminated, immunosuppression-related, and
2019 MIPS payment infographic
information on possible Remark codes: http://www.wpc-edi.com/reference/codelists/healthcare/remittance-advice-remark-codes
April
Issue ... April January February March April May June July August September October November December View digital flipbook In this issue ... From the Editor ... From the editor Asked and Answered ... I have a job opening at my practice. Where can I post it? What's hot ... What's
Off-label but not off-limits
Legally Speaking ... Robert M. Portman, JD, MPP, is a health care attorney with Powers Pyles Sutter & Verville, in Washington, DC, and serves as legal counsel for the AAD and AADA. ... By Ben Tesdahl, JD, LL.M, Megan La Suer, JD, MHA, and Rob Portman, JD, MPP, June 1,
Dermatitis
Parabens — A common allergen with lots of hype and no real harm Finding Joy in pediatric phototherapy Should dermatologists be anti-antihistamine for atopic dermatitis? Aha! The iodide paradox now makes sense! Dupilumab’s conjunctivitis conundrum Dupilumab: The first year The medical word to watch in 2018: Dysbiosis Hairdressers’ dermatologic odyssey:
A burning question: Should patients receive the zoster vaccine after an episode of shingles?
By Warren R. Heymann, MD Oct. 26, 2016 The question as to whether a patient should receive the vaccine after having had herpes zoster (HZ) has been asked since the initial release of the vaccine. There has been remarkably little data to help guide the clinician. ... The importance of
Neurofibromatosis type 1, juvenile xanthogranuloma, and leukemia: Wasting a good worry?
By Warren R. Heymann, MD May 22, 2017 A clinically pigmented neurofibroma associated with underlying café au lait macule. ... Credit: ... JAAD Worry comes with the territory of Neurofibromatosis Type I (NF-1). It often starts with the anxiety of determining if a child has enough criteria to confirm the
Perianal dermatologic exams are looking up
By Warren R. Heymann, MD Nov. 14, 2016 Every dermatologist confronts how to ask a person to disrobe for a full body skin examination. Ultimately, I came up with the following line when asked what should be exposed: "The more of you I see, the better off you are —
Step 3: Small and large practice reporting options
Access the PDF ... See a PDF version of the Academy ... ’ s ... practice reporting options . ... Review these reporting options for small practices (15 providers or fewer) and large practices (16 providers or more) to help achieve the minimum and maximum points needed to either avoid
Psoriasis
Finding Joy in pediatric phototherapy The newest frontier for biologics and psoriasis may be adherence Coughing up a new warning for ustekinumab Tofacitinib: A JAK inhibitor of all trades Psoriasin: Its other meaning and implications Asking Psoriasis Patients to Open Their Mouths and Say "Ahhh" Dyeing for a "new" topical
Understanding payer contracts
Practicing medicine often requires physicians to evaluate many different contracts with payers. The terms of these contracts are sometimes difficult to understand, but they can have a major impact on reimbursement and administrative burden. The many factors addressed in payer contracts add to the challenges physicians face in making good
PDF of Academy analysis regarding COVID-19
This material should not be construed as legal or tax advice and members should consult with their personal
Digital strategy for dermatologists
Answers in Practice ... By Emily Margosian, Assistant Editor, May 1, 2024 DermWorld ... talks to Lindsey Zubritsky, MD, FAAD, from Premier Dermatology and Skin Cancer Center in Ocean Springs, Mississippi, about tips for building a digital strategy and online presence. Lindsey Zubritsky, MD, FAAD ... DermWorld: Tell us about
Ongoing best practices for HIPAA
Legally Speaking ... Daniel F. Shay, Esq., is a health care attorney at Alice G. Gosfield and Associates, P.C. ... By Daniel F. Shay, Esq., March 1, 2024 DermWorld covers legal issues in "Legally Speaking." This month’s author, Daniel F. Shay, Esq. is a health care attorney at Alice G.
PDF of measure 402 flowchart
AND provide tobacco cessation intervention DATADERM (including at least one of the following: advice
Hair
Slivers of skin may diagnose silver hair syndromes Laboratory testing for syphilitic alopecia: Time to renew old habits? Adjusting the screen door: Developing a rational approach to assessing for thyroid disease in patients with alopecia areata Hairdressers’ dermatologic odyssey: From dye to death prevention Alopecia areata incognita in Cronkhite-Canada syndrome
American Academy of Dermatology Website Terms of Use
American Academy of Dermatology Website Terms of Use ... This website is owned and operated by the American Academy of Dermatology ("Academy") and the American Academy of Dermatology Association ("AADA"). For simplicity, all references below to the "Academy" are deemed to include both organizations unless otherwise indicated. ... General Terms
PDF of Employee Leave Form, second template
This material should not be construed as legal or tax advice and members should consult with their personal
PDF of Employee Leave Form, first template
This material should not be construed as legal or tax advice and members should consult with their personal
I'm retiring and want to sell my practice. Does the Academy have any resources to help?
Asked and Answered ... July 1, 2019 Yes! We offer the following resources to assist AAD members who are considering closing their practices: ... ... The AADA’s Practice Management Center breaks down: ... How to value your practice, with a detailed explanation of how to calculate EBITDA (Earnings Before
Building relationships and building leadership
Networking helped AAD member Benedict Wu, DO, PhD. Dr. Wu’s story ... Benedict Wu, DO, PhD, FAAD ... I attended the 2023 Leadership Forum (LF) and found the sessions and networking events helpful to improve my public speaking skills and identify ways to improve teamwork. After the LF, I took
Optimizing your patient portal
Answers in Practice ... By Emily Margosian, Assistant Editor, July 1, 2022 DermWorld ... talks to Laura Houk, MD, FAAD, from MaineHealth Medical Group in Portland, Maine, about her tips on how to effectively manage your patient portal. DermWorld: Tell us about your practice. Dr. Houk: I work at MaineHealth
Surviving and thriving after a natural disaster
Answers in Practice ... By Emily Margosian, Assistant Editor, September 1, 2023 DermWorld ... talks to Mary Lupo, MD, FAAD, from the Lupo Center for Aesthetic and General Dermatology in New Orleans, about how to prepare your practice for a natural disaster. Mary Lupo, MD, FAAD ... DermWorld: Tell us
Q3 2020 PDF of Derm Coding Consult articles
They are the Claim Adjustment Reason Codes (CARCs) and the Remittance Advice Remark Codes (RARCs).
PDF of understanding your 2019 medicare payment
information on possible Remark codes: http://www.wpc-edi.com/reference/codelists/healthcare/remittance-advice-remark-codes
Atrophic tinea versicolor: More than a mirage?
By Warren R. Heymann, MD April 22, 2016 On occasion I would examine a patient with tinea versicolor and wonder if the finely scaly patches were atrophic. Somehow, I figured (possibly mistakenly) that it was more of an optical illusion than genuine atrophy. That was a settled issue in
Having a mentor helped Kala S. Hurst, DO, become a dermatology resident.
Having a mentor helped Kala S. Hurst, DO, become a dermatology resident. Dr. Hurst's story ... Kala Hurst, DO, University Hospitals/Case Western Reserve University’s Department of Dermatology, PGY-2. ... I applied to the AAD Diversity Mentorship Program, but actually did not receive the award. Instead, I found my mentor, AAD
February 15, 2023
Derm World Weekly - A Publication of the American Academy of Dermatology | Association ... IN THIS ISSUE / Feb. 15, 2023 ... AADA addresses lidocaine shortage with manufacturers DermWorld Insights and Inquiries : A nail-biting commentary Risk of rebound psoriasis flare from systemic corticosteroids DermWorld Young Physician Focus :
To concierge or not concierge, that is the question
By Warren R. Heymann, MD June 10, 2017 After very long days of difficult patients (diagnostically, therapeutically, and otherwise), insurance denials, prior authorizations, business decisions, MACRA, et cetera, I think of the milkman Tevye from "Fiddler on the Roof," finally sitting down, and singing "If I Were a Rich Man."
Medical Ego Inflation and a Lesson from Mom
By Warren R. Heymann, MD Oct. 31, 2016 Last week my 95-year-old mother literally returned from the deceased. In classic Hollywood motif, my cousin Elysa, who was at her bedside when she was moribund, was pleading for me to desperately get to there, demanding that the attending do something, as
Employment-related legal considerations during COVID-19: Part II
Legally Speaking ... Robert M. Portman, JD, MPP, is a health care attorney with Powers Pyles Sutter & Verville, in Washington, DC, and serves as legal counsel for the AAD and AADA. ... By Megan La Suer, JD, MHA, Rob Portman, JD, MPP, and Ben Tesdahl, JD, June 1, 2020
Hair repigmentation in frontal fibrosing alopecia
By Warren R. Heymann, MD April 25, 2016 One of the major joys of practicing dermatology is that I’m stumped by something every day. Today an 81 year-old woman complained of months of hair loss along the frontal scalp with some loss of eyebrow hair. She had alopecia, follicular prominence,
Are you part of our AAD Clinical Community?
Launched earlier this year, your new online ... AAD Clinical Community is living up to its name and growing into a large, vibrant community! This new member benefit provides AAD members a moderated space to collaborate on clinical cases, advance medical skills and knowledge, and participate in a forum to
Recommended mentoring topics
The actual mentoring that happens in any individual relationship will, of course, be variable. Discussions can be open-ended and are meant to bring clarity to difficult issues or dilemmas that the mentee may be facing. Some may find that shared readings may be helpful to discuss. Some examples of common
Maximizing your retirement wealth
Money Matters ... David B. Snyder, JD, CLU ... ® ... , is an attorney, author, and financial advisor at the wealth management firm OJM Group. He covers financial issues for dermatologists in this quarterly ... Dermatology World column. ... By David B. Synder, JD, CLU, December 3, 2018 For
Smarter not harder
In Practice ... Dr. Gardner serves as assistant professor of medicine and dermatology at the University of Washington School of Medicine and works in the dermatology clinic at UW Medical Center Roosevelt and the Seattle Cancer Care Alliance. ... By Victoria Houghton, managing editor, March 1, 2019 Dermatology World talks
Challenging patient scenarios
Answers in Practice ... By Emily Margosian, Assistant Editor, January 1, 2023 DermWorld ... talks to Melissa Mauskar, MD, FAAD, associate professor of dermatology and obstetrics and gynecology at UT Southwestern Medical Center, about how to approach difficult conversations with patients. DermWorld: Tell us about your practice. Melissa Mauskar, MD,
Streamlining the claim denial process in your practice
Claim denials are a reality for every dermatology practice. It is wise to be proactive and understand what you need to do when you receive a claim denial. Streamlining your claim denial process requires understanding the meaning behind each denial on the explanation of benefits (EOB) and the appropriate action
Why you should choose AAD Camp Discovery flyer
the counselors have chronic skin conditions July 8–13, 2024 as well, and can provide support and advice
Journal of Investigative Dermatology
Cutting giant congenital nevi down to size molecularly I never wanted chaperones — until now An acne vaccine to make patients happy CAMPers? The rosy reality of coffee Aha! The iodide paradox now makes sense! A future therapeutic Harlequin Romance? A string of (clinical) pearls about drug-induced linear IgA disease
Beneficiary inducements: What's permissible?
Legally Speaking ... Alice G. Gosfield, Esq. is a health care attorney at Alice G. Gosfield and Associates, P.C. ... By Alice G. Gosfield, Esq., November 1, 2018 The anti-kickback statute with its criminal and civil penalties, fines, and exclusion options is incredibly broad. It implicates a wide range of
Payer contracts redux
Legally Speaking ... By Alice G. Gosfield, Esq., December 1, 2023 DermWorld ... covers legal issues in "Legally Speaking." This month’s author, Alice G. Gosfield, Esq. is a health care attorney at Alice G. Gosfield and Associates, P.C. Alice G. Gosfield, Esq ... In 2016, I wrote an ... article
Does the No Surprises Act affect dermatologists?
Legally Speaking ... By Allyn Rosenberger, JD, MPH, and Robert M. Portman, JD, MPP, May 1, 2023 Every month, ... DermWorld covers legal issues in ... "Legally Speaking." This month’s authors are health care attorneys with Powers Pyles Sutter & Verville in Washington, D.C. Portman is also general counsel for
Will PD-1 inhibitors be msed for Mastocytosis?
By Warren R. Heymann, MD May 8, 2016 Kuklinski L, Kim J. Expression of PD-L1 in mastocytosis. J Am Acad Dermatol 2016; 74: 1010-2. ... The authors evaluated 16 specimens from 12 patients with mastocytosis, using immunohistochemical stains for PD-L1, CD-117, and mast cell tryptase on all specimens. Of the12
Happy 4th of July from DI&I
By Warren R. Heymann, MD July 3, 2018 George Washington contracted smallpox when he was 19 years old. Although he nearly succumbed to the disease, he survived with pockmark scars and life-long immunity. (1) He and other founders recognized the severity of smallpox and its threat to their independence and
Forever young with chocolate
By Warren R. Heymann, MD May 19, 2016 Recently we discussed how dark chocolate can exacerbate acne. How many times have you heard a patient complain that it’s just not fair — they’re getting wrinkles and are still breaking out? Here is some good news! ... Kim et al have
Frozen sections to diagnose epidermolytic ichthyosis: Very cool!
By Warren R. Heymann, MD ... May 30, 2016 ... Is there anything more daunting than being called to the neonatal unit confronted by a desquamating, peeling, neonate? The differential diagnosis is broad, ranging from Staphylococcal Scalded Skin Syndrome (SSSS), Toxic Epidermal Necrolysis (TEN), Epdermolysis Bullosa, Bullous Congenital Ichthyosiform Erythroderma
Mee too: More than just arsenic
By Warren R. Heymann, MD June 11, 2016 Mee’s lines is the eponym for linear leukonychia, presenting as transverse white bands of the nail plate. It is due to interrupted growth of the nail matrix, resulting in parakeratosis of the nail plate. These lesions grow out with the nail and
British Journal of Dermatology
The pachydermoperiostosis prostaglandin paradigm Tofacitinib: A JAK inhibitor of all trades Focusing attention on X-linked ichthyosis We’ve gotta recognize GATA2 deficiency Sirolumus’s merit for the Kasabach-Merritt phenomenon Aha! The iodide paradox now makes sense! Changing perceptions of pediatric mastocytosis A string of (clinical) pearls about drug-induced linear IgA disease Dupilumab’s
Become a mentor
Use your practical observations, skills, and lessons learned to help foster early career dermatologists. Review the list of programs below and join our database of mentors by completing your unique mentor profile. This information will be shared with mentees in our fully searchable online mentor database. ... Become a mentor
Coding Resource Center
CPT coding overview ... This video gives an overview of the practical tips and tools you'll find in the Coding Resource Center. From CPT to ICD-10 to E/M coding, these Academy resources will simplify your coding life. ... Find practical tips, tools, quizzes, and videos about common dermatological coding issues.
July 4
Derm World Weekly - A Publication of the American Academy of Dermatology | Association ... IN THIS ISSUE / JULY 4, 2018 ... iPLEDGE hits a snag with patients Hawaii governor signs legislation banning sunscreen with oxybenzone and octinoxate Medicare announces new MUE limit for aminolevulinic acid HCI, 10% (Ameluz)
How to participate in AAD’s DataDerm™ clinical data registry
Legally Speaking ... By Allyn Rosenberger, JD, MPH, Ben Tesdahl, JD, LL.M, and Robert M. Portman, JD, MPP, September 1, 2023 Every month, ... DermWorld covers legal issues in "Legally Speaking." This month’s authors are health care attorneys with Allyn Rosenberger, JD, MPH, Ben Tesdahl, JD, LL.M, and Robert M.
Happy Father’s Day
By Warren R. Heymann, MD June 18, 2017 It is ironic that the founding father of the American Academy of Dermatology, Howard Fox, was a bachelor with no children. He was undoubtedly influenced by his father, the beloved and internationally known dermatologist, George Henry Fox. We are their legacy, and
Plantar melanoma and mechanical stress
By Warren R. Heymann, MD June 15, 2016 Acral lentiginous melanoma (ALM) involves the palms, soles, and nail beds. It is the most common type of melanoma in patients of African or Asian descent. Delays in diagnosis result in more advanced disease at the time of diagnosis. Trauma or chronic
Skin cancer/ melanoma
Cutting giant congenital nevi down to size molecularly Calcipotriene and 5-fluorouracil: Dermatology’s new dynamic duo? Rejecting preconceived notions of squamous cell carcinomas in patients experiencing transplant rejections Biting my nails worrying about atypical presentations of nail unit melanomas 41’s gracious contribution to skin cancer awareness Dermatopathology reports about basal cell
Physical leads to excision of "Ugly Duckling" lesion
Derm ECHO, a program connecting primary care physicians with dermatologic best practices, helps identify a patient’s ‘ugly duckling’ lesion leading to a critical surgical excision. ... Daniel's story ... Daniel Fessler – Fulton, Missouri ... Normally, I’m not someone who goes to the doctor on a regular basis, or even
Leadership story by Maria Teresa García-Romero, MD, MPH, IFAAD
AAD member Maria Teresa García-Romero, MD, MPH, IFAAD had her professional life changed through the Academic Dermatology Leadership Program. Dr. García-Romero’s story ... Maria Teresa Garcia-Romero, MD, MPH, IFAAD ... I completed the Academic Dermatology Leadership Program (ADLP) in 2021. I can say the ADLP was one of the most
GP - Antitrust Compliance Policy
turns to antitrust-sensitive issues, participants should discontinue the conversation until legal advice
DWI&I holiday greeting 2020: Eyeing dermatology’s future
By Warren R. Heymann, MD Dec. 18, 2019 Vol. 1, No. 40 2020 will be replete with innumerable references focusing on vision. As I composed this holiday greeting, I had the privilege of touring Norway above the Arctic Circle, perplexed and awestruck by the Northern Lights. Vision may be hindsight, current,
Psoriasiform eruptions during Kawasaki disease (KD): A prognosis that lets the good times roll
By Warren R. Heymann, MD June 27, 2016 Psoriasiform skin changes have been rarely described in the literature in both acute (1-4 weeks) and convalescent phases (4-12 weeks) of KD (1). ... Haddock et al, in their review of 870 cases of KD, identified 11 patients with a psoriasiform eruption
Future shock of teledermatology
By Warren R. Heymann, MD April 16, 2016 The authors surveyed 62 patients older than 18 years, and 43 caregivers of patients younger than 18 who had been taking isotretinoin for at least 3 months. "Most respondents reported no concern about the safety of an e-visit compared with that of
Neutrophil-rich subcutaneous fat necrosis of the newborn: Sometimes a cigar is just a cigar!
By Warren R. Heymann, MD June 24, 2016 Recently, I was consulted to the neonatal ICU to evaluate a newborn with red, indurated, fluctuant plaques on the back. I had no doubt that this was a classical case of subcutaneous fat necrosis of the newborn (SCFN). A biopsy demonstrated a
Diagnosing pyoderma gangrenosum? Consider cocaine/levamisole as a potential culprit!
By Warren R. Heymann, MD May 1, 2016 The authors presented 8 patients with PG following exposure to levamisole-contaminated cocaine. All patients had lower extremity involvement, and 6 also had PG on the upper extremities. Retiform purpura was only observed in 3 patients. Most had elevated titers for p-ANCA and
Another mastocytosis surprise: IgM on DIF in bullous mastocytosis
By Warren R. Heymann, MD ... May 2, 2016 ... If I read my horoscope this week, it would no doubt say "Beware of any preconceived notions in your patients with mastocytosis." ... Now that I have expanded my horizons about TMEP, I also need to reconsider the notion that
A trend I cannot endorse
By Warren R. Heymann, MD Feb. 17, 2017 A patient with a morbilliform eruption was assessed at our clinic. My resident evaluated him first before presenting the case to me. ... "Did he have any systemic symptoms?" I inquired. ... "He endorsed diarrhea," my resident replied. ... "You mean he
Changing a long-standing habit
By Warren R. Heymann, MD April 16, 2016 Topical corticosteroid has no influence has no influence on inflammation or efficacy after ingenol mebutate treatment of grade I to III actinic keratosis (AK): A randomized clinical trial. ... This is a randomized controlled clinical trial of patients with multiple AK and
Pityriasis rubra pilaris: Check a TSH!
By Warren R. Heymann, MD ... June 10, 2016 ... There are myriad ways to mine the data from the review of 100 cases of PRP by Ross et al, however, one key finding will change the way I will assess these patients — 20% were hypothyroid! (1) ... There
Allopurinol-induced adverse reactions: More than genetics
... By Warren R. Heymann, MD June 25, 2016 There are certain drugs that confer a high risk of severe cutaneous adverse reactions (SCAR) ranging from morbilliform drug eruptions, DRESS, Stevens-Johnson, to Toxic Epidermal Necrolysis. You know the usual suspects — anticonvulsive agents, sulfa drugs, other anti-infective agents, and
Pediatric dermatology
Finding Joy in pediatric phototherapy Congenital Juvenile Xanthogranulomas: Born To Be Wild (But Ultimately Mild) Sophie’s choice: Assessing atypical Spitz tumors in the molecular era The real jigsaw puzzle of the Brooke-Spiegler Syndrome: Translating the molecular biology to therapy Sirolumus’s merit for the Kasabach-Merritt phenomenon A future therapeutic Harlequin Romance?
Working together to provide optimal melanoma care
Medical, surgical, and radiation oncology; dermatology; and other specialties collaborate to improve skin cancer treatment. ... Dr. Albertini's story ... Mark R. Albertini, MD, Oncologist, University of Wisconsin School of Medicine and Public Health ... The melanoma tumor board at the University of Wisconsin School of Medicine and Public Health
#DermTok
TikTok as a tool to engage with public health and promote dermatologic expertise ... Feature ... By Emily Margosian, Assistant Editor, May 1, 2022 For a fleeting moment, there were few questions more pressing than, "Is it a Bones Day?" ... Last fall, Noodle, a 13-year-old pug, shot to stardom
Leaders in medicine – Part 2
DermWorld talks to dermatologists in leadership roles in the house of medicine. ... Feature ... By Matthew Walsh, Member Communications Specialist, June 1, 2023 This is the second part of a series of interviews in which ... DermWorld spoke with nine board-certified dermatologists who serve or have served in important
Hand-wringing over the histology of mechanic’s hands and other cutaneous manifestations of dermatomyositis
By Warren R. Heymann, MD April 23, 2018 Dermatomyositis. Erythematous papules overlying the metacarpal and interphalangeal joints (Gottron papules). ... Credit: ... JAAD Of all the cutaneous manifestations of dermatomyositis (DM) — the heliotrope rash, Gottron’s papules, Gottron’s sign, shawl sign, holster sign, flagellate erythema, photosensitivity, poikiloderma, periungual erythema, periungual
Selectivity and the choice of beta-blockers for infantile hemangiomas
By Warren R. Heymann, MD Sept. 11, 2017 Clinical evolution of an infantile ulcerated hemangioma on upper lip of patient 7. Clinical appearance: Before starting propranolol (A); after 12 months of follow-up (3 months of treatment) (B). ... Credit: ... JAAD Has there ever been a more radical change in
Voriconazole prophylaxis mandates cutaneous prophylaxis – and communication
By Warren R. Heymann, MD Sept. 28, 2017 The utilization of allogeneic hematopoietic stem cell transplantation (HSCT) has been increasing dramatically. According to the Health Resources and Services Administration, 92,784 procedures were performed between 2010 and 2014. ... Invasive fungal infections (IFIs) following allogeneic hematopoietic stem cell transplantation HSCT remain
Keeping current with Medicare enrollment
Legally Speaking ... Daniel F. Shay, Esq., is a health care attorney at Alice G. Gosfield and Associates, P.C. ... By Daniel F. Shay, Esq., December 1, 2024 DermWorld ... covers legal issues in "Legally Speaking." This month’s author, Daniel F. Shay, Esq. is a health care attorney at Alice
Primer on payer contract issues
Answers in Practice ... By Lou Terranova, Associate Director, Practice and Payment Policy, and Teresa Salaway, Senior Manager, Practice and Payment Policy, October 1, 2024 Each month, DermWorld ... tackles issues "in practice" for dermatologists. This month, AADA regulatory and payment policy staff highlight critical elements of payer contracts for
Using trusts to shield assets from potential liability
Money Matters ... David B. Snyder, JD, CLU ... ® ... , is an attorney, author, and financial advisor at the wealth management firm OJM Group. He covers financial issues for dermatologists in this quarterly ... Dermatology World column. ... By David B. Snyder, JD, CLU, September 3, 2018 Given
AccessDerm: Serving the underserved
In Practice ... Dr. Simpson serves in the Department of Dermatology at University of Pennsylvania. ... By Dean Monti, managing editor, special publications, September 2, 2019 Dermatology World speaks with Cory Simpson, MD, PhD, about why he uses AccessDerm — the Academy's volunteer teledermatology platform — how it works, and
Long-term care planning
Money Matters ... David B. Snyder, JD, CLU ... ® ... , is an attorney, author, and financial advisor at the wealth management firm OJM Group. He covers financial issues for dermatologists in this quarterly ... Dermatology World column. ... By David B. Snyder, JD, CLU, March 1, 2019 What
AccessDerm: Serving the underserved
Derm World Weekly - A Publication of the American Academy of Dermatology | Association ... With just a few minutes a day and a smartphone, dermatologists have the potential to make a significant impact in their community by using the Academy's volunteer teledermatology platform, ... AccessDerm . ... Dermatology World
Terra Firma-Forme Dermatosis
By Warren R. Heymann, MD, FAAD Nov. 13, 2024 Vol. 6, No. 46 The renowned gastroenterologist was rounding with his fellows when he summoned me to his patient’s bedside to impress me with his astute diagnosis of malignant acanthosis nigricans, having admitted his patient for an extensive endoscopic work-up for
The physician view of employment agreements
Legally Speaking ... Daniel F. Shay, Esq., is a health care attorney at Alice G. Gosfield and Associates, P.C. ... By Daniel F. Shay, Esq. , July 1, 2023 DermWorld ... covers legal issues in "Legally Speaking." This month’s author, Daniel F. Shay, Esq. is a health care attorney at
GP - Reinstatement of Membership
review by the Executive Committee acting on behalf of the Board of Directors. 1 In such cases, upon advice
PDF of AADA Immediate Past President Position Description
Accountability: Reports to the Board of Directors Role: Provide advice and counsel to the President
Thoughts and prayers ad infinitum
Dr. George and Kate Heymann, circa 1940 ... By Warren R. Heymann, MD Oct. 27, 2018 How many times do we have to hear our leaders offer the "thoughts and prayers" homily until it becomes devoid of meaning? ... The following are my thoughts and prayers: ... Thoughts. November 9th
Learning about proton pump inhibitor-induced dermatologic adverse reactions is ulcerogenic
By Warren R. Heymann, MD June 7, 2016 How many of your patients are on protein pump inhibitors (PPI) such as Nexium [esomeprazole], Prevacid [lansoprazole], or Prilosec [omeprazole] for GERD? Let me rephrase the question. How many of your patients are NOT on PPIs? ... Alkeraye et al reported two
Eruptive nevi: Trying to connect the dots
By Warren R. Heymann, MD Sept. 15, 2016 Eruptive nevi are striking — they may appear after a variety of disorders, including Stevens-Johnson/toxic epidermal necrolysis, primary blistering diseases, trauma, immunosuppression (from disease or iatrogenically-induced), PUVA therapy, or idiopathically. There are also several reports in the literature for eruptive Spitz nevi
Primary sclerosing cholangitis associated with pyostomatitis vegetans and pyodermatitis vegetans: A potentially bilious situation
By Warren R. Heymann, MD Aug. 29, 2016 Inflammatory bowel disease may be associated with multiple cutaneous manifestations including pyoderma gangrenosum (PG), erythema nodosum, or directly by fistulae or "metastatic" Crohn disease. Seven cases of pyostomatitis vegetans-pyodermatitis vegetans (PSV-PDV) were reviewed. All 7 patients had inflammatory bowel disease (IBD) —
Toxicity of topical timolol for infantile hemangiomas in preterm infants: Size matters
By Warren R. Heymann, MD Aug. 13, 2016 I have been using topical timolol (0.5% gel) for the past few years for infants with infantile hemangiomas (IH) with reasonable success, but I am always nervous about prescribing it, as data on the degree of topical absorption remains to be defined.
Cimetidine offers a ray of sunshine for patients With erythropoietic protoporphyria
By Warren R. Heymann, MD Nov. 16, 2016 Only once in a great while an article makes me want to break into my happy dance — the report of 3 pediatric cases of erythropoietic protoporhyria (EPP) by Tu et al had that effect. Recently, I ran a post on EPP
I’ll have a necrobiotic xanthogranuloma to go – with mustard!
By Warren R. Heymann, MD May 11, 2016 Mechlorethamine has been used for decades to treat cutaneous T cell lymphoma. Rodriguez et al utilized 0.01% topical nitrogen mustard to treat a 60+ year-old man with biopsy-proven NXG with paraproteinemia (IgG-κ), without myeloma. He had 20% body surface area involvement, including
Improving insomnia by increasing the diagnostic accuracy of desmoplastic melanomas
By Warren R. Heymann, MD May 21, 2016 Desmoplastic melanomas (DM) may only represent up to 4% of melanomas, however, they are responsible for 50% my insomniac nights. It is easy to lose sleep worrying if that the slightly indurated lesion that I reassured the patient was a "scar," or
Low dose isotretinoin for recalcitrant rosacea: I pledge to use it sporadically
By Warren R. Heymann, MD June 14, 2016 While rosacea can usually be reasonably managed with a combination of topical agents (metronidazole, azelaic acid, ivermectin, sulfacetamide, brimonidine), oral antibiotics (the tetracycline family), vascular lasers, intense pulsed light and surgery (for phymatous disease), some cases are recalcitrant to standard therapy. ...
Thinking of discontinuing the PD-1 inhibitor because of a lichenoid eruption? Don’t do it!
By Warren R. Heymann, MD May 21, 2016 Immune checkpoint inhibitors have been the proverbial "game changers" in oncology, and offer hope (and a chance of survival) where none existed just a few years ago. ... Cutaneous manifestations are the most common adverse reactions to these drugs. Indeed, more than
Move over Lues: Graft-versus-host disease is the new mimicker king
By Warren R. Heymann, MD May 9, 2016 I have always been intrigued by graft-versus-host disease (GVH). I first learned of the disorder in my college immunology course when it was referred to as a cause of "runting syndrome" in mice. ... In the context of transplant recipients, classical features
A surgical pearl (in waiting) for the medical dermatologist
By Warren R. Heymann, MD ... Oct. 21, 2016 ... I admit it — the surgical aspect of my practice is rudimentary. Honestly, any non-cosmetic procedure that takes me more than 5 minutes gets referred. It’s amazing how I can make a living with shave biopsies, tangential excisions, electrodesiccation
Nanotechnology for topical cyclosporine: Not a small matter
By Warren R. Heymann, MD July 19, 2016 Taken at face value, the study by Kumar et al, demonstrating the efficacy of topical cyclosporine for psoriasis, utilizing liposomal nanocarriers (lipogel), might elicit a shrug, because in this randomized study, at 14 weeks, complete clearance of psoriasis was observed in 41%
New pitfalls in the diagnosis of Kaposi sarcoma
By Warren R. Heymann, MD June 16, 2016 Human Herpes Virus-8 (HHV-8) is the common denominator in all forms of Kaposi sarcoma (KS) — classic, endemic, post-transplant/immunosuppressive, and epidemic/HIV. Virtually all cases will demonstrate HHV-8 by immunohistochemistry in all types. ... Manuraj et al present the instructive case of a
A heartfelt thank you note to my psoriasis research colleagues
... By Warren R. Heymann, MD May 11, 2017 Dear psoriasis researcher: ... I first met Casey (not his real name) when he was a child, referred to me for awful psoriasis. He was always upbeat and resilient, but clearly the disease adversely affected his life and that of
This year, the ADA celebrates its 30th anniversary
From the Editor ... Dr. Schwarzenberger is the physician editor of ... DermWorld. By Kathryn Schwarzenberger, MD, October 1, 2020 Not the dental ADA, or even the dermatologic one. The Americans with Disabilities Act ADA. This landmark piece of legislation sought to ensure that Americans living with a disability have
Finding the right type of small dermatology group practice: From an expert
An interview with Danette D. Bentley, MD Dermatologist, Pure Dermatology and Aesthetics What made you choose to become a group practitioner vs. solo practitioner? I really did not have any interest in running my own practice. While I love practicing dermatology and seeing patients, I also have a family and
Opening doors and paying it forward
AAD member John Zampella, MD, FAAD, loved participating in the AAD’s Leadership Institute programs . Dr. Zampella’s story ... John Zampella, MD, FAAD ... I am an Associate Professor of Dermatology at NYU School of Medicine. I am excited to share my experiences with the American Academy of Dermatology Leadership
Participation in mentorship programs is important to becoming a dermatologist
Support of mentors keeps Brittani Remé, MS, motivated to become a dermatologist. Brittani’s story ... Brittani Remé, MS, Kansas City University, DO Candidate 2024. ... I became interested in dermatology after shadowing a dermatologist for a couple of days before medical school. However, my interest peaked in my preclinical coursework,
Mind the gap
By Warren R. Heymann, MD, FAAD March 16, 2022 Vol. 4, No. 11 Two days from now there will be tears of joy and sorrow in our medical schools, especially for those applying for a dermatology residency. I congratulate those who have matched successfully and welcome you to a marvelous
Fake news, predatory journals, case reports, biostatistics, and other journalistic musings
By Warren R. Heymann, MD March 17, 2017 We live in an era of information excess delivered by print, digital devices, webcasts, podcasts, and tweets. Time for reflection is minimal. One of the major precipitants of physician burnout is the endless electronically documenting data, which has replaced speaking to and
Life insurance 102: Five success factors when using permanent life insurance
Money Matters ... David B. Snyder, JD, CLU ... ® ... , is an attorney, author, and financial advisor at the wealth management firm OJM Group. He covers financial issues for dermatologists in this quarterly ... Dermatology World column. ... By David B. Snyder, JD, CLU, September 2, 2019 In
Business associate agreements 101
Legally Speaking ... Daniel F. Shay, Esq., is a health care attorney at Alice G. Gosfield and Associates, P.C. ... By Daniel F. Shay, Esq., July 1, 2021 Every month, DermWorld ... covers legal issues in "Legally Speaking." This month’s author is a health care attorney at Alice G. Gosfield
Implications of the Corporate Transparency Act for physicians
Legally Speaking ... Robert M. Portman, JD, MPP, is a health care attorney with Powers Pyles Sutter & Verville, in Washington, DC, and serves as legal counsel for the AAD and AADA. ... By Allyn Rosenberger, JD, MPH, Jason Qu, JD, and Rob Portman, JD, MPP, April 1, 2024 Every
FTC proposed rule on non-compete clauses: What are the implications for dermatologists?
