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Archive for March, 2013

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Laser Resurfacing

Friday, March 29th, 2013

Today I had the pleasure of giving a lecture to the wonderful group of USC dermatology residents, as I am an Assistant Clinical Professor of Dermatology and volunteer faculty member at Keck USC School of Medicine. Preparing for this lecture made me realize what a gift I was given for being a resident at the right place at the right time. The advent of laser resurfacing began while I was a resident at NYU, where I had an opportunity to learn from my attendings, Drs. Roy Geronemus, Arielle Kauvar, Robin Ashinoff and Vicki Levine. It was an exciting time in lasers, and I had a great opportunity during my fellowship to perform full-face resurfacing on a regular basis with Drs. Hugh Greenway and Vic Ross.

I have seen lasers come and go, and continue to. Patients are always asking me about the latest devices, fillers, etc. While some doctors always brag about being on the cutting edge, my philosophy is to be a late adopter. I am a complete skeptic and need good evidence to justify offering procedures to patients to ensure efficacy and safety. Ethically, I just can’t do otherwise.

No matter what you see published in women’s magazines, the newspaper, on Dr. Oz, etc, you need to realize that a lot of what is “hot” and talked about is a publicity machine for certain companies and doctors. It is not necessarily truthful or honest. It amazes me how gullible the general public can be about what they read in print or see on TV.

On a lighter note, we have a lovely derm resident from Lebanon visiting, Dr. Jihane Rahal, and we enjoy having her observe Mohs surgery and laser. After a day with me yesterday, she got her fill of fractionated carbon dioxide laser. