AAD 2016 Annual Meeting: Dr. Eliot Mostow's Take-Aways
Dr. Eliot Mostow, Head of the Dermatology Section at Northeast Ohio Medical University in Rootstown, Ohio, and Editorial Board Member of PracticeUpdate Dermatology, offers his key “take-aways” from the Annual Meeting of the American Academy of Dermatology held from March 4–8, 2016, in Washington, DC.
FRM F015–Herpes Zoster: Controversies and Conundrums in Treatment and Prevention, Lorraine L. Rosamilia
This was an excellent case-based session moderated by Dr. Lorraine Rosamilia. She did a great job framing the “real world” questions related to herpes zoster as an effective set-up and closure to covering reviews on diagnostics given by:
- Dr. Whitney High—While Tzanck preps can still play a role, newer diagnostics such as polymerase chain reaction (PCR) are not too expensive and are relatively quick and accurate. The options for these will vary with locale.
- Dr. Vikash Oza—In pediatric cases, zoster can occur post vaccination, but it is often attenuated compared with wild-type cases except in the immunocompromised.
- Dr. Stephen Tyring—Vaccine is safe, and “moderately” effective in adults, although vaccination, once someone’s had shingles, is likely of minimal benefit.
- Dr. Ken Tomecki—Reviewed drug options and data
Searching for zoster in the AAD program shows that this was the only mention of it, although I hope there were lectures in other sessions that covered some of this material!
SYM S056–Wounds and Ulcers: The Good, the Bad and the Ugly, Robert S. Kirsner
Dr. Rob Kirsner (the newly appointed Chair at the University of Miami) has been a champion of wound care nationally and internationally. I heard his talks at the Medical Dermatology Society meeting as well as a session he moderated Monday at the AAD. Chronic wounds are a significant burden for individual patients, as well as for our healthcare system, with costs that are likely in the 10 to 20 billions of dollars and numbers that surely exceed one million patients per year (some of my spin on less specific detail in numbers relates to a talk I gave on cost and epidemiology of chronic wounds showing how difficult it is to capture accurate numbers, but that we can/should work to improve that process).
- Dr. Dan Eisen—A great lecture on closure of acute surgical wounds was delivered by Dr. Eisen, who reminded us that some of the dogma on wound eversion doesn’t pan out when studied more closely. A good deep closure and superficial suturing (or not, if the deep sutures are good enough for wound approximation) can provide excellent cosmetic results on many areas of the body.
- Dr. Afsaneh Alavi—Gave a thoughtful review of atrophie blanche, which I’ll refer back to when I need to add therapies beyond starting with good wound care and pentoxifylline.
- Dr. Marco Romanelli—Provided a nice review of the benefits of negative pressure wound therapy.
- Dr. Adam Friedman—Reviewed antimicrobials in wound care, highlighting the benefits and safety of defined silver dressings (especially the nanoparticle silver products).
Dr. Kirsner closed this session with a great review of skin substitutes that included the “off the body” substitute known as CelluTome. He didn’t mention the name, but it’s a very intriguing product that we are trying to study further in our wound center, as it’s really an old trick (so-called “pinch grafts”) in a newer, easier format.
FRM F029–Dermatology Teachers Exchange Group, Tammie C. Ferringer, Roy Mitchell Colven
Finally, I loved the overall session known as the Dermatology Teachers Exchange Group. I always leave inspired to think about new ways to advance the teaching of dermatology. This year, I’m going to use ideas proposed to “force” students to use accurate terms by filling in the blanks (sort of like a Mad Libs) of a script I’m going to compose…something like, “This patient has a___________(primary lesion) that is_________(descriptor of color, texture, etc) on the_________(location)…” with additional scripts that will help them improve their communication with me and to enter the medical record in a more defined fashion.
I also liked the lecture by Allison Cruse from the University of Mississippi Medical Center. She talked about efforts to increase hand hygiene in outpatient clinics by having medical students, residents, nurses, and faculty make a single knock on the desk or wall if anyone enters a patient room without using hand hygiene within 20 seconds. Their center went from about 40% hand hygiene to 80% in 6 months and 90% a year later. Nonthreatening immediate feedback can have dramatic results in improving behavior, even when ingrained in faculty over decades!
Time and space do not permit more comments on this session; but, if you like teaching, this is a great session every year.
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