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By: Melinda Taschetta-Millane
By: William J. Lynott
Carlotta Aiken's cheeks are sprinkled with brown spots, just like her grandmother had.
"She lived to be 93," Mrs. Aiken tells Dr. Simon Yoo, who is using a laser to remove the spots, a benign skin condition called dermatosis papulosa nigra.
Mrs. Aiken, a 58-year-old art teacher, is a volunteer in a study at Northwestern University's Center for Ethnic Skin, and she is playing a small part in a growing movement.
At clinics and research centers in Chicago, New York, Washington, Detroit and Miami, dermatologists are developing better treatments for skin problems of people with dark skin. Some skin doctors concentrate their practices on blacks, Hispanics and Asians, people who previously were neglected by drug and cosmetic company research.
"I have African-American patients come to me frustrated that their previous dermatologists didn't understand their hair and scalp disorders and pigmentation problems," said Dr. Diane Jackson-Richards, who specializes in multicultural dermatology at the Henry Ford Health System in Detroit. "I treat all races of people, but I've seen over the years how I've been sought out by patients of color."
The nation's changing demographics drive the movement, said Dr. Rebat Halder, chairman of the Dermatology Department at Howard University Hospital.
"By midcentury, half the U.S. population will be of pigmented skins," Dr. Halder said. He edited the first comprehensive textbook on the dermatology of ethnic skin, which was published this year. Dermatology conferences are adding more ethnic skin sessions to their agendas, he said.
A growing number of blacks, Hispanics and Asians are entering dermatology, which also fuels the trend, said Dr. Victoria Holloway Barbosa, director of the six-year-old L'Oreal Institute for Ethnic Hair and Skin Research in Chicago.
"It's long overdue," Dr. Barbosa said of the attention.
L'Oreal, the cosmetic company, sponsors an ethnic-skin research symposium with Howard University every other year, and funds its own research.
"We do both basic science research to understand specific differences in hair and skin and also talk directly to consumers to understand their common problems," Dr. Barbosa said.
Dark skin has many advantages, she said. Pigment protects the skin from the sun's damaging effects, and some research shows that darker skin is stronger structurally as well.
But dark skin can react differently than white skin to cosmetic treatments and medications. It is more prone to discoloration after injury, and more inclined to keloids, a type of scar that can be unsightly and sometimes itchy or painful.
A doctor unfamiliar with keloids might try to cut them out, which can cause them to return larger, said Dr. Heather Woolery-Lloyd, director of ethnic skin care at the University of Miami Cosmetic Center.
"I see patients all the time who've had keloids cut out on their shoulders. The doctors didn't realize it wasn't the best choice," Dr. Woolery-Lloyd said.
Instead, she uses a series of steroid injections.
Women with dark skin sometimes develop melasma, also called "the mask of pregnancy," a darkening of the face related to hormones. Vitiligo, a disorder affecting pop star Michael Jackson, leads to white patches on the skin.
A type of scarring hair loss that starts at the crown of the head can affect black women. The Skin of Color Center at St. Luke's-Roosevelt Hospital in New York is conducting a study to compare common treatments for that type of hair loss, which used to be called "hot comb alopecia," but now is called "central centifugal cicatricial alopecia."
Researchers aren't sure of its cause. One theory holds that hair-processing techniques such as chemical relaxers and tight braiding may contribute, said Dr. Roopal Kundu, director of Northwestern University's center.
Dr. Kundu, who is Indian, said her heritage gave her "an innate curiosity about understanding the biological differences in hair, skin and nails in persons from India and also those with darker pigmented skins."
Dermatologists can improve the way they communicate with patients if they understand cultural grooming and hair styling practices, she said.
"For me, education is critical for all my patients," Dr. Kundu said. "I try to give handouts on everything I diagnose."
By Carla K. Johnson, Associated Press, November 27, 2006
Personal misuse of super-strength botulinum toxin caused a Florida osteopath, his girlfriend, and two of his patients to become paralyzed and hospitalized for months in 2004.
Details of the much-publicized incident—which ended in the practitioner being sentenced to three years in prison—are only now published in this week's issue of the Journal of the American Medical Association.
At the time of the incident, Bach McComb was an osteopathic physician who was continuing to practice in Oakland Park, Fla., after his license had been suspended. In the four cases described, McComb did not use a medical version of Allergan Inc.'s Botox.