Legally Speaking ... Robert M. Portman, JD, MPP, is a health care attorney with Powers Pyles Sutter & Verville, in Washington, DC, and serves as legal counsel for the AAD and AADA. ... By Natalie Lorenz, JD, Ben Tesdahl, JD, and Robert M. Portman, JD, MPP, January 1, 2024 Every
Tax reform: What you need to know
Money Matters ... Jason P. Wainscott, JD, is an attorney, author, and general manager of the financial planning firm OJM Group. ... By Jason P. Wainscott, JD, March 1, 2018 Every dermatologist needs to know 2017 saw widespread changes to the federal tax code. There are many cuts and additional
PDF of AAD Immediate Past President Position Description
Accountability: Reports to the Board of Directors Role: Provide advice and counsel to the President
PDF of sample employee memo
This material should not be construed as legal or tax advice and members should consult with their personal
Multinucleated keratinocytes: A real histologic finding in factitial dermatoses
By Warren R. Heymann, MD ... Jan. 7, 2019 ... Patients presenting with factitial dermatoses are challenging on every level, and proving the diagnosis may be very difficult because of patient (or parental) denial of the situation. Recently, there have been a few reports of a histologic finding that
A point to make about punctate, pigmented, and verrucous papillomatosis
By Warren R. Heymann, MD July 25, 2016 What is your mental image of the Gougerot-Carteaud (GC) syndrome? I equate it with confluent and reticulated papillomatosis, presenting on the trunk with hyperpigmented minimally raised plaques. The KOH examination is negative and there is a quick, characteristic response to antibiotics such
“Black dot” alopecia areata
By Warren R. Heymann, MD April 16, 2016 This week I had a 35 year old man present with a one month history of a round patch of alopecia. He was told by his PMD that he had tinea and was started on oral terbinafine (which he had been on
Erythropoietic protoporhyria in an adult: Something I usually don’t think about!
By Warren R. Heymann, MD April 19, 2016 I examined a 53 year-old woman this morning with a mild facial eruption that at best was slightly erythematous and papular. She had been out in the sun a few days ago; apparently this has happened periodically over the last few years.
A Trumpian analysis of infliximab-induced follicular mucinosis: Something’s going on here
By Warren R. Heymann, MD July 10, 2016 Williams et al presented two cases of biopsy-proven facial follicular mucinosis (FM), apparently induced by infliximab, with a normal tissue CD4/CD8 ratio of 2/1 and the presence of CD7, thereby ruling out CTCL. The first case was a 23 year-old man with
PASI 100 and the perfection paradox
By Warren R. Heymann, MD June 27, 2016 I am not a psychiatrist, but over the years I have concluded that my patients’ happiness is more supratentorial than epidermal. ... As we approach perfection, imperfections take on far greater importance. Some examples: ... In medical school, I spent many Sunday
Iododerma from contrast material or Sweet syndrome?
By Warren R. Heymann, MD June 23, 2016 Take a look at "Images in Clinical Medicine" in the June 23rd issue of the ... New England Journal of Medicine (1). ... The authors present the case of a 57 year-old man who presented with a 12 hour history of hematuria.
A revelation: Drug-induced pseudoglucagonoma syndrome
By Warren R. Heymann, MD Aug. 21, 2016 Although only having diagnosed the glucagonoma syndrome (GS) once, I have always been fascinated by necrolytic migratory erythema (NME), and conditions that mimic NME, the so-called pseudoglucagonoma syndrome (PGS). ... PGS has been reported with the following conditions: liver disease, inflammatory bowel
Reflectance confocal microscopy, driverless cars, and Uber: The future of dermatopathology
By Warren R. Heymann, MD ... Sept. 12, 2016 ... In a matter of days, you will be able to use Uber to hail a driverless car to your destination in Pittsburgh. During these trials, initially there will be a human monitor (1). You know where this is going
The telltale plastic bag of flakes
From the Editor ... Dr. Schwarzenberger is the physician editor of ... DermWorld. By Kathryn Schwarzenberger, MD, April 1, 2020 For many of us, that baggie is the start of a really bad day, because while we all recognize delusions of parasitosis, few of us are completely comfortable treating it.
Out with the old and in with the new!
From the President ... Dr. Hruza served as Academy president from March 2019 to March 2020. ... By George Hruza, MD, MBA, January 1, 2020 Happy New Year! I trust that everyone has their New Year’s resolutions in order. Whether they be resolving to tackle your burnout or contribute more
About DermWorld Insights and Inquiries
Mission statement ... DermWorld Insights and Inquiries provides critical perspectives on current dermatologic literature meant to be used in the clinic today and in the future. ... About the editor ... Dr. Warren R. Heymann is the editor of ... DermWorld Insights & Inquiries . He received his MD degree
Holiday Greeting 2022
By Warren R. Heymann, MD, FAAD Dec. 21, 2022 Vol. 4, No. 50 Dear ... DermWorld Insights and Inquiries Devotee: ... Soaked and nervous by the end of the 8th inning with the Phillies down by a run, I turned to my daughter Andrea and whispered, "JT Realmuto needs to
DWI&I Holiday Greeting 2021
By Warren R. Heymann, MD, FAAD December 22, 2021 Vol. 3, No. 50 Dear ... DWI&I devotee: ... The end of the year is a time for reflection and hope. Everyone reading this commentary has been affected by the pandemic. My heart goes out to anyone who has lost a
Following up on “A Trend I Cannot Endorse”
By Warren R. Heymann, MD, FAAD Sept. 22, 2021 Vol. 3, No. 38 I admit defeat. ... For those of you who did not read " ... A Trend I Cannot Endorse ," which was published on Dermatology Insights and Inquiries (the forerunner of Dermatology World Insights and Inquiries), please
Truth in advertising in Georgia
Ask the Expert ... February 1, 2024 DermWorld ... interviews Alexander Gross, MD, FAAD, chair of the Academy State PolicyCommittee, about his efforts in advocating for a truth in advertising bill in Georgia. DermWorld : In a win for Georgia dermatologists, the entire medical community in Georgia, as well as
Leaders in medicine – Part 1
DermWorld talks to dermatologists in leadership roles in the house of medicine. ... Feature ... By Matthew Walsh, Member Communications Specialist, May 1, 2023 The American Academy of Dermatology is one of hundreds of medical associations in the U.S., each offering opportunities for doctors to assume important leadership positions. Engaged
What dermatologists need to know about workplace disability accommodations under the ADA
Legally Speaking ... Robert M. Portman, JD, MPP, is a health care attorney with Powers Pyles Sutter & Verville, in Washington, DC, and serves as legal counsel for the AAD and AADA. ... By Jason Qu, JD, and Robert M. Portman, JD, MPP, January 1, 2025 Every month, DermWorld ...
Quality fraud: What’s that?
Legally Speaking ... Alice G. Gosfield, Esq. is a health care attorney at Alice G. Gosfield and Associates, P.C. ... By Alice G. Gosfield, Esq., July 1, 2024 Every month , DermWorld ... covers legal issues in "Legally Speaking." This month’s author is a health care attorney at Alice G.
Protect your ability to practice
Money Matters ... David B. Snyder, JD, CLU ... ® ... , is an attorney, author, and financial advisor at the wealth management firm OJM Group. He covers financial issues for dermatologists in this quarterly ... Dermatology World column. ... By David B. Snyder, JD, CLU, June 3, 2019 For
Incident to: Old wine in modern bottles
Legally Speaking ... Alice G. Gosfield, Esq. is a health care attorney at Alice G. Gosfield and Associates, P.C. ... By Alice G. Gosfield, Esq., March 1, 2021 Every month, DermWorld ... covers legal issues in "Legally Speaking." This month’s author, Alice G. Gosfield, Esq., is a health care attorney
Der(mom)atology: Navigating parenthood as a physician
Answers in Practice ... By Emily Margosian, Assistant Editor , November 1, 2023 DermWorld ... talks to Asmaa Chaudhry, MD, FAAD, from Stone Ridge Dermatology in Aldie, Virginia, about her tips for balancing two demanding jobs — physician and parent. Asmaa Chaudhry, MD, FAAD ... DermWorld : Tell us about
Cash-only dermatology practice: The key to this dermatologist’s success
You have been practicing dermatology for decades. You have stayed up-to-date with the latest advances in the field. Every day, you come in dedicated to giving your patients the best care, but something is standing in the way — insurance companies. ... Madhavi Kandula, MD, found herself in this position
PS-AAD-BAD Joint Position Statement on LLM Principles
en-USOutputs from LLMs may be inaccurate and potentially harmful if used to seek medical or healthcare advice
DWI&I Holiday Greeting 2020
By Warren R. Heymann, MD Dec. 23, 2020 Vol. 2, No. 50 Dear ... DWI&I Devotee: ... For my 65th birthday this year, my wonderful older brother George presented me with a marvelous gift — a leather-bound compilation of the front page of ... The New York Times including every
2019 DW Insights and Inquiries archive
Explore Dermatology World Insights and Inquiries articles by publication date. ... December ... December 18 - DWI&I holiday greeting 2020: Eyeing dermatology’s future December 11 - Topical retinoid therapy for acanthosis nigricans: In the thick of it December 4 - Beware: Discordance abounds among pathologists in the diagnosis of melanocytic
Holiday wishes, Darwin, and dermatology
By Warren R. Heymann, MD Dec. 21, 2018 In 1835, Charles Darwin visited the Galápagos Islands for only 5 weeks as a naturalist on the HMS Beagle; it was his perceptive assessment of finches that congealed his view of natural selection, which was published in 1859 in ... On the
Why we do what we do
By Warren R. Heymann, MD June 19, 2018 The relentless drumbeat of dictates, regulations, prior authorizations, audits, and social media reviews is taking its toll on physicians’ psyche. Combined with downward reimbursement, narrow insurance networks, pressure to be increasingly productive, and far too many clicks on the electronic medical record,
Going retro: Reactivation of incontinentia pigmenti
By Warren R. Heymann, MD Oct. 11, 2016 The concept of reactivating incontinentia pigmenti (IP) has always fascinated me — I have only encountered cases in my readings. Of course you will recall the vesicular, verrucous, hyperpigmented, and hypopigmented (atrophic) phases of this X-linked dominant disease. Eighty percent of
Pineapple and cicatricial pemphigoid: A need to dole out more studies
By Warren R. Heymann, MD Oct. 4, 2016 The benefits of pineapples have been touted in folk medicine for years. Increasing knowledge of its active ingredient bromelain has lead to a therapeutic pineapple renaissance. Bromelain is a complex natural mixture of proteolytic enzymes derived from pineapple (Ananas cosmosus) and possesses
Rheumatoid vasculitis? Rule-out methotrexate-associated EBV
By Warren R. Heymann, MD June 19, 2016 Rheumatoid vasculitis (RV) is a serious complication of rheumatoid arthritis (RA) causing high morbidity and mortality, despite aggressive immunosuppressive treatment. The incidence appears to be decreasing, possibly due to the recognition of smoking as the most important contributory factor. Male patients with
Got milk? Got acne?
By Warren R. Heymann, MD July 30, 2016 I loved to drink milk as a kid — I would guzzle it. I was on the chunky side, so my mother encouraged me to have skim milk to cut down on the calories. I never really cared for it, but she
Acquired acrodermatitis enteropathica from “total” parenteral nutrition: Still crazy after all these years
By Warren R. Heymann, MD ... May 26, 2016 ... Last week I concluded my introductory dermatology lecture to the first year medical students at Cooper Medical School of Rowan University with the case that convinced me that dermatology would be a great career. During my dermatology elective under the
An incisive approach to chronic paronychia: The square flap technique
By Warren R. Heymann, MD Aug. 2, 2016 I cannot begin to guess how many patients I have seen with chronic paronychia (CP) since I started my residency 36 years ago. I know precisely how many patients I have referred for surgical correction of CP — zero! The reason for
Pseudomolluscoid papules: A more accurate description than pseudoverrucous papules
By Warren R. Heymann, MD April 28, 2016 When patients ask me how I made their diagnosis so quickly, I politely tell them that if any particular lesion takes more than 25 milliseconds to diagnose, they really do have a problem. ... Today I saw a patient that made me
Danazol for telomerase disorders: Prolonging the end — For chromosomes (yes), for dyskeratosis congenita (perhaps)
By Warren R. Heymann, MD May 18, 2016 Telomeres are located at the ends of chromosomes; they are repaired by telomerases. Shortening of telomeres leads to cell senescence, apoptosis, and chromosome instability. Male hormones have been used for decades to treat bone marrow failure and may have their effect by
Being aware of the “Chik” sign in the current arbovirus renaissance
By Warren R. Heymann, MD ... April 24, 2016 ... As the world focuses its attention on the Zika virus, with its profound complications of microcephaly in neonates and Guillain-Barré in adults, we cannot ignore other arboviruses that may cause devastating illness – Dengue Fever and Chikungunya Fever. ... All
Interfering with interferon Gamma: The mechanisms behind acquired resistance to PD-1 inhibitors for melanoma
By Warren R. Heymann, MD Sept. 4, 2016 Astounding major advances in targeted therapies for melanoma, most notably by PD-1 blockade, have given hope and life to patients with metastatic melanoma. Approximately 30 % of advanced melanoma patients experience tumor responses from checkpoint blockade monotherapy, with better clinical responses seen
Purpuric dermatitis herpetiformis: Itching to know why
By Warren R. Heymann, MD July 24, 2016 Last week my partner, Justin Green MD, asked for my opinion about a man with biopsy-proven dermatitis herpetiformis (neutrophilic abscesses and granular IgA deposition) with negative serologic studies for anti-endomysial antibodies (tissue transglutaminase). He had classical lesions on his elbows (grouped vesicles)
The brave new world of melanoma gene expression markers
By Warren R. Heymann, MD May 14, 2016 Epidermolysis bullosa nevi (EBN) are clinically alarming lesions that may display "pseudomelanoma" features histologically. Changes within these lesions may be disconcerting, necessitating repeated biopsies. Any advances to predict biologic behavior would be welcome. ... Ahn et al report the case of a
From the editor
From the Editor ... Dr. Schwarzenberger is the physician editor of ... DermWorld. By Kathryn Schwarzenberger, MD, August 1, 2019 August is already upon us. I never quite understand where the summer goes. It seems like the flowers begin blooming and, suddenly, the leaves already start to change colors. Don’t
From the editor
From the Editor ... Dr. Schwarzenberger is the physician editor of ... DermWorld. By Kathryn Schwarzenberger, MD, November 1, 2018 November is a perfect month to give thanks. It’s also a good time for personal reflection. As physicians, we have many privileges and, hopefully, much to be thankful for. With
On the front lines during COVID-19
Derm World Weekly - A Publication of the American Academy of Dermatology | Association ... Linda Stein Gold, MD ... ... Dermatology World Weekly talks with Linda Stein Gold, MD, recently chosen as the AAD’s next vice president-elect and the current division head of dermatology at the Henry Ford
DWI&I Holiday Greeting 2025
By Warren R. Heymann, MD, FAAD Dec. 18, 2024 Vol. 6, No. 50 Dear ... DWI&I Devotee: ... How are you now that 2024 is about to conclude? I’m sure there are many emotions, from relief to anxiety, and from hope to despair. I concluded my holiday greetings in 2023
Best of DermWorld Insights and Inquiries
Dec. 27, 2023 We know how much you enjoy Dr. Heymann and the editorial board’s weekly analyses of dermatologic literature, so we’ve created a list of the top 10 most popular issues in 2023 — starting with the most popular issue of the year. ... 1. After 23 years, a
2022: Best of DermWorld Insights and Inquiries
December 29, 2022 We know how much you enjoy Dr. Heymann and the editorial board’s weekly analyses of dermatologic literature, so we’ve created a list of the top 10 most popular issues in 2022 — starting with the most popular issue of the year. ... 1. Coming full circle (almost)
International Journal of Dermatology
Rejecting preconceived notions of squamous cell carcinomas in patients experiencing transplant rejections Stress2 + Hormones2 = Acne2 Dermatologists will increasingly meet mammalian meat allergy Dermatologists cannot be lax about acquired cutis laxa A potentially life-threatening association of autoimmune blistering disease we bloody well need to be aware of: Acquired The
It is finally a beautiful day!
