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Archive for January, 2012

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RIP Robert Hegyes; RIP La Cachette

Saturday, January 28th, 2012

Juan Epstein RIP

So sad to hear that he died. I loved Welcome Back Kotter as a kid. This was probably one of the only shows my brother made me watch that we both actually enjoyed. It had great characters including Juan Epstein, the Puerto Rican Jew, and a great theme song. He was my favorite Sweathog on the show. I liked the twinkle in his eye. He was a sweet-talker and a bit of a smart alec. The funniest running bit about his character were the fake excuse notes for missing class signed by “Epstein’s mother.” It is pretty funny reading some people’s comments on the internet today about his passing, “Juan won’t be in class today, he is in heaven. Signed, Epstein’s mother.”

Also, I was disappointed to hear that La Cachette just closed on the Eater LA blog that I follow. We had such a good time there recently.

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What is a dysplastic (atypical) nevus?

Friday, January 27th, 2012

This is a common diagnosis in Caucasian patients. A dysplastic (atypical) nevus is a mole that clinically (to the doctor’s eye) and microscopically has features that are atypical for a mole, but not quite enough to categorize as melanoma. They often look like large (>4 mm) or two-toned “fried eggs” and may be asymmetric or have blurry borders. However, I have diagnosed many under 4 mm in diameter. Many Caucasian patients have one or more of these and some have “dysplastic nevus syndrome” where the patient may have ten’s to more than one hundred atypical moles.

Not all dysplastic nevi need to be biopsied, however it is important to have an experienced dermatologist do regular total body exams and for the patient to do self exams. Often times, not all lesions need to be removed. We even do total body photography on some patients. Dysplastic nevi are now categorized as having mild, moderate or severe atypia on a biopsy report. This determines whether they need to be cut out again. Dysplastic nevi with severe atypia are what I like to call “pre-melanomas” which absolutely need to be removed.

Dysplastic nevi are not necessarily going to turn into melanoma, but are a marker for a much higher risk of melanoma in general. Therefore, anyone with these lesions should take extra precautions in the sun, as we know that sun does cause direct damage to moles as well as the skin in general. Because this also tends to be an inherited trait, it is important to have family members also screened

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The gift that keeps on giving…

Thursday, January 26th, 2012

…Not in a good way. Lately, we have had a streak of young men under the age of 40 with genital warts. Most of them were self-discovered, some on total body skin exams. It is an unpleasant and embarrassing subject and highly distressing for those who have them, since recurrences are frequent and the observation period for recurrence is prolonged. Luckily these days we have more treatments available than 15 years ago. We just got in some samples of Veregen ointment today which is based on green tea. I don’t think I’d use it as a first line treatment but definitely a good option for those worried about recurrence who’ve already been treated. If you are already in a relationship, it pays off to have both partners checked, as I had one married patient who had a recurrence after 15 years. If you aren’t, be careful out there!

My experiences lately are bringing back memories from my dermatology residency in NYC. Bellevue was the mecca of STD treatment for the NYC county clinics and I treated my share of them. One of my attendings in this clinic was a complete hoot and I have a funny story to share that shall go untold here in cyberspace.

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Restylane and laser for under eye bags

Wednesday, January 25th, 2012

Many patients ask about what can be done for the bags and wrinkles underneath their eyes. Luckily these days we have procedures which are minimally invasive that can make a significant difference. Last night I had the opportunity to attend a local dermatology meeting where colleagues could discuss their experiences with lasers and fillers for this problem. It is amazing how much we can do without any cutting these days and how little needs to be done.

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Brotox

Wednesday, January 11th, 2012

Apparently Dr. Oz had a segment about Bro-tox (men who get Botox). It is a popular procedure for men in business and the entertainment industry. While Botox is not a complicated procedure, because men require a larger dose of Botox, it is important that you choose a doctor who understands how to properly inject Botox and tailor treatment to your specific wrinkles, skin type and face. The biggest complications a male patient can have is having too much Botox put in, which can cause heavy brows and a frozen look, or improperly placed Botox which can feminize the eyes

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Happy New Year!

Thursday, January 5th, 2012

Hope you all had a nice holiday. We had a nice stay-cation in LA. My daughters got more Xmas gifts in one year than I think I received my entire childhood. One of my kids already figured out I am Santa :( The Escalade seen here stayed at Toys R’Us, but gave me visions of 14 years into the future. Yikes! I am totally exhausted from one of them running into my bed every night. I guess this will go on for possibly a couple of years.

This is a good time to initiate your fractionated CO2 laser treatments, Efudex, etc. I’ve been performing a lot of laser on brown spots, wrinkles and scars with very good results. They do often take multiple treatments so this is a good time to start.

Anyone remember the Ronco Mr. Microphone commercial?

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