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Archive for September, 2011


Arsenic in apple juice?

Tuesday, September 20th, 2011

In case you didn’t hear Dr. Oz created a stir last week claiming that most of the apple juice we drink is from China and contains loads of arsenic. Then came the comments from other health experts which pointed out that he didn’t distinguish between organic and inorganic forms. One article I read stated that only inorganic arsenic causes cancer (namely skin and bladder cancer).

From what limited information I could gather, it seems that both organic (derived from soil and other natural sources) and inorganic arsenic (found in pesticides) can be toxic and cause cancer.

When I went to buy a bottle of apple juice from the store, two major brands said their sources of apple juice come from more than half a dozen countries including China. Considering the pet food scare involving China a few years ago, I am definitely concerned.

We ask our Mohs surgery patients about exposure to well water, and examine the palms of the hands, specifically in the interest of finding out exposure to arsenic.

So, Dr. Oz wasn’t that far off the mark, though He didn’t tell the whole story. A patient of mine told me today that he advised protecting your face and hands and exposing your arms to 20 minutes of sunlight to get Vitamin D. He should have been more specific. In California it can take as little as 8 minutes to burn. In a patient with a history of skin cancer, this isn’t advisable. The best thing to do is to get your serum Vitamin D level checked by your primary care doctor or dermatologist, and go from there.

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How to spot a melanoma

Thursday, September 8th, 2011

“What do I look for?” is a common question I get asked. Some of you have heard of the ABCDE rules (Asymmetry, irregular Border, Color, Diameter, Evolving).

Yeah, yeah, yeah, blah, blah, blah…one of my favorite quotes from a derm I know. I don’t find the ABCDE rule that helpful because there are plenty of benign lesions which would fit these criteria. My favorite way to explain it is “The Ugly Duckling” rule. Look at your moles, the ones that stick out like the ugly duckling are the ones usually to be concerned about. The most sensitive criteria tends to be color (black, very dark brown/black), though there is a rare variant of melanoma known to be colorless or red.

75% of melanomas arise spontaneously without a pre-existing mole, and they can arise quickly. Every year I find some of my established patients I’ve been checking for yearly for years all of the sudden present with a new black lesion, sometimes in the earliest stages, or already invasive. Scary. The good news is that melanomas caught in the earliest stages have an excellent prognosis.

In addition, anyone with a personal or family history of skin cancer, should not only worry about themselves, but also their family members. Remind them to get checked as well!

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