From the Editor ... Dr. Schwarzenberger is the physician editor of ... DermWorld. By Kathryn Schwarzenberger, MD, May 1, 2021 I don’t know about you, but I feel like we are nearing the end of an 18-month winter…I guess spring is good for that, and this May, in particular, offers
Academic medical center
Finding the right type of academic practice: From an expert ... An interview with Michel McDonald, MD Academic Dermatologist, Vanderbilt University Medical Center How did you choose your current position? Why did you want to work in the academic setting? I began working at Vanderbilt right out of residency. The
Granulomatous slack skin: More than one type of mimicry
By Warren R. Heymann, MD November 18, 2020 Vol. 2, No. 46 My chief resident presented a case to me enamored with his clinical diagnosis of granulomatous slack skin (GSS). Although I was delighted that he considered the disorder, I explained why I thought these inguinal and submammary pink-white subtly
What dermatology practices need to know about laws protecting pregnant and lactating employees
Legally Speaking ... Robert M. Portman, JD, MPP, is a health care attorney with Powers Pyles Sutter & Verville, in Washington, DC, and serves as legal counsel for the AAD and AADA. ... By Ben Tesdahl, JD, LLM, Jason Qu, JD, and Rob Portman, JD, MPP, September 1, 2024 Every
Information blocking rules for physicians and other health care providers
Legally Speaking ... Robert M. Portman, JD, MPP, is a health care attorney with Powers Pyles Sutter & Verville, in Washington, DC, and serves as legal counsel for the AAD and AADA. ... By Allyn Rosenberger, JD, MPH, Jason Qu, JD, and Rob Portman, JD, MPP, August 1, 2024 Every
FTC narrowly passes final rule prohibiting non-compete clauses
Legally Speaking ... Robert M. Portman, JD, MPP, is a health care attorney with Powers Pyles Sutter & Verville, in Washington, DC, and serves as legal counsel for the AAD and AADA. ... By Natalie Lorenz, JD, Ben Tesdahl, JD, LLM, and Robert M. Portman, JD, MPP, June 1, 2024
COVID-19 impact on employed dermatologists: Part 1
Legally Speaking ... Robert M. Portman, JD, MPP, is a health care attorney with Powers Pyles Sutter & Verville, in Washington, DC, and serves as legal counsel for the AAD and AADA. ... By Ben Tesdahl, JD, Megan La Suer, JD, MHA, and Rob Portman, JD, MPP, September 1, 2020
Life insurance 101: Options and considerations
Money Matters ... David B. Snyder, JD, CLU ... ® ... , is an attorney, author, and financial advisor at the wealth management firm OJM Group. He covers financial issues for dermatologists in this quarterly ... Dermatology World column. ... By David B. Snyder, JD, CLU, September 2, 2019 Life
Lipschütz ulcers: Not only for women
By Warren R. Heymann, MD March 24, 2021 Vol. 3, No. 12 Superstar dermatologists do not throw softball questions to presenters at the Annual Meeting of the American Academy of Dermatology. A few years ago, following my presentation on the cutaneous manifestations of Epstein-Barr infection, Dr. Jeffrey Callen, one of
Tips for avoiding fraud and abuse liability – Part II
Legally Speaking ... By Christina A. Hughes, JD, MPH, Megan La Suer, JD, MHA, and Robert M. Portman, JD, MPP, February 1, 2022 Every month, DermWorld ... covers legal issues in "Legally Speaking." This month’s authors are health care attorneys with Powers Pyles Sutter & Verville in Washington, D.C. Portman
Tips for avoiding fraud and abuse liability – Part I
Legally Speaking ... By Christina A. Hughes, JD, MPH, Megan La Suer, JD, MHA, and Robert M. Portman, JD, MPP, January 1, 2022 Every month, DermWorld ... covers legal issues in "Legally Speaking." This month’s authors are health care attorneys with Powers Pyles Sutter & Verville in Washington, D.C. Portman
COVID-19 impact on employed dermatologists: Part 2
Legally Speaking ... Robert M. Portman, JD, MPP, is a health care attorney with Powers Pyles Sutter & Verville, in Washington, DC, and serves as legal counsel for the AAD and AADA. ... By Ben Tesdahl, JD, Megan La Suer, JD, MHA, and Rob Portman, JD, MPP, October 1, 2020
Intellectual property issues for dermatology practices
Legally Speaking ... Robert M. Portman, JD, MPP, is a health care attorney with Powers Pyles Sutter & Verville, in Washington, DC, and serves as legal counsel for the AAD and AADA. ... By Ben Tesdahl, JD, LL.M, Fernando Montoya, JD, and Robert M. Portman, JD, MPP, January 1, 2023
Home at last
... By Warren R. Heymann, MD Jan. 20, 2018 (This is a continuation of posts about my mother. Please see "Happy 95th Birthday Mom! A Birthday Wish in the Era of ‘Value-Based’ Healthcare" June 5, 2016 and "Medical Ego Inflation and a Lesson from Mom" October 31, 2016) ...
Clinician-educator or a clinician who educates?
By Warren R. Heymann, MD July 11, 2016 Ever since my first exposure to dermatology as medical student at the Albert Einstein College of Medicine, I was mesmerized by the enthusiasm of the dermatology faculty, lead by Dr. Michael Fisher. He was a teacher par excellence; I cannot overestimate the
PDT for erosive pustular dermatitis of the scalp: Seeing the light (but reaching a different conclusion)
By Warren R. Heymann, MD June 9, 2016 Erosive Pustular Dermatitis of the Scalp (EPDS) is a relative common condition, typically seen on the actinically damaged scalps of the elderly men. Lesions characteristically present as hyperkeratotic, crusted erosions with varying degrees of pustulation. Lesions may become secondarily infected. The etiology
Joining the bullae pulpit: PD-1 inhibitors
By Warren R. Heymann, MD Aug. 25, 2016 As the use of immune checkpoint inhibitors has increased, so have the number of severe immunotherapy-related adverse events (irAEs). Although discontinuation of therapy may result in resolution of these untoward reactions, long-term sequelae and death have been reported. In a recently published
Getting a toehold on subungual tumors: Aneurysmal bone cysts join the club
By Warren R. Heymann, MD Aug. 26, 2016 Subungual tumors make me nervous. I realize that most are benign (subungual exostosis, osteochondroma, onycholemmal cyst, glomus tumor, pyogenic granuloma, wart, fibroma, acral fibromyxoma), however subungual malignant lesions (squamous cell carcinoma, keratoacanthoma, melanoma) occur. A delayed diagnosis can result in a profoundly
You like tomato, I like tomahto, you soak with steroids, I use them dry…
By Warren R. Heymann, MD July 28, 2016 I have been a firm believer in the “Soak and Smear” approach to treating recalcitrant dermatoses, including atopic dermatitis, as detailed by Gutman et al, more than a decade ago. The authors defined soaking and smearing as soaking an affected body part
Tofacitinib for dermatomyositis: A potential belle of the ball?
By Warren R. Heymann, MD Aug. 23, 2016 JAK1/3 signaling participates in the pathogenesis of inflammatory disorders while JAK1/2 signaling plays a role in the development of several malignancies including leukemias, lymphomas, and myeloproliferative neoplasms. Tofacitinib (Xeljans) is a pan-JAK inhibitor that is approved by the FDA for the treatment
Make no bones about it: Primary cutaneous ewing sarcoma is for real
By Warren R. Heymann, MD Aug. 15, 2016 Recently my partner biopsied a verrucous papule from the face of a young boy, without being confident of his clinical impression. Histologically, I knew I was looking at a malignant lesion, but could not identify it. I sent the slide for a
Systemic amyloidosis presenting as nail dystrophy (and inducing onychophagia in the reviewer)
By Warren R. Heymann, MD June 20, 2016 I admit it — I am plagued with onychophagia (nail biting). It is a life-long habit, and now that I’m 61, I presume that this foible will remain with me to the end. It is worse with anxiety — after reviewing the
Stiff skin syndrome: Hard in many ways
By Warren R. Heymann, MD July 4, 2016 Stiff skin syndrome (SSS) is a noninflammatory, fibrosing condition of the skin and fascia, often affecting the limb girdle region, notably the buttock and thighs, resulting in a lordotic posture. It may be accompanied by subtle hypertrichosis and hyperpigmentation. The course tends
Paraneoplastic syndromes (PNS) associated with merkel cell carcinoma are analogous to small cell cung Cancer: A comparison to other lung cancers
By Warren R. Heymann, MD Sept. 2, 2016 Merkel cell carcinomas (MCC) are neuroendocrine tumors associated with the Merkel cell carcinoma polyomavirus in >80% of tumors (1). Small cell lung cancer, another neuroendocrine tumor, is associated with paraneoplastic syndromes (PNS) in up to 20% of cases, notably the syndrome of
A plasma cell dyscrasia fable: AESOP and POEMS presenting concurrently
By Warren R. Heymann, MD Sept. 7, 2016 There is a moral to every fable. In this commentary, it is that VEGF (vascular endothelial growth factor) may have multiple cutaneous manifestations, even in the same patient. ... Rongioletti et al presented the case of a 70 year-old man with an
Waiting for Wong
By Warren R. Heymann, MD ... Oct. 6, 2016 ... The Wong variant of dermatomyositis was originally described by O’Leary during the Eisenhower administration (1953) and named for Wong during Nixon’s tenure (1969). I have been involved with dermatology since Carter’s term in office (1979). Since that time (Reagan,
Spot on! Lentigines in resolved psoriatic plaques
By Warren R. Heymann, MD Nov. 30, 2016 Having treated psoriatic patients throughout my career, there have been innumerable occasions where patients were concerned about pigmentary changes following successful treatment of the plaques. I have usually reassured them that these are postinflammatory pigmentary alterations that should abate with time. Recently,
Doxycycline as prophylaxis for EGFR-induced folliculitis: Is a pound of cure worth an ounce of prevention?
By Warren R. Heymann, MD May 23, 2016 Epidermal Growth Factor Inhibitors (EGFRI) may cause acneiform eruptions that characteristically appear within a few weeks of their administration. These appear in > 50% of cases treated with EGFRI and in up to 100% of those cases treated with cetuximab. The appearance
A sweeter approach to treating scleroderma?
By Warren R. Heymann, MD March 14, 2017 Scleroderma fingernail changes. A, Longitudinal ridging and pitting. B, Brachyonychia. C, Trachyonychia. D, Thickened and enlarged cuticles. E, Thickened, enlarged, and irregular cuticles. F, Nailfold capillaroscopy: presence of enlarged and giant capillaries. G, Nailfold capillaroscopy: presence of enlarged and giant capillaries,
Intralesional triamcinolone for hidradenitis suppurativa and thoughts on confirmation bias
By Warren R. Heymann, MD Dec. 2, 2016 Anyone who has treated the scourge of hidradenitis suppurativa (HS) has probably injected inflamed nodules and cysts with triamcinolone (TAC) successfully, resulting in very grateful patients. Despite the useful advent of adalimumab to the other (less than satisfactory) modalities of antibiotics,
Short duration cyclosporine may undress DRESS
By Warren R. Heymann, MD July 22, 2016 DRESS (Drug Rash with Eosinophilia and Systemic Symptoms) is a severe drug-induced hypersensitivity syndrome (DIHS) that may affect adults and children. The eruption of DRESS usually appears 3 weeks to 2 months after introduction of the drug. The rash is primarily morbilliform,
Any month is a good month to give thanks.
From the Editor ... Dr. Schwarzenberger is the physician editor of ... DermWorld. By Kathryn Schwarzenberger, MD, FAAD, November 1, 2024 However, there is something special about November — other than the obvious day of Thanksgiving — that encourages me to think about the good things in my life. November
It’s always the gluten
From the Editor ... Dr. Schwarzenberger is the physician editor of ... DermWorld. By Kathryn Schwarzenberger, MD, November 1, 2020 Gluten is to dermatitis as brown recluse spider bites are to ulcers. Often blamed, but rarely the cause. I run a contact dermatitis clinic, and without fail, at least one
I’m tired
From the Editor ... Dr. Schwarzenberger is the physician editor of ... DermWorld. By Kathryn Schwarzenberger, MD, June 1, 2020 I hear that a lot these days. COVID-19 blew up the world as we knew it and the process has been, among other things, exhausting. Almost overnight we turned on
Journal of Cutaneous Pathology
Eosinophilic dermatosis of hematologic malignancy: Reality bites Oy, another "Oid" to worry about: Cryptococcoid lesions Biting my nails worrying about atypical presentations of nail unit melanomas Deep penetrating thoughts about deep penetrating nevi Sophie’s choice: Assessing atypical Spitz tumors in the molecular era Develop a nose for suspecting angiosarcoma Granulomatous
How do we get dermatologic care to those who need it?
From the Editor ... Dr. Schwarzenberger is the physician editor of ... DermWorld. By Kathryn Schwarzenberger, MD, FAAD, June 1, 2022 Many potential barriers that limit access to our services — financial, geographic, and social issues — all come into play, often combining into the perfect storm. Reviewing this month’s
Itch
From the Editor ... Dr. Schwarzenberger is the physician editor of ... DermWorld. By Kathryn Schwarzenberger, MD, FAAD, April 1, 2022 That final frontier that torments us almost as much as it does our patients. I have always considered itch to be one of the worst conditions that our patients
March is a strange month
From the Editor ... Dr. Schwarzenberger is the physician editor of ... DermWorld. By Kathryn Schwarzenberger, MD, March 1, 2021 Other than the AAD Annual meeting (sadly, canceled for the second year, courtesy of the ongoing COVID-19 pandemic), there’s usually not much to look forward to in March. Sure, we
Who knew?
From the Editor ... Dr. Schwarzenberger is the physician editor of ... DermWorld. By Kathryn Schwarzenberger, MD, FAAD, November 1, 2023 When it comes to skin health, we all know that a board-certified dermatologist knows best. In years past, we were comfortable being known and respected for our expertise. Our
Moving on to snail mucin…
From the Editor ... Dr. Schwarzenberger is the physician editor of ... DermWorld. By Kathryn Schwarzenberger, MD, FAAD, October 1, 2023 Last month, we explored the subject of allergic contact dermatitis to cosmetic ingredients. It appears that we may have missed some potential allergens, including snail mucin. While reports of
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2020 DW Insights and Inquiries archive
Explore ... DermWorld Insights and Inquiries articles by publication date. ... December ... December 23 - 2020 holiday greeting December 16 - We’re in hot water! Vibrio vulnificus infections are heading north December 9 - Much ado about nothing in dermatopathology December 2 - Pigmented onychomatricoma: Avoid getting nailed by
The congenital perineal groove: Defective recognition of a dermal defect
By Warren R. Heymann, MD ... Feb. 28, 2018 ... It has been nearly half a century since Stephens first detailed the perineal groove (PG) as a congenital malformation consisting of three features: (1) a wet groove in the midperineum between the fourchette and the anus; (2) normal formation of
A 2019 resolution: Talk more, Tweet less
By Warren R. Heymann, MD Dec. 30, 2018 Long ago, and far away, I encountered a patient that changed the way I practice. I was with a medical student while examining a middle-aged woman who presented with a dramatic eruption that was probably DRESS syndrome (DRESS syndrome was not yet
Reflections on vacation and terrorism impacting continuing medical education
By Warren R. Heymann, MD Aug. 18, 2016 What impacts your life, either personally or professionally? What external factors influence what we learn and how we practice? ... This commentary was composed over the Atlantic Ocean, returning from a cruise sponsored by the Alabama Dermatology Society. For anyone who has
An association of rosacea with risk of glioma? More research please!
