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Patient Care

Dr. Susan Weinkle Receives ODAC JDD Award

By Aesthetic Dermatology, Patient Care No Comments
Susan Weinkle MD image from ODAC Dermatology conference

Source: Practical Dermatology

Susan Weinkle, MD, has been awarded the Outstanding Educator and Mentor in Dermatology Award by the ODAC Dermatology, Aesthetics & Surgical Conference, in partnership with the Journal of Drugs in Dermatology (JDD).

The award recognizes Dr. Weinkle for her long-standing commitment to educating and mentoring the next generation of dermatologists and for devoting a major portion of her professional life to enhancing the practice and profession of dermatology through education.

“Susan has given all of us in aesthetics so much of her time and energy, and I am honored to present this award to her.”“It is a pleasure and an honor to recognize the tireless work of exceptional leaders in dermatology,” said Shelley Tanner, CEO and president of SanovaWorks, which produces the JDD, ODAC, Derm In-Review, and Next Steps in Dermatology. “Not only do these dermatology leaders dedicate their entire lives to benefiting patients every day, but after the ‘work day’ ends, they spend countless hours involved in activities to improve the specialty’s future. We congratulate Dr. Weinkle for being chosen for this award.”

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Susan Weinkle, M.D., Presented JDD Outstanding Educator Award

By Aesthetic Dermatology, Patient Care No Comments
Susan Weinkle MD image from ODAC Dermatology conference

Source: DermatologyTimes

A south Florida practitioner’s contribution to dermatology is not going unnoticed at the 2020 Orlando Dermatology, Aesthetic & Surgical Conference (ODAC) with the recent presentation of the Journal of Drugs in Dermatology (JDD) Outstanding Educator & Mentor in Dermatology Award to Susan Weinkle, M.D, Tampa, Fla.

Dr. Weinkle, an assistant clinical professor of dermatology at the University of South Florida, was recognized for her dedication to mentoring and educating future dermatologists, and commitment to advancing the dermatology industry through education.

Aside from being an educator, Dr. Weinkle specializes in cosmetic surgery and Mohs Micrographic Surgery at her private practice in Bradenton, Fla.

She was also the president of the American Society for Dermatological Surgery and the Women’s Dermatological Society. Additionally, she was previously a committee chair and board of directors member at numerous dermatology organizations including the Florida Society of Dermatology and Dermatologic Surgery, American Academy of Dermatology and Dermatology Foundation.

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CBD for Psoriasis?

By Medical Dermatology, Patient Care
CBD Oil for Psoriasis

Source: Next Steps in Dermatology

Health recently wrote an article asking if CBD oil can relieve psoriasis symptoms.

In recognition of Psoriasis Awareness Month, I consulted Adam Friedman, MD, FAAD, professor and interim chair of dermatology at the George Washington School of Medicine and Health Sciences. Dr. Friedman is also the residency program director, director of translational research and director of the Supportive Oncodermatology Clinic. In addition, Dr. Friedman serves as Medical Director for ODAC -Dermatology, Aesthetic & Surgical Conference.

Can CBD help relieve psoriasis symptoms? 

We have only begun to scratch the surface of the unbridled potential of cannabinoids as therapeutic agents. Interestingly enough, psoriasis is one of the listed indications for medical cannabis in the great state of Connecticut, though little is really known on this and many other spaces in dermatology.

Let’s take a step back and first talk about CBD. CBD stands for cannabidiol, one of about 120 different molecules that come from the cannabis plant. It’s the second most prevalent active ingredient in cannabis – tetrahydrocannabinol (THC) is the first. But unlike other cannabinoids – such as THC — CBD does not produce a euphoric “high” or psychoactive effect. That said, it has tremendous biological reactivity through binding to a multitude of receptors, including the cannabinoid specific receptor, CB2r, which is expressed by practically every immune cell (as opposed to CB1r, which is most heavily expressed in the peripheral and central nervous system), regulating skin physiology by being anti-inflammatory, lipostatic and antiproliferative.