Instead, he mistakenly gave himself and the three others four to six injections of a preparation of paralyzing botulinum toxin that was 2,800 times stronger than that typically used on patients, according to the authors of the JAMA article. This formulation was only intended for laboratory work.
The vial's labeling clearly marked the product as not being suitable for human use.
"The fact that clinical practitioners were using an unlicensed product was very disturbing," said Dr. Christopher R. Braden, a medical epidemiologist at the U.S. Centers for Disease Control and Prevention, and an author of the report. "It needed to be highlighted and the issue dealt with so that it does not recur."
"A 100-microgram vial of toxin taken from the same manufacturer's lot as the toxin administered to the case patients contained a toxin amount sufficient to kill approximately 14,286 adults if disseminated evenly," according to the JAMA report.
McComb, his two patients, Eric and Bonnie Kaplan, and McComb's girlfriend, Alma Hall, were each paralyzed by the time they were admitted to a hospital.
All of the patients eventually survived but were hospitalized for months and required assistance for basic functions such as breathing, speaking and walking. McComb was later sent to prison for three years.
The incident does not reflect on the safety of standard treatments of Botox, stressed Dr. John Canady, a professor of plastic surgery at the University of Iowa and vice president of the American Academy of Plastic Surgeons.
"This was clearly not Botox," Canady said. "More than 3 million people got Botox injections in 2005, which is the last year we have statistics on, and I don't believe any reaction such as this has been reported."
The real Botox is carefully packaged by its manufacturer, Allergan, Canady explained. "Botox comes in a vial that does not have an excessive dose, and it is reconstituted in the same vial," he said. "None of these safeguards were in place" in the Florida case, Canady added.
Basic precautions against such misuse are obvious, Canady said.
"It is important to go to a board-certified plastic surgeon," he said. "You should feel free to ask that person what his track record has been in the use of Botox. Probably the biggest take-home message is that it is important to do your homework before any medical procedure, and that includes Botox."
In addition, "It's absolutely fair to ask what material is being injected into you personally," Canady said. "I don't think it's too much to ask to see the container or the material."
And Braden cautioned consumers about bargain-hunting.
The last time he looked at the Internet, he saw advertisements for "Botox-like" medications. "I would be very suspect of those kinds of products," Braden said.
By Ed Edelson, HealthDay Reporter, November 21, 2006
The Australian government has launched an advertising campaign aimed at raising awareness among teenagers of the dangers of skin cancer.
A graphic series of TV ads shows that overexposure to the sun can cause skin cancer in people of all ages.
Australia's chief medical officer, John Horvath, told the Australian Broadcasting Corporation many teenagers are unaware of the facts about skin cancer and they are too young to remember earlier public education campaigns.
"You have to get the message out there again and dispel some of the myths that, 'if you don't get sunburned you'll be all right,' or that a suntan or an olive skin protects you. None of those things are true," Horvath said.
United Press International, November 19, 2006
The Abbott Laboratories drug Humira (adalimumab) has been given expanded approval by the U.S. Food and Drug Administration to slow structural joint damage in people with psoriatic arthritis. The condition affects people who have skin psoriasis.
Humira was initially approved for overall treatment of psoriatic arthritis in October 2005. It's also been sanctioned to treat moderate-to-severe rheumatoid arthritis, and an inflammatory disease of the spine called ankylosing spondylitis.
Psoriatic arthritis combines symptoms of arthritis—including joint pain and inflammation—with those of psoriasis, including painful red lesions on the skin. Clinical testing on 313 people who hadn't responded to NSAID therapy found that people given Humira had significantly less joint damage than study participants who took a non-medicinal placebo, Abbott said in a statement.
People who took Humira also demonstrated increased ability to perform daily functions such as getting dressed, walking, and climbing stairs, the company said.
HealthDay News, November 14, 2006
Murad's Lighten and Brighten Eye Treatment was the top pick for “Best Dermatologist Brand” in the annual Shape of Beauty Awards, chosen by Shape magazine editors, beauty professionals and more than 6,000 readers. 800-336-8723
Skin Care Consultants is celebrating 30 years in the industry. The company was founded, and is still run, by husband-and-wife team Hubert and Pat Lam. 877-694-9777, email@example.com