By Warren R. Heymann, MD May 9, 2016 Egeberg A, et al. Association of rosacea with risk for glioma in a Danish nationwide cohort study. JAMA Dermatology 2016; 152: 541-545. ... A nationwide cohort study of the Danish population of all citizens older than 18 over a 14-year period (1997-2011),
Increasing evidence for the use of topical timolol for pyogenic granulomas
By Warren R. Heymann, MD May 16, 2016 There are multiple approaches to treating pyogenic granulomas (PGs). If possible, I usually perform a shave biopsy and electrodesiccate the base of the lesion. Certainly there are times when that approach may not be optimal, such as a PG the face of
InCYSTing on searching for explosives
By Warren R. Heymann, MD Sept. 8, 2016 I have enjoyed medical writing and editing since publishing my first article in 1983 when I wrote about a penile Fibroepithelioma of Pinkus (my medical school roommate’s father was the patient). Once in a great while, some interest would be generated from
Topical crisaborole ointment for atopic dermatitis: Hoping for a painless introduction
By Warren R. Heymann, MD Aug. 13, 2016 Any dermatologist who treats atopic dermatitis (AD) must be eagerly awaiting the introduction of 2% Crisaborole ointment. This is equally true for patients (and their parents!) who are steroid-phobic and uncomfortable with the black box warning for calcineurin inhibitors (despite our reassurances).
The risk of melanoma in adults with giant pigmented nevi
By Warren R. Heymann, MD May 27, 2016 Giant pigmented nevi (GPN, defined in reference 1 as > 20 cm in an adult) are among the most challenging lesions from so many perspectives. When diagnosed in childhood, questions from parents regarding the risk of melanoma, approach to monitoring, managing, and
Atrophic tinea versicolor: Knowledge about its pathogenesis is hypertrophying
By Warren R. Heymann, MD April 12, 2017 In the entry "Atrophic Tinea Versicolor: More Than a Mirage" (April 22, 2016), I learned that the atrophic appearance of some cases of tinea versicolor is not just an optical illusion. The case of a 35-year-old man with depressed brown lesions on
Generalized multinucleate cell angiohistiocytomas and thoughts on diagnostic first impressions
By Warren R. Heymann, MD April 1, 2017 I became aware of multinucleate cell angiohistiocytomas (MCA) when I learned of an article published by friends who reported the first cases in the United States (1). The following abstract by Smolle et al (2) accurately described the entity, and my concept
Do not take a pass on the PAS stain
By Warren R. Heymann, MD Nov. 7, 2016 My threshold for obtaining a Periodic acid-Schiff (PAS) on inflammatory lesions rivals the opinion of most Americans’ opinion of tomorrow’s election as reported in the New York Times — very low. ... When I read the article by Elbendary et al I
Prognosticating folliculotropic mycosis fungoides: Everything old is new again
By Warren R. Heymann, MD Sept. 16, 2016 I was dermatology resident in 1980 learning about mycosis fungoides when the late Peter Allen was in his glory singing "Everything Old is New Again". The universe of cutaneous T cell lymphoma was simultaneously more confusing (how would you differentiate poikiloderma
Getting a leg up on squamous cell carcinomas of the teratoacanthoma type
By Warren R. Heymann, MD Oct. 8, 2016 I thought it was my imagination, but apparently not — there is distinct subset of patients, mostly mature women, with squamous cell carcinomas (SCC) of the keratoacanthoma type (KA) usually presenting on the anterior distal lower extremities. ... These patients are not
Glomus tumors point a finger at neurofibromatosis
By Warren R. Heymann, MD ... Nov. 21, 2016 ... The correct diagnosis of the ... JAMA Dermatology Clinicopathological Correlation of a glomus tumor presenting as longitudinal erythronychia was straightforward — I was fascinated by this comment in the discussion: "The presence of multiple glomus tumors in the digits
Topical minocycline for acne: A good Idea?
By Warren R. Heymann, MD May 28, 2016 Concerns about the safety of minocycline have been increasing over the past two decades, with rare, serious adverse immunologic reactions including DRESS syndrome, pneumonitis, nephritis, autoimmune hepatitis, and a lupus-like syndrome (1). There have been several reports of ANCA-positive polyarteritis nodosa (PAN)
What features in psoriasis patients indicate that the patient is at high risk of developing psoriatic arthritis?
Clinical Applications ... Dr. Abate is a member of the ... DermWorld Editorial Advisory Workgroup. ... By Mallory Abate, MD, FAAD, December 1, 2023 In this month’s Clinical Applications column, DermWorld ... Editorial Advisory Workgroup member Mallory Abate, MD, FAAD, talks with Luigi Naldi, MD, about his JAAD ... paper,
From the editor
From the Editor ... Dr. Schwarzenberger is the physician editor of ... DermWorld. By Kathryn Schwarzenberger, MD, April 2, 2018 I hope you enjoyed the AAD Annual Meeting in San Diego. I certainly did. I came home yet again feeling renewed, returning to the clinic armed with new knowledge that
August 22
Derm World Weekly - A Publication of the American Academy of Dermatology | Association ... IN THIS ISSUE / August 22, 2018 ... 6 new biopsy codes for 2019 August Access Hero: Jessica Burgy, MD Submit your comments on psoriasis draft guidelines 2018 QPP exception applications now available Ortho Dermatologics
Best of DermWorld Insights and Inquiries
Dec. 26, 2024 We know how much you enjoy Dr. Heymann and the editorial board’s weekly analyses of dermatologic literature, so we’ve created a list of the top 10 most popular issues in 2024 — starting with the most popular issue of the year. ... 1. Weighing in on glucagon-like
2021 DW Insights and Inquiries archive
Explore ... DermWorld Insights and Inquiries articles by publication date. ... December ... Dec. 29 - 2021: Best of DermWorld Insights and Inquiries Dec. 22 - DWI&I Holiday Greeting 2021 Dec. 15 - Speculating on spicules: Our incomplete knowledge of trichodysplasia spinulosa Dec. 8 - Propranolol and neutrophilic dermatoses: Can
2022 DW Insights and Inquiries archive
Explore ... DermWorld Insights and Inquiries articles by publication date. ... December ... Dec. 28 - 2022: Best of DermWorld Insights and Inquiries Dec. 21 - Holiday Greeting 2022 Dec. 14 - A Frank discussion about earlobe creases Dec. 7 - Xylazine ("Tranq"): The potential for loss of life and
2021: Best of DermWorld Insights and Inquiries
December 30, 2021 We know how much you enjoy Dr. Heymann and the editorial board’s weekly analyses of dermatologic literature, so we’ve created a list of the top 10 most popular issues in 2021 — starting with the most popular issue of the year. ... 1. Biotin supplementation for hair
From the editor
From the Editor ... Dr. Schwarzenberger is the physician editor of ... DermWorld. By Kathryn Schwarzenberger, MD, March 1, 2018 Change is a recurring theme in this month’s ... Dermatology World . Change seems to be a given these days; perhaps it always was, but it’s hard to imagine a
AAD guidance on steps members can take in response to COVID-19
(See PPE Use Recommendations & Supply Chain Advice by the CDC and Rational Use of PPE for COVID-19 by
June 28, 2023
Derm World Weekly - A Publication of the American Academy of Dermatology | Association ... IN THIS ISSUE/ June 28, 2023 ... A beneficial botanical extract for actinic keratosis? DermWorld Insights and Inquiries : Dermatologic ergonomics — Straighten up and fly right FDA approves alopecia areata treatment in adults and
Immediate pathology report release to patients – Is the 21st Century CURES Act worse than the disease?
By Lorraine L. Rosamilia, MD, FAAD Staff Dermatologist, Geisinger Health System Aug. 25, 2021 Vol. 3, No. 34 The 21st Century Cures Act, signed into federal law in 2016, was enacted to optimize medical product development and advance patient access to medical innovations. Notable for inclusion of patient perspectives in
Anti-kickback implications for company-sponsored speaker programs
Legally Speaking ... Robert M. Portman, JD, MPP, is a health care attorney with Powers Pyles Sutter & Verville, in Washington, DC, and serves as legal counsel for the AAD and AADA. ... By Megan La Suer, JD, MHA, and Rob Portman, JD, MPP, February 1, 2021 Every month, DermWorld
A big, fat lie
By Warren R. Heymann, MD Feb. 17, 2019 At my heaviest, circa 1997, with my daughters Andrea, Deborah, and our (sorely missed) late puppy Heidi. ... "Packing on the pounds, aren’t you, doc?" ... What a lovely greeting that patient gave me that morning more than twenty years ago.
Telangiectasia macularis eruptiva perstans revisited
By Warren R. Heymann, MD April 29, 2016 I have always struggled with the diagnosis of telangiectasia macularis eruptive perstans (TMEP). Aside from taking the first 6 months of my residency to remember how to say it, I have never been confident of securing the diagnosis. It would always enter
Differentiating lichen planopilaris from chronic cutaneous lupus may be as easy as 1,2,3 (actually CD123)
By Warren R. Heymann, MD June 4, 2016 My last dermatopathology case of the week was that of a woman with scarring alopecia, which was clearly well advanced. Hardly any follicles remained, and on one section there was a small follicular unit with a peri-infundibular mononuclear infiltrate and slight vacuolar
Write this down if your patient has multiple PENS: Look further
By Warren R. Heymann, MD June 18, 2016 Papular Epidermal Nevus with Skyline Basal Cell Layer (PENS) was first described by Torrelo et al. They detailed 5 infants with solitary or multiple 1 to 7 mm congenital keratotic papules. Lesions were randomly distributed and did not follow Blaschko lines. They
Rapalogs for vascular lesions: Caveat mTOR
By Warren R. Heymann, MD Sept. 21, 2016 Rapalogs are drugs that inhibit the mTOR pathway and include sirolimus (rapamycin), temsirolimus, everolimus, and deforolimus. All are immunosuppressive and have antineoplastic/antiproliferative effects. The mTOR protein is a serine-threonine kinase involved in complex intracellular signaling pathways affecting the key processes of cell
Preventing hair loss in breast cancer patients is very cool
By Warren R. Heymann, MD Feb. 15, 2017 Dramatic change in physical appearance before (A) and 1 month after (B) treatment with paclitaxel and carboplatin. ... Credit: ... JAAD The loss of my late aunt Millie to breast cancer was devastating; it was even harder to bear after learning that
Diagnosing atypical hand, foot, and mouth disease by routine microscopy
By Warren R. Heymann, MD Dec. 15, 2016 Hand, foot, and mouth (HFM) disease is childhood exanthem usually caused by Coxsackie A16; enterovirus 71 has been implicated in cases of HFM complicated by encephalitis, flaccid paralysis, myocarditis and pulmonary edema. Coxsackie A6 has recently been associated with severe, atypical episodes
Topical amelioration of neuropathic pain and pruritus leading to painful consequences
By Warren R. Heymann, MD Dec. 26, 2016 Increasingly, compounded amitriptyline and ketamine have been utilized for the management of neuropathic pain and pruritus. A review of PubMed reveals its utility in erythomelalgia and diverse neuropathic disorders (peripheral neuropathy, radiation-induced neuropathy, chemotherapy-induced neuropathy, post-herpetic neuralgia, proctodynia, and pain associated with
Hidradenitis suppurativa and socioeconomic status: Food for thought (and benefit)
By Warren R. Heymann, MD ... Oct. 2, 2016 ... We see many patients with hidradenitis suppurativa (HS), especially in our Camden practice. I am certainly not surprised by the well-documented comorbidities of obesity and smoking (1), which may play a role in the pathogenesis of the disease. While
Fooled again: Misdiagnosing cutaneous follicle center lymphoma
By Warren R. Heymann, MD Nov. 9, 2016 I had never been so happy to misdiagnose a lesion. The patient was an 88 year-old man who I had known for years, as he is a life-long friend of my mother in-law. When he was examined for a variety of skin
Idiopathic facial aseptic granuloma — Have we met?
By Warren R. Heymann, MD July 20, 2017 I’m racking my brain wondering if I have ever seen a case of idiopathic facial aseptic granuloma (IFAG) — I know that I never made the diagnosis because I had never heard the term until I read the first reference. I surmise
The neutrophil-to-lymphocyte ratio in cancer: Beauty in simplicity
By Warren R. Heymann, MD ... Sept. 29, 2016 ... The world was stunned and saddened on January 28th, 1986 when the Space Shuttle Challenger exploded. Six months later, during the meeting of the Rogers Commission analyzing the disaster, the famed physicist Richard Feynman demonstrated how O-rings lost their
Oral tranexamic acid to treat melasma: Are you bloody kidding me?
By Warren R. Heymann, MD Aug. 1, 2016 Tranexamic acid (TA) is a synthetic derivative of lysine utilized as an antifibrinolytic agent to prevent bleeding (for dental surgery in patients with hemophilia, post-cardiac bypass surgery patients, or in women with menorrhagia) and as a treatment option for hereditary angioedema.
Dupilumab and the dawn of the biologic era for atopic dermatitis
By Warren R. Heymann, MD Aug. 28, 2016 I have a list of patients with severe, recalcitrant atopic dermatitis (AD) eagerly awaiting the release of dupilumab. I first became aware of this biologic from the article by Beck et al, who noted that dupilumab, a fully humanized monoclonal antibody that
Vulvar hidradenoma papilliferum and mammary-like gnogenital glands: The whole story
By Warren R. Heymann, MD July 31, 2016 I had always assumed that hidradenoma papilliferum (HP), which characteristically appears in the vulvar region, was derived from apocrine glands. Until I read the article by El-Khoury et al (1) I had never even heard of mammary-like anogenital glands (MLAGs). ... Although
Scratching under the surface: The Temple Itch Center experience
By Warren R. Heymann, MD Sept. 22, 2016 Nothing raises more questions than the development of a database. Nothing needs a database more than the study of chronic pruritus. Mollanazar et al reviewed their data from the Temple Itch Center in Philadelphia, encompassing 920 visits by 597 patients, in the
Atopic dermatitis: Up in smoke!
By Warren R. Heymann, MD Feb. 8, 2017 The etiology of atopic dermatitis (AD) is multifactorial, with genetic mutations of the filaggrin mutations affecting barrier function, immunodysregulation of the TH2 pathway, and environmental triggers being of primary importance. AD has long been associated with autoimmune diseases such as vitiligo and
2024 DW Insights and Inquiries archive
Explore ... DermWorld Insights and Inquiries articles by publication date. ... December ... Dec. 17 - DWI&I Holiday Greeting 2025 Dec. 11 - Idiopathic granulomatous mastitis joins the pantheon of erythema nodosum-associated disorders Dec. 4 - Darier disease is rough clinically and therapeutically. MEK inhibition may offer a smoother future
2023 DW Insights and Inquiries archive
Explore ... DermWorld Insights and Inquiries articles by publication date. ... December ... Dec. 20 - DWI&I Holiday Greeting 2023 Dec. 13 - Sparking the interest in Spark nevus Dec. 6 - Aquagenic pruritus and polycythemia vera: Still valid (and mysterious) after all these years November ... Nov. 29 -
DWI&I Holiday Greeting 2023
By Warren R. Heymann, MD, FAAD Dec. 20, 2023 Vol. 5, No. 50 Dear ... DWI&I Devotee: ... I always look forward to writing my annual holiday greeting, but admittedly, doing so this year has been a source of angst and consternation. The past few years have been about the
The prescience of Bernie Ackerman: The road from “pseudoleukemia cutis” to “intralymphatic proliferation of T-cell lymphoid blasts (IPTCLBs)”
By Warren R. Heymann, MD Dec. 13, 2016 Hand, foot, and mouth (HFM) disease is childhood exanthem usually caused by Coxsackie A16; enterovirus 71 has been implicated in cases of HFM complicated by encephalitis, flaccid paralysis, myocarditis and pulmonary edema. Coxsackie A6 has recently been associated with severe, atypical episodes
I don’t know JAK — but I will! Ruxolitinib improving chilblain lupus erythematosus
By Warren R. Heymann, MD May 31, 2016 The JAK inhibitors are among the current darlings of treating autoimmune diseases. Recent articles about tofacitinib for vitiligo (1) and alopecia areata (2) have been reported in the lay press with considerable fanfare. ... Ruxolitinib (Jakafi) is indicated for treating intermediate to
Top 3 administrative burdens in dermatology and how to tackle them!