Now back to the original question. Inflammatory skin conditions such as psoriasis result from a number of aberrant responses of the immune cells and immune signaling in the skin. Looking at psoriasis specifically, dysregulation of the skin immune system results in marked proliferation and keratinization of epidermal cells. Overactivation of Th1 and Th17 inflammatory responses in psoriasis produces cytokines like IL-17 and IL-22 that set off cascades of events resulting in increased keratinocyte proliferation, expression of keratins 6 and 16, and inflammatory cell infiltration. Because of its role in regulating the inflammatory response of keratinocytes and dermal immune cells, the endocannabinoid system offers potential targets for the management of many inflammatoryskin conditions, but the data to date is rather limited, mostly to cell bases, ex vivo and animal models.

This is what we know:Activation of the endocannabinoid system in the skin reduces inflammation through a number of mechanisms, such as shifting the pro-inflammatory Th1 response to an anti-inflammatory Th2 response via CB2r activation (thank you, CBD). The endocannabinoid system also plays a role in regulating keratinocyte proliferation and differentiation, which are pathologically increased in psoriasis. For example, CB1r activation by cannabinoids such as anandamide (AEA) inhibits keratinocyte differentiation and decreases production of keratin K6, a marker of keratinocyte hyperproliferation. The potential therapeutic effects of CBD in psoriasis also include activation of non-cannabinoid receptors such as GPR55, which reduces inflammation caused by nerve growth factor, and PPARα and PPARγ which reduces epidermal hyperplasia via suppressed proliferation of keratinocytes.

Platelet-Rich Plasma for Skin Rejuvenation

By Aesthetic Dermatology, ODAC Sessions, Patient Care
PRP Injection in Patient

Source: Next Steps in Derm

Dr. Deirdre Hooper, an expert aesthetic and medical dermatologist, discussed the emerging use of Platelet-rich Plasma in the treatment of alopecia and skin rejuvenation at the 16th Annual ODAC Dermatology, Aesthetics and Surgical Conference. Dr. Nikhil Shyam shares his takeaways and pearls from this lecture.

Platelet-rich plasma (PRP) is rapidly gaining popularity amongst dermatologists for its potential use in treating hair loss, acne scarring and facial rejuvenation. However, there is significant variability in the processing of PRP and there are currently no established treatment protocols.

Evidence for PRP in Treating Hair Loss and Skin Rejuvenation

  • The literature review for the use of PRP in androgenetic alopecia shows significant benefit without any serious complications. However, the data also reveals wide ranging processing systems for PRP and treatment protocols.
  • PRP may be used topically or intradermally in combination with fractional ablative laser resurfacing to enhance skin rejuvenation and acne scarring with faster recovery between treatments.
  • PRP has also been shown to improve the cosmetic outcome of striae with high patient satisfaction.

Practical Tips for Using PRP in Hair Loss:

  • Use about 5 – 7 ml PRP
  • Inject intradermally or in the deep subcutaneous tissue
  • Inject 0.3 to 0.5 cc per area using a 27- or 30-gauge needle
  • Typically perform 3-4 treatment sessions every 4-6 weeks
  • Maintenance treatments every 6 to 9 months

Practical Tips for Using PRP in Skin Rejuvenation:

  • Apply topical numbing medication to the target areas.
  • Inject PRP using a 1 cc syringe and a 25 or 27 gauge, 1.5” cannula.
  • Utilize a fanning technique to inject in the problem area.
  • Alternatively, use a 30-31-gauge needle and inject intradermal blebs.
  • Perform 3-4 treatment sessions in 4-6 week intervals.
  • Maintenance treatments every 6 to 9 months.

Patient Instructions After Treatment:

  • May experience some burning or stinging 5-15 minutes post procedure.
  • May result in potential “bleeding” appearance and recommend patients bring hats.
  • Avoid strenuous exercise for about 24 hours post procedure.

Overall, PRP is increasingly being utilized for hair loss, scarring and facial rejuvenation. Currently, PRP appears to be safe with no long-term side effects noted. It may be used synergistically with existing treatment options with added benefit. Further research is required to establish the optimal PRP processing technique and to establish standardized treatment protocols.

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Dermatology Contract Negotiations and Legal Tips

By ODAC Sessions, Patient Care
Dermatology Business deal

Source: Next Steps in Derm

If you are navigating the confusing landscape of contract negotiations or considering partnership in a private practice after years of employment, then take note! Ron Lebow, Senior Counsel in the Health Law practice group at Greenspoon Marder LLP, led a fantastic workshop at the 2019 ODAC conference. He covered common concerns when negotiating employment agreements with dermatology practices, as well as issues to address when it comes time to become a partner.

