Summer 2004 derm newsletter

The Virginia Dermatological Society
Volume 6 Number 5
Summer 2007
I have enjoyed serving as president of the fortunate to have Virginia dermatologists as Virginia Dermatological Society this past leaders in the American Academy of Dermatol- ogy: David Pariser, MD is President-Elect and dermatologists in Virginia. In the fall, I Evan Farmer, MD is Vice President. We are represented our Society as a delegate at the certainly proud of their accomplishments, and of the accomplishments of dermatologists who serve in their local medical societies and in the MSV Foundation, headed by Lawrence E.
Blanchard, III, MD, awarded the state’s Award, given annually to the specialty with Cordodo, MD is leaving for California to begin the highest percentage of members contribut- a fellowship in pediatric dermatology. Amalie ing to the annual fund. I’m proud of the Derdeyn, MD who will soon begin practice in Charlottesville will assume the duties of secretary-treasurer in July. New ideas and newleadership are always important to the continued success of our Society. Those who legislative issues before the General Assem- are interested in the positions of President and Secretary-Treasurer for 2008 should please members, restrictions on the use of tanning contact me at or by phone beds by teenagers have been put in place, and at (434) 924-1966. Thank you for the privilege and pleasure I’ve had of serving you in this physician use of products and devices that can alter the living layers of the skin. We are Notes from the Medicare Carrier
wish to participate in. If you choose not to Advisory Committee
participate with these plans, educate your someone who can better address your concerns.
office staff so they will recognize a medicare advantage insurance card. Allowing one patient Medical Society of Virginia
to come in opens your practice to all of them.
Foundation Recognizes
change in reimbursement for cryotherapy. The Dermatologists’ Support
Medicare Advantage Plans. These plans are only reason we have been fortunate enough to be so well compensated for this procedure is At the March 31st meeting of the Virginia which replace a patients traditional Medicare.
current payment system was instituted.
Patients are unaware that they are not enrolled Unlike other specialties, dermatology went presented Virginia’s dermatologists with its along and made an effort to capture as much Power of Partnership Award. This award physicians is that if you accept one patient and revenue as was possible instead of fighting the bill the plan you are “deemed” to particiapte in the plan even though you have not signed a codes were up for review that this would be a contract nor seen a fee schedule. You must, by reduction because that is inevitable - codes are contribution to MSVF’s annual fund.
accept the fee schedule which is often far below reimbursement. The dedicated physicians who traditional Medicare. You, as a taxpayer, are represent the AAD were able to salvage most Foundation to Dr. Julia Padgett, President also being taken “advantage” of, because these of the previous pay scale. If we were to start of the Virginia Dermatological Society.
plans bill CMS for more than what Medicare costs for the same services, while at the same therapy as a “new” code we would be lucky to get two dollars per lesion in the opinion of health of Virginians. To learn more about experts in coding and reimbursement.
I cannot of course recommend any action for MSVF’s physician-driven initiatives or to you to take concerning your own practice or If you have any questions or concerns with make a contribution, visit their website at business decision, however, each of us should medicare please contact me at (804) 282-0831 be given all the relevant information to come to Bortz, the Foundation’s Executive Director make informed choices about which plan we Of course, I can’t solve all problems but will do SPEAKERS PEARLS FROM THE TIDEWATER, RICHMOND AND
Joseph B. Bikowski, MD Cases About Faces and Vehicular
Antoinette F. Hood, MD Dermatology at EVMS and Advances in
Look out for pseudo rhinophyma with swelling of the She reminded us to think of nephrogenic systemic fibrosis when nasal bridge due to constriction of lymph channels from Kimberly A. Scott, MD Really Great Cases from Eastern Virginia
Doxycycline beats minocycline in its anti-inflammatory Medical School.
effect. Doxycycline is 33 times and minocycline 12 timesthe anti-inflammatory effect of tetracycline.
Cases included bullous tinea corporis, milia-like-syringomas,eccrine angiomatosis, erythema caloricum, cryptoccus neoformans, For facial redness, scaling, and folliculitis think demodex neurolytic acral erythema (with hepatitis C), primary systemic amyloidosis, nephrogenic systemic fibrosis, verrucous sarcoidosis,neonatal HSV, and bullous dermatomyositis.
For severe angular cheilitis, do a culture and sensitivity.
Dr. Bikowski likes to treat with desonide ointment and Judith V. Williams, MD and David Darrow, MD Vascular
either ketoconazole cream or mupirocin ointment.
Molluscum responds well to daily applications of Dr. Willams reminded us that hemangiomas can cause permanent dysfunction, pain when ulcerating, andpossible permanent visual loss.
“Pomade” acne on the forehead may be pityrosporumfolliculitis. The same yeast organism may be the cause of In 25% of cases there is more than one lesion. There can Grover’s. Treat with oral ketoconazole or Diflucan.
You can double or even triple the dose of a non-sedating It’s best to use a team approach for hemangiomas, and to manage early and modify the life cycle of these lesions.
Treatments include observation, pulsed dye laser, topical, If a patient on isotretenoin does not have hyperlipidemia intra-lesional and systemic steroids, surgical removals, after thirty-days, it won’t happen.
Brian B. Adams, MD, MPH. Cutaneous Infections that Sideline
Dr. Darrow reminds us that ulcerated hemangiomas Athletes and Traumatic Hair and Nail Injuries in Athletes.
In treating infections in athletes think of fomites Robert J. Pariser, MD The Story of Syphilis: It’s Still Our
including mats, equipment, towels, and weights.
Whirlpools are also a good way of spreading infections.
Think lues! While there are only 1,000 new cases of MF a year, HSV is not spread by fomites, but in wrestling there is a there are 34,000 new cases of Syphilis a year.
30% chance of contacting the virus if exposure to anactive lesion. Lesions show up on the head and neckmost.
HSV is frequently misdiagnosed as impetigo or tinea.
Look for scalloped lesion edges.
HPV or tinea can spread readily through shower floors,wet pool decks, and the weight room.
For friction blisters, the blisters need to be ruptured three times over 24 hours. Preventive measures includeantiperspirants, Johnson & Johnson’s Liquid Bandage and petrolatum. Also consider the use of gloves, well- sized shoes, and synthetic, not cotton, socks.
Look for “joggers’ toes” involving the longest toe andfeaturing a thickened toenail, periungual hemorrhage, and The three favorite sunscreens of Dr. Adams’ athletes are:Blue Lizard, Ocean Potion, and Banana Boat spray.


Seeing other people

Seeing Other People Gina and Stress went to the coffee shop to discuss the future of their They waited in line behind a worn-out woman and her Stress, who looked like a big thug. He wore decaying clothes, and he smelled sweaty and unwashed. On the back of his wifebeater T-shirt was one word, in black: Jobless. While Gina and Stress waited, Jobless pressed down on his partner’s shoulders th

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