Answers in Practice ... By Faiza Wasif and Swapna Pachauri, AADA Practice Management, December 1, 2021 Each month, DermWorld ... tackles issues "in practice" for dermatologists. This month, practice management staff offer tips on managing the top three administrative burdens. A successful dermatology office is established not only on optimal
Minutes of the May 21, 2022 AAD Board of Directors meeting.
Weinstein presented the following resolved: WHEREAS, in recent months companies in the skincare
Becoming whipped up over flagellate dermatoses
By Warren R. Heymann, MD ... July 13, 2017 ... A, A 44-year-old male patient with characteristic flagellate dermatitis after ingestion of shiitake. B, Same patient 4 days after balneo PUVA therapy. ... Credit: ... JAAD The literature on flagellate dermatoses has been whipped into frenzy. The initial description
A watershed discovery for potential treatment of pseudoxanthoma elasticum
By Warren R. Heymann, MD Feb. 28, 2017 Pseudoxanthoma elasticum. A, Multiple and yellowish papules on the neck. B, Polarized light dermoscopy revealing multiple blotchy, yellowish areas alternating with prominent superficial linear vessels. ... Credit: ... JAAD We had the honor of presenting a family with pseudoxanthoma elasticum (PXE) at
Stepping back from the abyss: A kinder, gentler variant of calciphylaxis
By Warren R. Heymann, MD March 16, 2017 My reaction to the diagnosis of calciphylaxis is Pavlovian — I automatically think about an end-stage renal insufficiency patient with an abysmal prognosis. Increasingly there are reports of nonuremic forms of the disease, where the prognosis may not be as bleak (*although
My core incompetencies
By Warren R. Heymann, MD May 19, 2017 It is time for our semiannual ritual — the meeting of our Clinical Competency Committee (CCC). Our dermatology program is small, having twice as many faculty members as residents, so everyone serves on the committee. The process has changed dramatically from the
The “rope” sign is knot pathognomonic: Autoimmunity ties the etiologies together
By Warren R. Heymann, MD July 8, 2016 The "rope" sign is a dramatic finding presenting as a linear to curvilinear cords ("cordonifom") on the lateral chest. It was originally described as an uncommon, but specific feature of Interstitial Granulomatous Dermatitis with Arthritis (IGDA), and has been considered pathognomonic for
Here’s looking at you, KID
By Warren R. Heymann, MD April 7, 2017 Late skin findings in lethal keratitis-ichthyosis-deafness syndrome. Intertriginous hyperkeratosis and denudation in a patient with GJB2 p.A88V mutation. ... Credit: ... JAAD Keratitis, ichthyosis, and deafness (KID) syndrome is a rare genodermatosis associated with mutations in the GJB2 gene, which encodes connexin
Patients’ (mis)understanding of their skin cancer diagnosis
By Warren R. Heymann, MD ... Sept. 26, 2016 ... "If names be not correct, language is not in accordance with the truth of things." — Confucius ... Occasionally a patient’s misunderstanding of their dermatologic diagnosis can elicit a smile. How can you not chuckle when someone says that
Perspectives on peristomal pyoderma gangrenosum
By Warren R. Heymann, MD Oct. 28, 2016 Peristomal pyoderma gangrenosum (PPG) is a challenging problem, both physically and emotionally. The diagnosis may be delayed, often being mistaken for an irritant dermatitis or an infection. Barbosa et al have performed an extensive review of their experience in 44 patients
Treating acrodermatitis continua of hallopeau in 2018? Try guselkumab!
By Warren R. Heymann, MD April 21, 2017 Acrodermatitis continua of Hallopeau (ACH) is a disorder well known to dermatologists, but absolutely mysterious to everyone else. It is now considered a localized form of pustular psoriasis of the digits that may be accompanied by onychodystrophy and osteolysis. ... In my
Multiple café au lait spots in fair skinned children without evidence of neurofibromatosis type 1: Don’t SPRE(A)D the word – yet
By Warren R. Heymann, MD Oct. 13, 2016 Café au lait spots (CALS) are extraordinarily common; six or more lesions (at least 0.5 cm prior to puberty or 1.5 cm post puberty) are considered one of the criteria for diagnosing neurofibromatosis type I (NF1), and are also seen in
The darkness of lichen planus pigmentosus
By Warren R. Heymann, MD Oct. 24, 2016 Darkness defines lichen planus pigmentosus (LPP) — lesional morphology, the patient’s mood about their appearance, and our ability to understand or treat it. Both patient and physician are literally in the dark. ... The following abstract by Ghosh and Coondoo (1) is
Expanding indications of the excimer laser for disorders of hypopigmentation: Equivocally seeing the light
By Warren R. Heymann, MD Aug. 31, 2016 The excimer laser is a reasonably effective modality for treating vitiligo. Other disorders of hypopigmentation, such as a nevus depigmentosus (ND), or post-inflammatory hypopigmentation (PIH) secondary to lichen striatus (LS) may be distressing to patients (or their parents). Is the excimer laser
Demonstrating the value of dermatologic care to state legislators
Ask the Expert ... By Victoria Houghton, Managing Editor, April 1, 2022 DermWorld ... spoke to Victoria Pasko, assistant director of State Policy for the American Academy of Dermatology Association (AADA), about the Academy’s participation in the National Conference of State Legislatures. DermWorld: The AADA recently participated in the National
Group practice without walls: When separate practices work together
As a dermatologist for more than 20 years, William Davey, MD, has seen his fair share of changes in the field, from innovations in patient care to emerging care models. And one statistic always stands out to him. ... "For solo practitioners over age 60, half of them are willing
The profound dermatological manifestations of COVID-19
By Warren R. Heymann, MD March 18, 2020 Vol. 2, No. 11 Disclaimers: This commentary was written on March 12, 2020 for a publication date of March 18, 2020. The issues related to the COVID-19 pandemic are changing at breakneck speed. The content included in this commentary may no longer
Reopening the dermatologic surgery office in the COVID-19 era
By Ashley Decker, MD, Henry Heaton, MD, and Naomi Lawrence, MD May 20, 2020 Vol. 2, No. 20 Authors Ashley Decker, MD, Naomi Lawrence, MD, and Henry Heaton, MD, wearing PPE. ... The coronavirus disease 2019 (COVID-19) presents extraordinary challenges to the health care community, including dermatology and dermatologic surgery.
ADA issues for dermatology practice websites
Legally Speaking ... Robert M. Portman, JD, MPP, is a health care attorney with Powers Pyles Sutter & Verville, in Washington, DC, and serves as legal counsel for the AAD and AADA. ... By Ben Tesdahl, JD, LLM, and Rob Portman, JD, MPP, May 1, 2024 Every month, DermWorld ...
Malignant syphilis: History in the making
By Warren R. Heymann, MD, FAAD Jan. 3, 2024 Vol. 6, No. 1 As our new academic year commences, soon I will remind our new residents of Sir William Osler's famous aphorism, "He who knows syphilis knows medicine." As the great mimicker, our trainees will never go astray by including
Can we chat?
By Warren R. Heymann, MD, FAAD March 29, 2023 Vol. 5, No. 13 Flying back from the annual AAD meeting in New Orleans, I reflected on the past few days with newly acquired knowledge, joy (how wonderful it was to see my mentors, mentees, colleagues, and friends), pain (sore feet
Insult to injury: COVID-19-associated mucormycosis
By Warren Heymann, MD June 9, 2021 Vol. 3, No. 23 As America unmasks this Memorial Day, COVID-19 is ravaging India. The scenes of desperation stemming from the overwhelmed heath system, poverty, and funeral pyres are almost unfathomable. In the midst of the devastation, doctors in India have observed an
Does your dermatology practice comply with the Family and Medical Leave Act?
Legally Speaking ... Robert M. Portman, JD, MPP, is a health care attorney with Powers Pyles Sutter & Verville, in Washington, DC, and serves as legal counsel for the AAD and AADA. ... By Jeremy Lewin, JD, Ben Tesdahl, JD, LL.M, and Robert M. Portman, JD, MPP, September 1, 2022
December 4, 2024
Derm World Weekly - A Publication of the American Academy of Dermatology | Association ... IN THIS ISSUE / December 4, 2024 ... What’s the best treatment for squamous cell carcinoma in situ? DermWorld Insights and Inquiries : Darier disease is rough clinically and therapeutically. MEK inhibition may offer a
PDF of medical career case study
My at Hofstra/Northwell, What personality traits are most desirable and helpful advice would be to
Intestinal obstruction of justice raises a question for dermatology residency applicants: Are you a real doctor?
By Warren R. Heymann, MD Jan. 19, 2019 Hon. George M. Heymann ... "Are you a real doctor?" ... Every dermatologist has been asked this question. ... Ask Sam (not his real name). Last summer, he and his wife came for their annual skin cancer examinations. Sam, an ordinarily jovial
The autumn of a career
... But now the days grow short, I’m in the autumn of the year ... And now I think of my life as vintage wine from fine old kegs ... From the brim to the dregs, and it poured sweet and clear ... It was a very good year
Laboratory testing for syphilitic alopecia: Time to renew old habits?
By Warren R. Heymann, MD June 4, 2018 I’m not sure how this happened. I used to check several laboratory studies in patients presenting with alopecia, including a rapid plasma reagin (RPR) for syphilis (in addition to a CBC, TSH, iron binding studies, ANA and vitamin D; testosterone and DHEAS
Red genitals: New roads to recovery
By Warren R. Heymann, MD July 23, 2018 ... Red scrotum syndrome. Sharp border between the erythematous skin and the normal scrotum skin in a 65-year-old male patient. ... Credit: ... JAAD I searched PubMed for Quality of Life (QoL) studies on the Red Scrotum Syndrome (RSS) and Red Vulva
Aha! The iodide paradox now makes sense!
By Warren R. Heymann, MD Oct. 1, 2018 Dermatitis herpetiformis. Grouped papulovesicles with excoriations on the extensor surface of the shoulder. ... Credit: ... JAAD In the pre-direct immunofluorescence days of yore (before my time in dermatology), the exacerbation of dermatitis herpetiformis (DH) by oral or topical iodides could be
The real jigsaw puzzle of the Brooke-Spiegler Syndrome: Translating the molecular biology to therapy
By Warren R. Heymann, MD Oct. 22, 2018 Residents jump for joy when they see the characteristic "jigsaw puzzle" appearance of cylindromas under the microscope. Histopathology, however, takes us only so far. The future lies in elucidating the molecular pathways of these tumors that lead to therapy. Who could have
The heartrending aspects of incontinentia pigmenti
By Warren R. Heymann, MD March 12, 2018 Incontinentia pigmenti (IP, aka Bloch-Sulzberger syndrome) provides lessons in genetics, immunology, and neuroectodermal development. Frankly, I have never given much (if any) thought about its cardiovascular manifestations. Albeit rare, they are part of the spectrum of IP. ... IP is a rare
No need for panic with MANIC
By Warren R. Heymann, MD March 22, 2018 As a medical student, I would panic over embryology of the neck. I never quite understood the development and anomalies of branchial arches or the migration of the thyroid anlage from the foramen cecum; yet I knew that as a clinician, it
An acne vaccine to make patients happy CAMPers?
By Warren R. Heymann, MD Nov. 12, 2018 When walking back to my office after receiving my flu shot, I thought about how wonderful it be to have a preventive therapy for common dermatologic disorders such as acne. That may not be so far-fetched. ... Acne vulgaris (referred to as
Welcome to Dermatology World Insights and Inquiries
By Warren R. Heymann, MD March 13, 2019 Vol. 1, No. 1 Keeping up with clinically relevant dermatologic literature has become an increasingly daunting task. The time constraints facing dermatologists (and all physicians) have multiplied, as have administrative demands, burdens of electronic records, etc., challenging even the most time-efficient, organized
Taking psoriasis by the throat
By Warren R. Heymann, MD Nov. 2, 2016 Once the transient satisfaction of explaining the association of streptococcal infections with psoriasis (guttate, vulgaris, or pustulosis palmaris et plantaris) passes, the reality of treatment must be addressed. Of course we’ll prescribe the usual regimens — topical steroids, phototherapy, retinoids, biologics, etc.,
Are you at risk for pityriasis rubra type V? It’s in the cards!
By Warren R. Heymann, MD Feb. 1, 2017 Characteristic facial involvement in caspase recruitment domain family member 14 gene (CARD14)-associated papulosquamous eruption. Symmetric and geometric pink, scaly patches or plaques involving the cheeks, upper cutaneous lip, and chin with sparing of the infralabial region is highly characteristic of CARD14-associated papulosquamous
Dermatomyositis oddities: Could one be responsible for the other?
By Warren R. Heymann, MD Sept. 19, 2016 So much about dermatomyositis (DM) has intrigued me since medical school. Over the years, I have probably read more about this disease than any other malady. I am always amazed how I much more there is to learn. ... There were two
Hallelujah! A negative comorbidity study: Putting comorbidities in perspective
By Warren R. Heymann, MD July 30, 2016 Upon reading the title "Assessment of the risk of cardiovascular disease in patients with rosacea," I was braced for yet another reason why we should invest in cardiac nuclear scans in our dermatology office instead of a new laser. ... Recently, we
Taking biologics to heart
By Warren R. Heymann, MD Oct. 16, 2016 Comorbidities related to psoriasis have dominated the dermatologic literature for more than a decade since Joel Gelfand published his seminal paper (1). In my 2008 commentary for ... Dialogues in Dermatology , I stated that "It remains to be determined if treating
Keeping abreast of the expanding literature of implant-associated Anaplastic Large Cell Lymphoma (ALCL)
By Warren R. Heymann, MD July 6, 2016 Silicone gel implants were removed from the US market in 1992 because of health concerns, only to be reintroduced in 2006, with the provision for increased surveillance of health outcomes (1). I was under the (apparently mistaken) impression that the FDA put
Herpes zoster, immunosuppression, and vaccination: Far from a blistering pace
By Warren R. Heymann, MD July 5, 2016 Do you recognize the name Chris Gueffroy? He was the last person shot trying to escape from East Berlin, before the wall came down. I had long promised myself that I would get Zostavax when I turned 60. Now 61, I am
Labor Day thoughts on increasing dermatologist burnout
By Warren R. Heymann, MD Sept. 5, 2016 "Love and work…work and love. That’s all there is" – Sigmund Freud ... Today you probably received an email from ... Dermatology Times entitled "Tips for taking advantage of Labor Day 2016." A recent Mayo Clinic study was quoted, noting that between
Secukinumab for pityriasis rubra pilaris: Tread lightly
By Warren R. Heymann, MD Nov. 17, 2016 Every dermatology resident preparing for their board examination can rattle off Griffiths’ classification of pityriasis rubra pilaris (PRP) — Type I (Classical Adult), Type II (Atypical Adult), Type III (Classic Juvenile), Type IV (Circumscribed Juvenile), and Type V (Atypical Juvenile). Type VI,
Mucho de Mucha-Habermann
By Warren R. Heymann, MD Dec. 19, 2016 As we approach interview season for our residency program, I try to think of some questions I haven’t asked before. I usually do not discuss dermatologic disorders per se, as I am more concerned about the interviewee as a person knowing how
Desquamative gingivitis: Sinking your teeth in miagnosis and management
By Warren R. Heymann, MD Jan. 7, 2017 Cycle of oral hygiene in desquamative gingivitis. ... Credit: ... JAAD Patients presenting with desquamative gingivitis (DG) are typically some of the most frustrated, aggravated patients I encounter. Frequently, they have not been adequately evaluated, are in pain, and are desperate for
Tofacitinib for adolescent alopecia areata: Balancing the risk-benefit ratio
By Warren R. Heymann, MD Jan. 17, 2017 Alopecia areata with patient 4 after 2 months of treatment with 2% tofacitinib in VersaBase cream (A) and after 6 months of treatment with 2% tofacitinib in liposomal base (B). ... Credit: ... JAAD There has been acute interest in utilizing Janus
A novel sebum inhibitor for acne vulgaris: A slick maneuver
By Warren R. Heymann, MD Jan. 11, 2017 Illustrative photos of severe inflammatory acne vulgaris, largely without nodules (A). B, Very severe acne with cysts. ... Credit: ... JAAD What a pleasure it is to think about a novel treatment for acne! Honestly, have you gotten excited learning that the
Treating psoriatic patients with associated inflammatory bowel disease: A personal bias
... By Warren R. Heymann, MD Feb. 20, 2017 My late brother Andrew succumbed to complications of Crohn disease (CD) at age 29. His brief, but valiant life was punctuated by multiple hospitalizations, surgeries, remissions, and exacerbations. Although prednisone and azathioprine offered an occasional respite, he suffered. Sharing a
Of strife and SDRIFE
By Warren R. Heymann, MD May 17, 2017 Patient 3. SDRIFE. Frontal view (A) and right lateral view (B) with erythema and blanching papules coalescing into plaques with vesicles on back, abdomen, and bilateral inframammary and inguinal folds. ... Credit: ... JAAD A conceivable Yelp review: I was so uncomfortable
Maximizing knowledge about infantile hemangioma with minimal or arrested growth
By Warren R. Heymann, MD Feb. 3, 2017 Areas affected by segmental infantile hemangioma (IH) and IH with minimal or arrested growth (IH-MAG) of the arms (A to E) with correlating arterial supply areas. ... Credit: ... JAAD Knowledge about hemangiomas is proliferating at a rate the compares with the
Thyroid hormone, mitochondria, photoaging and April 7, 2017
By Warren R. Heymann, MD Sept. 24, 2016 On April 7, 1997 I filed a patent entitled "Method for the treatment of dry skin," utilizing topical thyroid hormone. The publication date of the patent US5951989 was September 14, 1999. The expiration date is April 7, 2017. ... Some of you
The retiring type?
