Proactive infectious disease approach to dermatologic patients who are taking tumor necrosis factor-alfa antagonists: Part II. Screening for patients on tumor necrosis factor-alfa antagonists.

Tumor necrosis factor-alfa levels are linked to disease severity in patients with inflammatory conditions, such as psoriasis. Inhibitors of this cytokine are commonly used with significant success in the treatment of such inflammatory disorders. Their use, however, can be plagued by infectious complications.

Proactive infectious disease approach to dermatologic patients who are taking tumor necrosis factor-alfa antagonists: Part I. Risks associated with tumor necrosis factor-alfa antagonists.

Tumor necrosis factor-alfa levels are linked to disease severity in patients with inflammatory conditions, such as psoriasis. Inhibitors of this cytokine are commonly used with significant success in the treatment of such inflammatory disorders. Their use, however, can be plagued by infectious complications.

Curricular factors associated with medical students' practice of the skin cancer examination: an educational enhancement initiative by the integrated skin exam consortium.

Importance: As medical school curricula become progressively integrated, a need exists to optimize education related to the skin cancer examination (SCE) for melanoma, a relevant competency gap that influences secondary prevention efforts.

Objectives: To identify curricular factors associated with medical students' confidence, intent, and performance regarding the SCE.

Design, Setting, And Participants: Survey-based cross-sectional study from the Integrated Skin Exam Consortium at accredited US medical schools among a volunteer sample of second-year students representing 8 geographically varied public and private institutions.

The Integrated Skin Exam film: an educational intervention to promote early detection of melanoma by medical students.

Background: Knowledge of the skin cancer examination (SCE) and its practice remain relevant competency gaps among medical students.

Objective: We elaborate on a method of SCE known as the Integrated Skin Exam and discuss the development of an instructional film that illustrates its principles. We assess the tool's effect on knowledge, attitudes, and perceptions related to the SCE.

Employing an aesthetician in a dermatology practice: facts and controversies.

Employment of aestheticians in dermatology offices is becoming an everyday occurrence, as the dermatology patients' demand for cosmetic services taxes the availability of limited resources. Proponents of the practice state that aestheticians can help meet patients' expectations, while allowing dermatologists to focus their practice on the medical needs of patients. Opponents believe employment of fee-for-service aesthetic technicians compromises our ethical duties to our patients and diminishes the stature of dermatology as a profession.

Brand name versus generic drugs: the ethical quandary in caring for our sophisticated patients while trying to reduce health-care costs: facts and controversies.

Medical ethics are the values and guidelines that govern decisions made in medical practice. Four prima facie moral principles can serve as a framework to help physicians analyze problems and make ethical decisions: (1) respect for autonomy, (2) beneficence, (3) non-maleficence, and (4) justice. With the cost of health care rising, all parties involved in the delivery of health care need to work to reduce costs, while continuing to provide quality care to our patients.

Conundrum: who should care for the dermatologic needs of the medicaid patient? Facts and controversies.

With the impending implementation of Obamacare in the context of a depressed American economy; an unsustainable national deficit and debt; and increasing personal dependency upon government largesse, a perfect storm is developing in the United States. This perfect storm is embodied by the paradox that an expanding population of Title XIX insured patients is increasingly dependent upon a diminishing number of American dermatologists to provide essential dermatologic care. In this context, we discuss whose responsibility it is to care for the dermatologic needs of Title XIX patients.

Kickbacks, stark violations, client billing, and joint ventures: facts and controversies.

Many current business trends in the field of dermatopathology deserve ethical scrutiny. An important point to consider in these analyses is that which is legal is not necessarily ethical. We examine the topics of client billing, contractual joint ventures, and health information technology donations, including both the legal implications as pertaining to the Stark Law and Anti-Kickback Statute, and the ethical ramifications of these practices.

The role of nutrition in dermatologic diseases: facts and controversies.

Many dermatologic diseases are chronic with no definitive cure. For some diseases, the etiology is not completely understood, with treatment being difficult and associated with side effects. In such cases, patients may try alternative treatments to prevent onset, reduce symptom severity, or prevent reoccurrence of a disease.

Melanoma in skin of color in Connecticut: an analysis of melanoma incidence and stage at diagnosis in non-Hispanic blacks, non-Hispanic whites, and Hispanics.

Background: The incidence of melanoma is increasing in Caucasians and in Hispanic subgroups in California and Florida. There is a paucity of information regarding melanoma incidence, stage at diagnosis, and other patient and tumor factors among minority subgroups in the northeast USA. This report examines melanoma in non-Hispanic white, non-Hispanic black, and Hispanic residents of Connecticut.

Metastatic melanoma in the older patient: special considerations.

Cancer is a disease of older age where genomic instability, impaired DNA repair, and weakened immune surveillance against cancer are recognized to play a causative role. Because the incidence of melanoma is increasing at a very fast pace in the elderly and there is a rapid expansion of the aging population, a large number of elderly patients with metastatic melanoma will be encountered in clinical practice. As a result, significant burden is expected to be placed on health care resources as effective treatment of this condition is sought.