The most important point and recurring theme of Ron Lebow’s workshop was simply this:

“Make sure everything you want is in writing. Nothing is inferred. Everything is written and agreed upon by both parties.”

This point was stressed time and time again and will continue to be the overarching theme throughout the many parts of contract negotiations. With this in mind, here are some of the main takeaways and important questions we, dermatologists, should constantly keep in mind.

What Do I Do When Searching For A Job?

Surround yourself with experts! Find people who have your back. Make sure you find a lawyer who deals with medical professionals (particularly your specialty) for a living. You may need to find an accountant to work with you depending on your situation. Lastly, it may be in your best interest to work through recruiters. Some recruiters are better than others, and Ron Lebow recommends Dermatology Authority as an organization that provides good recruiting services for dermatologists.

Can I Negotiate When Looking For A Job?

When dealing with negotiations, it is important to recognize the many aspects of the process. With respect to the job you are offered:

  • They expect you to negotiate. It’s not rude to negotiate. It is part of the process.
  • They aren’t doing you a favor by hiring you. They are making a profit on you and therefore, you do have some leverage in the process. You can negotiate because they want you.
  • They will (almost) never take the offer away. The only instance in which they may take an offer away is if you ask for something, they say no, and then you continue to ask for something that is already off the table.
  • Don’t negotiate before you bring a lawyer in to help with the contract and negotiation. It may already be too late for them to be useful.
  • Don’t sign term sheet/offer letter until you have spoken with a lawyer who has reviewed the information. Again, it may already be too late for them to be useful.
  • The term of the contract, the length of time you sign for, is a non-issue. The real term of the contract is actually the notice you have to give before leaving, not the actual term of the contract itself. For example, if you sign a two-year contract but the notice you must give is three months, the term for all intents and purposes is three months from the time you decide you want to break your contact.
  • Make sure it is spelled out when partnership will be happening if that is on the table. Three years is a common timetable for partnership to be offered. If partnership is a possibility, make sure there is something written in the contract in case ownership changes between the time you start and the time you would have been allowed to start buying into partnership (e.g. if the group sells to private equity).

Compensation and Bonuses

Continue reading. 

ODAC and JDD Award Dr. Alan Menter

By Medical Dermatology, ODAC Sessions, Patient Care
Dr. Mentor Presenting at ODAC

Source: Practical Dermatology

Alan Menter, MD, has been awarded the Outstanding Researcher and Educator in Psoriatic Disease Award by the ODAC Dermatology, Aesthetics & Surgical Conference, in partnership with the Journal of Drugs in Dermatology (JDD).

The award recognizes Dr. Menter’s significant contribution and lifetime commitment to the advancement of psoriatic disease research as well as his work guiding the next generation of psoriasis experts and researchers.

“Dr. Menter has dedicated his career to improving psoriasis treatment options and standards of care while also pouring countless hours into up-and-coming psoriasis experts and researchers, ensuring his legacy will continue for generations to come,” said Shelley Tanner, CEO and president of SanovaWorks, which produces the JDD and ODAC.

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Male vs. Female Aesthetic Consultation – ODAC Dermatology Conference

By Aesthetic Dermatology, ODAC Sessions, Patient Care
Terrence Keaney Male Aesthetics at ODAC

Source: Dermatology News

The first time a man walks in for an aesthetic consultation, he probably doesn’t know what to expect, according to Terrence Keaney, MD, a dermatologist in private practice in Arlington, Va. And he may not even be sure what he’s looking for.

However, he probably knows what he doesn’t like about his appearance. When men are questioned, the three areas they are most concerned about is their hairline, their eyes, and their jawline, said Dr. Keaney, speaking at the Orlando Dermatology Aesthetic and Clinical Conference.

It’s important to evaluate men differently, not just for anatomic differences from women, but also for behavioral and psychological factors unique to men as aesthetic patients, he noted.

ODAC Dermatology Conference Returns to Orlando, Florida

By Aesthetic Dermatology, Medical Dermatology, ODAC Sessions, Patient Care, Surgical Dermatology
Orlando Florida Hotel

Source: Dermatology Times

The Orlando Dermatology Aesthetic & Clinical Conference (ODAC), formerly known as Orlando Derm, is scheduled for January 18-21 at the JW Marriott in Orlando.