By Warren R. Heymann, MD April 23, 2017 "Tell me, Dr. Heymann, when do you plan to retire?" ... Patients seem to ask me that every day. ... My usual response: "Why do you ask, do I look that bad?" ... "No, you look pretty good for your age." (According
Sirolimus for microcystic lymphatic malformations: Caviar for frog spawn
By Warren R. Heymann, MD Jan. 23, 2017 Recently, our understanding of lymphatic malformations (LMs) has vastly expanded. Genetic advances have focused on the PI3K/AKT/mTOR pathway allowing the use of mTOR inhibitors for those lesions involved in this pathway. As noted in a previous post (Rapalogs for vascular lesions: Caveat
Rituximab therapy for recalcitrant dermatitis herpetiformis: A gut feeling
By Warren R. Heymann, MD March 20, 2017 Dermatitis herpetiformis. Grouped papulovesicles with excoriations on the extensor surface of the shoulder. ... Credit: ... JAAD Recently I "accidentally" diagnosed a severely pruritic man with dermatitis herpetiformis (DH). He had seen leading authorities for his life-altering pruritic dermatosis, that clinically and
Eyeing the use of cryotherapy for eyebrow alopecia areata
By Warren R. Heymann, MD April 5, 2017 I am always looking for alternatives to injecting eyebrow alopecia areata with triamcinolone acetonide (TAC). My protocol, based on the recommendation by Alkhalifah et al, is TAC 2.5 mg/mL, 0.5 mL to each eyebrow, every 4 to 6 weeks, as necessary (1).
Can oral ivermectin cure pediatric periorificial dermatitis? It mite!
By Warren R. Heymann, MD March 5, 2017 A 13-year-old boy with severe rosacea before (A) and 1 month (B) and 4 months (C) after receiving oral therapy with a single dose of 250 μg/kg ivermectin (case 3). Note the facial desquamation after the first weeks of therapy, not attributable
Bringing pigmented lupus to light
By Warren R. Heymann, MD Dec. 7, 2017 ... Cutaneous lupus. Biopsy of the left distal thigh shows interface dermatitis, dyskeratosis, superficial perivascular lymphocytic infiltrate, focal red blood cell extravasation, and pigment incontinence. ... Credit: ... JAAD Lettie (not her real name) was an elderly, charming, courtly, soft-spoken African-American woman
Incretin-based therapy for diabetes and dermatology: Promise and peril
By Warren R. Heymann, MD Oct. 23, 2017 In a given day, how many of your patients are diabetic? According to the American Diabetes Association, in 2015, 9.4% of the US population (30.3 million) were diabetic; 29 million of this group had type 2 diabetes. ... Incretin hormones refer to
Aleppo to Zika: 2016’s anxieties may lead to 2017’s dermatoses
By Warren R. Heymann, MD Dec. 17, 2016 "Doctor, did stress cause my breakout?" ... How many times have your patients with acne, psoriasis, or urticaria asked you this question? My usual response is "No, it didn’t cause it, but it sure can make it worse!" ... The first time
Getting within a hair’s breadth of understanding prurigo pigmentosa
By Warren R. Heymann, MD March 2, 2017 Prurigo pigmentosa is an uncommon, acquired inflammatory disorder with a predilection for young adults of Asian descent. A 30-year-old Chinese man presented with reticulated erythematous and hyperpigmented papules on his back and shoulders (A and B). The eruption was present for 2
Koebnerization in Henoch-Schönlein purpura: How does it line up with prognosis?
By Warren R. Heymann, MD Nov. 20, 2017 ... Urticarial hemorrhagic lesions of Henoch-Schönlein purpura in characteristic distribution. Note Koebner phenomenon in lines of scratch. ... Credit: ... JAAD Heinrich Koebner is eponymically known for having first described the phenomenon of developing an existing dermatosis in previously normal skin following
Blasé about the acronym BLAISE (Blaschko Linear Acquired Inflammatory Skin Eruptions)
By Warren R. Heymann, MD April 29, 2017 Lichen striatus. A, Erythematous, scaly, papular eruption following the lines of Blaschko on the right leg. B, Detail of lichenoid lymphocytic interface dermatitis. C, Lymphocytic infiltrate involving eccrine gland coils (B and C, Hematoxylin-eosin stain; original magnifications: ×100). ... Credit: ... JAAD
Sézary syndrome and Shakespeare: What’s in a name?
By Warren R. Heymann, MD ... March 24, 2017 ... Initial clinical presentations of Sézary syndrome without erythroderma. Normal-appearing skin with moderate pigmentation on back of patient 2 (A), several seborrheic keratoses and a hematoma secondary to skin biopsy for patient 3 (B), no apparent lesion on back of
Vitamin C as treatment of basal cell carcinoma: Is it fruitful?
By Warren R. Heymann, MD ... July 3, 2016 ... For those of us who learned that taking mega dose vitamin C for the common cold, as advocated by the late Nobel Laureate Linus Pauling, was truly something to sneeze at, I always approach studies lauding the effects of nutrient-based
Pediatric melanoma: A wolf in sheep’s clothing
By Warren R. Heymann, MD ... Sept. 27, 2016 ... Despite its rarity, the incidence of pediatric melanoma (PM) has been increasing. Every practicing dermatologist, past or present, has been humbled or fooled by the clinical appearance of melanomas, examples being amelanotic or desmoplastic variants. ... The A (asymmetry),
Adherence to acne treatments: Flipped sides of the coin for physicians and patients
By Warren R. Heymann, MD Dec. 6, 2016 It takes a motivated, dedicated patient to adhere to their prescribed acne regimen. According to Moradi Tuchayi et al, primary nonadherence occurs when the medication is not even started. This may be due to lack of knowledge, confusion about usage, a weak
“Brain fog” and mastocytosis: In patients and me
By Warren R. Heymann, MD Dec. 4, 2016 When following patients with mastocytosis — whether classical urticaria pigmentosa in children or adult mastocytosis — I usually ask a directed review of systems, focusing on flushing, palpitations, and gastrointestinal symptoms. I am always concerned about the possibility of systemic disease,
Mindfulness for the patient and the dermatologist
By Warren R. Heymann, MD ... March 28, 2017 ... While meditation has been present for millennia, the concept of mindfulness has recently come into vogue. Conceptually, mindfulness aims to have a person focus their attention on the present moment by developing coping strategies, such as meditation or deep
Vitiligo and melanoma: New thoughts on an old observation
By Warren R. Heymann, MD Nov. 27, 2016 I was fortunate that as a resident and fellow I had marvelous attending physicians who would offer their pearls of wisdom. As it is impossible to study every dictum, I would (usually) accept these viewpoints as "facts" and incorporate them into practice.
Covfefe and the art of the diagnostic deal
By Warren R. Heymann, MD June 2, 2017 Progressive nodular histiocytosis. A, Multiple papulonodular lesions over upper extremities and trunk. B, Leonine appearance for coalescing of lesions on face. ... Credit: ... JAAD I don’t know what’s more frightening — making diagnoses on autopilot or being genuinely stumped and having
Becker’s nevus: Mutations that shoulder responsibility
By Warren R. Heymann, MD Aug. 31, 2017 Systematized, bilateral Becker nevus with hypoplasia of left areola in 19-year-old man (Courtesy of Dr Carlos de la Torre, Pontevedra, Spain). ... Credit: ... JAAD My wife insisted I take a break from studying for the dermatology boards. ... "Warren, give it
Pubic hair grooming: Less means more
By Warren R. Heymann, MD Oct. 14, 2016 It is essential for dermatologists to comprehend current mores that affect our patients’ health. Understanding the trend toward increased genital hair grooming in men and women can help us instruct patients on how to avoid injuries related to hair removal. Indeed, 19-
Could wart immunotherapy open a therapeutic window for congenital nevi at risk for melanoma?
By Warren R. Heymann, MD ... June 13, 2017 ... Dermatoscopic image of congenital melanocytic nevus. Arrows point to reticular network (left), perifollicular hypopigmentation (center), and globules contained within empty spaces in the network ("target globules," right), features that are reportedly suggestive of congenital melanocytic nevi. ... Credit: ...
Reflections on “Being Mortal” by Atul Gawande
By Warren R. Heymann, MD Sept. 13, 2016 I was given this best-selling book as a holiday gift last winter. I wanted to read it, but somehow it was easier to deny my fears about aging by ignoring the text. With increasing rapidity, I am losing patients that I
Melanoma risk in patients with melaoncortin-1 receptor independent of ultraviolet radiation: Is there a way not to be burned by your genome?
By Warren R. Heymann, MD July 18, 2016 I admit that my concept of Type I skin red-headed patients getting melanoma was simple: They have a polymorphism(s) of the melanocortin-1 receptor (MC1R), pheomelanin, ultraviolet exposure, DNA damage, increased reactive oxygen species, and voila: melanoma! While conceptually elegant, this is apparently
How dry I am: The white scale sign of xerosis
By Warren R. Heymann, MD Dec. 22, 2016 When winter approaches my skin dries out. Fortunately, it doesn’t bother me at all. For others, especially in the elderly, xerosis be a predisposing factor for asteototic eczema, nummular dermatitis or dyshidrotic eczema (1). With so many people presenting with dry
Ustekinumab: A topic for atopics?
By Warren R. Heymann, MD Jan. 9, 2017 Atopic dermatitis patient shows drastic improvement at week 19 of ustekinumab treatment. ... Credit: ... JAAD If you’re like me, you have a cadre of patients with severe atopic dermatitis (AD) patients who are counting the minutes for the release of
Giving dermatology a boost
From the President ... Dr. Desai is the Academy’s current president. ... By Seemal R. Desai, MD, FAAD, June 1, 2024 Dear members, ... With Skin Cancer Awareness Month wrapping up and summer starting soon, I think this is a perfect time to reflect on our role as dermatologists, and
Of every possible solution for elastosis perforans serpiginosa, fractional carbon dioxide laser may be the best
By Warren R. Heymann, MD Nov. 13, 2017 ... Elastosis perforans serpiginosa. Clinical presentation. ... Credit: ... JAAD My initial attraction to dermatology, which still offers great appeal, is the challenge and joy of differential diagnosis and clinical-pathologic correlation. I learned quickly, however, that patients don’t want to be interesting
Ubiquitous ubiquitination
By Warren R. Heymann, MD June 28, 2017 Generalized severe epidermolysis bullosa simplex. Blister classification. Single blisters were defined as a count of 1. Blister nests derived from 1 healing blister were defined as a count of 1. Redness without convexes was not counted. Only time points for which good
JAMA Dermatology
Life is just a bowl of cherry angiomas Breaking the terbinafine laboratory habit for onychomycosis Coughing up a new warning for ustekinumab The rosy reality of coffee The real jigsaw puzzle of the Brooke-Spiegler Syndrome: Translating the molecular biology to therapy Old stains leaving new marks in dermatology A future
Cannabinoids may elevate therapy for connective tissue diseases to a higher level
By Warren R. Heymann, MD Nov. 2, 2017 Medical "reefer madness" is taking hold in the United States with approximately 10% of cannabis users utilizing it for diverse medical conditions, including dermatologic disorders such as pruritus and atopic dermatitis. To date, at least 28 states allow for the use of
What is the role of sentinel lymph node biopsy for primary cSCC of the head and neck?
Clinical Applications ... Dr. Schwarzenberger is the physician editor of ... DermWorld . She interviews the author of a recent study each month. ... By Kathryn Schwarzenberger, MD, FAAD, September 1, 2022 In this month’s Clinical Applications column, Physician Editor Kathryn Schwarzenberger, MD, FAAD, talks with Christian L. Baum, MD,
Understanding medical decision making
Medical Decision Making (MDM): In a nutshell ... Three components go into correctly coding the levels of evaluation and management (E/M) services. Medical Decision Making (MDM) is one of them. (History and examination are the other two.) ... Three factors determine MDM: ... The number of possible diagnoses and treatment
Virtual credit card payments
Electronic funds transfer (EFT) is a secure and efficient payment method used by health care organizations. EFTs enable direct deposits of funds from insurance companies into bank accounts, reducing administrative hassles. In contrast, virtual credit card (VCC) payments are made by insurance companies issuing single-use credit card numbers to physicians.
Getting started resources
Telemedicine allows dermatologists to deliver care to patients remotely using technology. For years, dermatologists have used telemedicine to evaluate patients in remote areas, where a trip to the practice may have taken hours. Now, dermatologists and patients alike are discovering the benefits of teledermatology, even for those with easy access
AAD's guidance on resources related to workplace violence
Unfortunately, violence in the workplace has become more common in health care and incidences are slowly rising. Has someone at your dermatology practice ever experienced any type of violence at work? Is your practice equipped or prepared to handle violence, if it were to occur? Dermatologists are not always trained
Advocacy Update Aug. 20 2024
IN THIS ISSUE / Aug. 20, 2024 Take Action: Ask Senators to stabilize Medicare physician reimbursement AADA advises FDA to include dermatologists in advisory boards Dr. Knight appointed to Florida Board of Medicine Modifier 25 advocacy podcast available Meet with your member of Congress in your district Support dermatology champions
Here comes summer (and sunscreen conversations)!
By Warren R. Heymann, MD April 29, 2020 Vol. 2, No. 17 As the summer solstice approaches, days will lengthen, as will patient-related conversations regarding sunscreen use. In this anxiety-ridden age, with all the information overload, patients’ questions have expanded beyond what sunscreen we recommend. Concerns for safety — both
PDF of Academy teledermatology standards
physician-to-physician consultative telemedicine services in order to improve access to specialists’ advice
January 17, 2024
Derm World Weekly - A Publication of the American Academy of Dermatology | Association ... IN THIS ISSUE / Jan. 17, 2024 ... Risk of skin cancers in patients with actinic keratoses DermWorld Insights and Inquiries : A cold abscess remains a cold case — Multiple neonatal staphylococcal cold abscesses
October 4, 2023
Derm World Weekly - A Publication of the American Academy of Dermatology | Association ... IN THIS ISSUE / Oct. 4, 2023 ... Dermoscopic predictors of melanoma in small-diameter melanocytic lesions DermWorld Insights and Inquiries : The Venetian antithesis – Treating median canaliform nail dystrophy Risk between history of rosacea
February 2, 2022
Derm World Weekly - A Publication of the American Academy of Dermatology | Association ... IN THIS ISSUE / Feb. 2, 2022 ... A high-fiber diet may affect immunotherapy response for melanoma patients DermWorld Insights and Inquiries : An old dog with a new trick — High dose intralesional steroids
PDF of Academy managing your practice checklist for COVID-19
This material should not be construed as legal or tax advice and members should consult with their personal
PDF of pediatric career case study
Seek advice and mentor- with.
