Ted Rosen, MD, reviewed clinical pearls from his own analysis of the published medical literature of 2022 in a riveting presentation highlighted with valuable information shared through humor and personal experiences. In a national survey of 2,000 participants, it was revealed that 74% of patients check online reviews before choosing a provider and 61% of respondents consider the ability to make online appointments an important factor in their decision. Integrating telemedicine into practice has dramatically increased since the beginning of the COVID-19 epidemic. Review of the literature has revealed patients who are >55 years of age are less satisfied with telemedicine than younger patients. Additionally, the majority of patients who utilized telemedicine for medical appointments prefer to do so for follow up rather than for initial provider appointments. An important finding to note is that African American patients had significant concerns about confidentiality when utilizing telemedicine.
Coverage: SDPA 20th Annual Fall Dermatology Conference Nov. 17-20, 2022, in Miami
Dr. Rosen highlighted the updates from the 2022 literature in regard to skin cancer. A small study compared the outcomes of Mohs removal for the distal third of the nose and found satisfaction of repairs was best for flaps followed by grafts, with secondary intention the least preferred surgical outcome. Patients who are diagnosed with multiple myeloma are at an increased risk for developing malignant melanoma with the risk highest in the first two years following their myeloma diagnosis. This highlights the importance of performing full skin examinations on these patients. “Surgery is not always the optimal treatment,” Dr. Rosen emphasized. He highlighted a study of imiquimod as an alternative treatment with therapeutic efficacy for keratoacanthomas. For patients who are not good surgical candidates, this may be a useful option. An alternative treatment option of refractory classic Kaposi’s sarcoma is oral propranolol. This may be helpful in a patient with a challenging surgical location such as the bottom of the feet or a large facial lesion. Lastly, review of the efficacy of smart phone applications for detection of melanoma has exposed phone applications are highly variable with low accuracy and sensitivity. Dr. Rosen went on to review topics including monkeypox, misinformation, hidradenitis suppurativa and treatment of lid ptosis status post botulinum toxin.
For the second half of the presentation, Dr. Lucia Diaz highlighted updates in the pediatric literature through case presentations. Capillary malformations need to be evaluated for risk of Sturge-Weber syndrome (SWS), and Dr. Diaz highlighted the modernized approach for the evaluation of SWS. Patients who present with capillary malformations in the forehead, upper eyelid and midline frontonasal prominence are at higher risk of SWS. These patients should be evaluated at birth with early treatment recommended to minimize psychosocial issues and referrals should be made to pediatric ophthalmology and neurology. Treatment of SWS with pulsed die laser is best when the patient is younger, resulting in clearance in 50-90% of patients after 8-10 sessions. Additional topics of review included infantile hemangioma, staph-scalded skin syndrome, head lice and mycoplasma-induced rash and mucositis (MIRM).
Byline: Sarah B.W. Patton, PA-C
Pictured: SDPA2022 Conference Attendees