This year’s meeting will open with presentations from physicians who will address advances in treating skin of color, hot topics in surgical dermatology and cutaneous malignancy, the latest on photodynamic therapy, and a year in review from the Journal of Drugs in Dermatology, among others.

Drs. Eric Bernstein and Jason Pozner will host a panel discussion on “My Top Picks for Laser and Energy Based Treatments.” And, Dr. Joel Cohen will give an overview of facial arterial supply.

During the general session on Saturday, Jan. 19, Dr. Brian Berman will address managing urticaria, which will be followed by talks by Dr. Deirdre Hooper on platelet rich plasma for hair growth and skin rejuvenation; Dr. Andrew Alexis on keloids and disorders of hyperpigmentation in skin of color; and, Drs. Bernstein and Pozner will address advances in non-surgical skin tightening.

On Sunday, January 20, Dr. Jean Bolognia will open the day’s general session with a review of advances in systemic therapies for melanoma.

For more information, visit ODAC online at https://orlandoderm.org.

Vascular Compromise

By ODAC Sessions, Patient Care
Dr. Joel Cohen presenting at ODAC dermatology conference

Source: Dermatology Times

Avoiding and treating vascular compromise with hyaluronic acid (HA) injections requires understanding the subtleties of underlying facial anatomy and keeping a well-stocked arsenal of treatments for impending necrosis, said an expert at the Orlando Dermatology Aesthetic and Clinical Conference (ODAC) in Miami.

“Some blood vessels may actually be in different locations than in some of the anatomic diagrams and cartoons that have long characterized their course,” said vice conference chair Joel L. Cohen, M.D., from Greenwood Village, Colorado, who serves on the teaching faculty for both the University of California, Irvine and the University of Colorado.

Although textbooks commonly depict the angular artery tracking adjacent to the nasofacial sulcus, he said, “it’s more common for the angular artery to be more lateral to that area, closer to the infraorbital distribution. In a recent cadaver study, only 19% of the time did the facial artery actually project upward along the side of the nose-cheek junction. But 32% of the time, the angular artery came off the facial artery earlier, and therefore coursed to more of the medial cheek area.”

The technique of aspirating before injecting is not foolproof. “There can be false negatives. A study indicates you probably have to pull back on the plunger for several seconds in order to physically be able to see if you’re in a vessel. We all surely realize that it is very difficult to have the needle in the exact spot you plan to inject, and then reposition your hand to pull back on the plunger of the syringe to try to aspirate, and then have your needle-tip remain in the exact same spot when you reposition again in order to inject. As you change your hand position to pull back on the plunger, you probably move a bit, maybe just a millimeter, from the original location to the location you later inject,” Dr. Cohen said.

A recent report also shows that it is possible to puncture and get into a vessel with small cannulas — the injectors aspirated blood despite using a cannula.

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Want to expand aesthetic dermatology business? Appeal to men

By Aesthetic Dermatology, Patient Care
Terrence Keaney Male Aesthetics at ODAC

Source: Dermatology Times

Bringing more men into an aesthetic dermatology practice can expand the patient population, increase business revenue, and pay long-term dividends in terms of patient loyalty and repeat business.

But men aren’t like women when it comes to aesthetic concerns, so the strategies used to market your aesthetic offerings to female patients might miss the mark with men, cautioned Terrence Keaney, MD.

Men are less cosmetically savvy and need more upfront education and counseling, Dr. Keaney said at the 2018 Orlando Dermatology Aesthetic and Clinical Conference.

“I spend more time explaining therapies and what might be best for them,” he noted. “I explain the scientific rationale and treatment mechanisms so they will be more comfortable.” Making sure they understand is important, because “men often nod and don’t ask questions.”

The extra effort up front can pay off.

“The beauty of men is when they get a great result and are happy with you, men are very physician loyal. Once they get a great result, they’re yours forever,” said Dr. Keaney, an assistant clinical professor of dermatology at George Washington University, Washington, and a private practice dermatologist in Arlington, Va.

Cost is the leading deterrent for men to embrace aesthetic procedures, a factor that also ranks first among women. Men are also concerned that results will not look natural and want information about safety and side effects, Dr. Keaney said. “These deterrents can be overcome with proper education and counseling.”

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