Countering corticophobia
By Warren R. Heymann, MD Oct. 19, 2017 "I don’t want to use steroids on my baby! I’m really afraid of the side effects! I see what they’ve done to athletes. Can’t you prescribe something natural?" ... I am amazed people think that applying 2.5% hydrocortisone cream can pump up
The medical word to watch in 2018: Dysbiosis
By Warren R. Heymann, MD Jan. 4, 2018 With increasing rapidity, new words enter the dermatological lexicon, reflecting concepts that change our perceptions of disease and treatment. Recent examples include "comorbidities," "programmed cell death inhibition," and "teledermatology". The word to watch in 2018 is "dysbiosis." ... The microbiome has been
Ruth Heymann (1921-2018): A son’s reflection
... By Warren R. Heymann, MD Feb. 9, 2018 Any life spanning from Warren Harding’s Teapot Dome Scandal to the Trumpian-Russian mishegas warrants reflection and celebration. Our first president, George Washington, understood that life’s trajectory is rooted in its first decades — for mom that included the Depression and
Taking the challenge: Social media, adolescents, and the skin
By Albert C. Yan, MD June 12, 2019 Vol. 1, No. 14 Patterned skin injury can raise the specter of non-accidental trauma. However, over the past decade or so, striking examples of patterned skin injury have emerged among adolescents and pre-teens that share certain features: these are self-induced voluntarily; the
When ads subtract
By Warren R. Heymann, MD Aug. 2, 2018 "Could the skin lesion you’re seeing…actually be a deadly blood cancer?….Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is an aggressive and deadly hematologic cancer with skin lesions that may be mistaken for other skin disorders…When biopsying skin lesions, ask your pathologist to test
Hidden in plain sight: Satoyoshi syndrome
By Warren R. Heymann, MD Feb. 19, 2018 I was inspired by the conclusion of a report detailing an 11 year-old boy from India diagnosed Satoyoshi syndrome: "We present this case to emphasize the importance of recognizing Satoyoshi syndrome, which could go unnoticed if not suspected." (1) ... I have
The rosy reality of coffee
Ronnie and me enjoying our rosacea prevention tour of Madrid in 2012 ... By Warren R. Heymann, MD Nov. 5, 2018 To paraphrase Justice Kavanaugh, I loved coffee. I still love coffee. I have probably been drinking coffee since my time in utero. My mother was a coffee addict; she
Focusing attention on X-linked ichthyosis
Ichthyosis vulgaris ... Credit: ... JAAD By Warren R. Heymann, MD Jan. 2, 2019 I thought it was me. Like every dermatologist, I learned the classical appearance of the ichthyoses, and wonder why I’m not sure if I am looking at a patient with ichthyosis vulgaris (IV) or X-linked ichthyosis
The appeal of molecular medicine for the peeling skin syndrome
By Warren R. Heymann, MD April 17, 2018 A, After soaking his foot in warm water for 30 minutes, the patient could peel superficial layers of skin. B, After the peeling, erythematous base is revealed. C, Healed area with slight thickening and pigmentation. ... Credit: ... JAAD This may not
As molecular knowledge of PROS expands, lesions contract
By Warren R. Heymann, MD April 19, 2018 PIK3CA patient showing hemifacial hypertrophy. ... Credit: ... JAAD Somatic activating mutations in the phosphatidylinositol-3-kinase/AKT/mTOR pathway manifest as heterogeneous segmental overgrowth phenotypes Historically, the clinical diagnoses in patients with PIK3CA activating mutations have included Fibroadipose Hyperplasia or Overgrowth (FAO), Hemihyperplasia Multiple Lipomatosis
Old stains leaving new marks in dermatology
... By Warren R. Heymann, MD Oct. 15, 2018 A new blue-gray papule was noted on the left side of the neck and was excised as outlined by gentian violet surgical marker. ... Credit: ... JAAD Periodically I will pull an ancient tie from my rack. I’m delighted if
Prolactin and its role in stress-induced psoriasis: Milking the data
By Warren R. Heymann, MD Jan. 18, 2018 Patients will readily acknowledge that stress worsens their psoriasis. When asked how this happens, I respond by mentioning the "mind-body connection" using the term "psychoneuroimmunology;" patients nod in agreement, feigning understanding; appropriately so, because frankly, I don’t understand it either. ... The
Trial balloons of gene expression profiles of calloon cell melanoma predict the future
By Warren R. Heymann, MD Jan. 29, 2018 Satellite metastasis of balloon cell melanoma. Graft scar of melanoma and satellite bluish skin–colored indurated papules with pseudovesiculation (black arrow points to the papule examined with dermoscopy). ... Credit: ... JAAD The site of balloons is joyous; however, I am always nervous
A potentially life-threatening association of autoimmune blistering disease we bloody well need to be aware of: Acquired hemophilia A
By Warren R. Heymann, MD Oct. 29, 2018 I have been treating patients with autoimmune bullous disorders for nearly four decades. The diseases’ vagaries and associations always astound me. I have never encountered (nor have been aware of) acquired hemophilia A (AHA) in the context autoimmune bullous diseases (ABD), until
We’ve gotta recognize GATA2 deficiency
Cutaneous findings in GATA2 deficiency. (A) Extensive human papillomavirus infection with vulvar and anal intraepithelial neoplasia, (B) cutaneous mycobacterial infection, and (C) erythema nodosum–like panniculitis in a 40-year-old woman with GATA2 deficiency. ... Credit: ... JAAD By Warren R. Heymann, MD Dec. 26, 2018 I’ll begin with my conclusion —
Diagnosing infectious diseases in 2028: Let the good times roll
By Warren R. Heymann, MD Aug. 27, 2018 You may be overwhelmed by the "omics" — genomics, epigenomics, transcriptomics, proteomics, metabolomics, with good reason. "Big Data" are changing the diagnostic landscape in infectious diseases and oncology at breakneck speed. Warning: By the time this is posted, it may be obsolete!
Slivers of skin may diagnose silver hair syndromes
By Warren R. Heymann, MD Jan. 7, 2019 As my hair gets progressively grayer trying to keep up with molecular advances in dermatology, it is refreshing to read how simple tests may help distinguish the rare silver hair syndromes (SHS): Chediak-Higashi (CHS) and Griscelli (GS). ... CHS is an autosomal
Checking in on the adverse reactions to checkpoint inhibitors
By Warren R. Heymann, MD Oct. 17, 2016 Earlier this year there have been two posts devoted to adverse reactions of checkpoint inhibitors ("Thinking of Discontinuing the PD-1 Inhibitor Because of a Lichenoid Eruption? Don’t do it!" published on May 21st and "Joining the Bullae Pulpit: PD-1 inhibitors" posted on
Frontal fibrosing alopecia: Bewitched, bothered, and bewildered
By Warren R. Heymann, MD Feb. 13, 2017 Women given the diagnosis of frontal fibrosing alopecia (FFA) with different severity grades. A, FFA grade I/V in a premenopausal 30-year-old woman, with a less than 1-cm wide area of cicatricial skin produced by the recession of the frontal and temporal hairline.
Decomplexing plexiform neurofibromas
By Warren R. Heymann, MD Dec. 29, 2016 Plexiform neurofibromas (PNs) are some of the most disfiguring and therapeutically challenging lesions that dermatologists confront. PNs are mostly associated with autosomal dominant neurofibromatosis type 1. Rarely, they may also be seen in germline p16 mutation-positive heritable melanoma and Cowden syndrome. Diffuse
Thoughts about genital melanosis on Melanoma Monday
By Warren R. Heymann, MD May 1, 2017 Vulvar genital melanosis. The lesions on the posterior fourchette are dark brown to black in color while other superior macules in the labia minora and vagina are lighter brown. Additively, the lesions are more than 2 cm in diameter. The lesions are
The ultimate prognosis of eosinophilic fasciitis may not be groovy
By Warren R. Heymann, MD Sept. 18, 2017 Presentation in March 2017 with diffuse hyperpigmented sclerodermoid lesions of the bilateral upper extremities with palpable fasciitis and tightening of the distal forearm muscles. ... Credit: ... JAAD My patients with eosinophilic fasciitis (EF, Shulman syndrome) have been fortunate. They have been
Viva ex vivo dermoscopy?
By Warren R. Heymann, MD March 12, 2017 Evaluation of dermoscopic features on a formalin-fixed specimen (ex vivo dermoscopy) using a smartphone attached to a dermoscope. ... Credit: ... JAAD It has been said that the best "special stain" is a deeper section — wise words indeed. While always gratifying
Nailing the diagnosis of psoriatic arthritis
By Warren R. Heymann, MD Oct. 30, 2017 ... A to E, Patient with psoriatic arthritis. A, Dactylitis of 4th toe. B, Enthesitis of Achilles tendon. C, X-Ray of dactylitis of 4th toe. D, Severe nail dystrophy. E, Large discoid plaques on elbows. ... Credit: ... JAAD Nail psoriasis (NP)
DI&I encore: Better than a back scratcher?
By Warren R. Heymann, MD March 30, 2017 The potential toxicity of the combination of topical ketamine/amitriptyline/lidocaine (TKAL) was discussed in a recent entry detailing the encephalopathic findings in an octogenarian Parkinsonian man with atopic dermatitis who was treated with the compound. I concluded: "As our therapeutic options for recalcitrant
From a JAK to a king of Castleman disease
By Warren R. Heymann, MD May 15, 2017 A 44-year-old Chinese woman with a 10-year history of asymptomatic cutaneous patches and plaques on her trunk (Fig 1, A) who reported intermittent fever and lymphadenopathy for 6 months. A skin biopsy specimen from a cutaneous plaque showed perivascular infiltration of plasma
Of sirolimus, shagreen, and chagrin
By Warren R. Heymann, MD July 24, 2017 Shagreen patch is a connective tissue hamartoma composed of excess collagen and elastic tissue. ... Credit: ... JAAD By the time I left the superlative World Congress of Pediatric Dermatology in Chicago I wanted to add sirolimus to the water supply. The
A dermatologic riddle: How is IgG4-related ophthalmic disease parliamentary?
By Warren R. Heymann, MD March 22, 2017 Immunostains of infiltrate. A, Immunostain shows an infiltrate rich in IgG4+ plasma cells. The infiltrate had an IgG4+ cell count of 80 per HPF and an IgG4+/IgG+ ratio of 80%. B, IgG immunostain shown for comparison. (A and B, original magnifications:
A presidential viewpoint: “Nobody knew that benign vascular lesions of the lip could be so complicated”
By Warren R. Heymann, MD April 14, 2017 Well, maybe not as befuddling as replacing Obamacare, but there may be occasional difficulties in diagnosing benign vascular lesions of the lip, with implications for appropriate therapy. ... Tobouti et al, in a study from an oral pathology service, found that of
Scratching below the surface for the etiology of lichen amyloidosis — no sweat?
By Warren R. Heymann, MD July 10, 2017 Lichen amyloidosis reveals multiple hyperkeratotic papules on anterior leg. ... Credit: ... JAAD We have all confronted patients with maddeningly pruritic, recalcitrant cases of lichen amyloidosis (LA). Establishing the diagnosis is easier than treating the disorder; understanding its pathogenesis is even more
Charlottesville, Anzio beachhead, eponyms, and Roger Maris
By Warren R. Heymann, MD Aug. 18, 2017 I never anticipated the need to write this commentary on our vacation to celebrate our 35th anniversary. We had long planned visiting Anzio, where my late father-in-law, Louis Schnur, fought valiantly on the beachhead in the army artillery unit. He suffered from
Understanding the risk of Wilms Tumor in hemihypertrophy: Are we halfway there?
By Warren R. Heymann, MD Nov. 16, 2017 ... Diffuse capillary malformation with overgrowth. A 2-month-old girl with ill-defined erythematous patches of the bilateral upper extremities, posterior trunk, and left lower extremity. There is also overgrowth of the left lower extremity. ... Credit: ... JAAD Wilms tumor (WT, nephroblastoma) is
APACHE no more
By Warren R. Heymann, MD Dec. 4, 2017 ... A, Dark red, linear plaque on posterior area of right lower leg. B, Slightly raised, scaly, undulating lesion measuring 50 × 12 mm. ... Credit: ... JAAD This commentary is about being DC (Dermatologically Correct), not PC (Politically Correct as in
Angiosarcomas and morbid obesity: An enormous problem
By Warren R. Heymann, MD Feb. 26, 2017 Localized lymphedema. A, Case 7 showed many polypoid lesions that varied in size and were localized throughout the vulva, pubis, and perineum. B, Case 9 showed multiple small polypoid lesions with cauliflower-like morphology in the penis and scrotum. C, Case 3 showed
Can steroids extinguish the fire of erythromelalgia?
By Warren R. Heymann, MD March 7, 2017 Red, hot, and painful feet of patient with erythromelalgia. ... Credit: ... JAAD The burning sensation of erythromelalgia is matched by a burning desire to help these patients. According to Tang et al: "This rare and debilitating disorder was first reported and
Does your dermatopathologist recommend treatment suggestions for melanocytic lesions? My two cents (and sense)
My dermatopathology fellowship photo from 1985 at the University of Pennsylvania: Standing Left to Right: Myself, Wallace H. Clark, Jr, and Margaret Freeman (co-fellow); Seated: Bernett Johnson, Jr and Margaret Gray Wood. I learned from the best! While they (the professors) are no longer with us, somehow I hope they
Atopic dermatitis: Fantasizing about a dual approach
By Warren R. Heymann, MD March 9, 2017 Patient photos before and after dupilumab. A, Subject-provided photograph before the start of dupilumab therapy. B, Photograph taken in the clinic 1 year after the patient started dupilumab therapy. ... Credit: ... JAAD It has been acknowledged that we are on the
Nom de plume: Affaire risquée
By Warren R. Heymann, MD ... Dec. 28, 2016 ... Performing laser surgery is risky business for the patient and the laser surgeon. Potential hazards may be due to the beam itself causing ocular or cutaneous injury. Nonbeam hazards may arise from the laser device or its interaction with
Platelet rich plasma: Good for whatever ails you?
By Warren R. Heymann, MD Jan. 13, 2017 Hair regrowth in ophiasis-type alopecia areata after platelet-rich plasma (PRP) injection. Occipital hair loss before treatment (A) and occipital hair regrowth 3 months after administration of PRP at a concentration 3.5 times above baseline (B). ... Credit: ... JAAD Okay, okay, I
The concept of atrophoderma of pasini and pierini as morphea may be falling off a cliff
By Warren R. Heymann, MD Nov. 6, 2017 ... Clinical photos of idiopathic atrophoderma of Pierini and Pasini. ... Credit: ... JAAD Diagnosing Atrophoderma of Pasini and Pierini (APP) is reasonably straightforward — it usually presents in adolescents and young adults, more often in females, with sharply defined, single or
The nerve of Zika!
By Warren R. Heymann, MD April 17, 2017 Zika virus–associated skin exanthem. Peripheral edema of bilateral hands (A) and feet (B). Generalized lymphadenopathy was also present. ... Credit: ... JAAD Zika virus infections have dominated the headlines, most notably because of its association with microcephaly. According to the valuable CDC
Collodion babies and endocrine disorders: Another concern
By Warren R. Heymann, MD June 23, 2017 Collodion baby. Tight, shiny film or dried collodion reminiscent of the skin of a sausage covers the entire surface of this 2-day-old neonate whose mother was treated with infliximab throughout her pregnancy. ... Credit: ... JAAD Collodion baby (CB) describes an infant
Debunking the myth of the aggressive nature of acantholytic squamous cell carcinomas
By Warren R. Heymann, MD ... Feb. 6, 2017 ... Acantholytic squamous cell carcinoma (aSCC), follicular pattern. The tumor is centered upon follicular epithelium but also involves epidermis. Some features of actinic keratosis (parakeratosis, basilar epidermal atypia) are present; by our definition, this example did not qualify for aSCC
Proliferating tests for proliferative nodules of congenital melanocytic nevi
By Warren R. Heymann, MD Oct. 19, 2016 Proliferative nodules (PN) arising in congenital melanocytic nevi (CMN) require differentiation from melanoma. These are disconcerting, if not frightening, lesions to contend with. Do new techniques help in differential process? ... The standard assessment involves clinical-pathologic correlation. PNs far more commonly arise
Melanoma: A family affair
By Warren R. Heymann, MD Nov. 4, 2016 It has now been 5 years since I was diagnosed with melanoma. Six years ago, my wife Ronnie found a tick on my back; when she noted a lesion in the same region a year later, I remember asking her "What did
Tying up loose ends
Answers in Practice ... By Swapna Bhatia, MPH, December 1, 2019 Shutting down a dermatology practice can be stressful, whether it be planned or unplanned circumstances — especially if you are not familiar with the protocols of what to do with your patients’ electronic health records (EHRs). Do not make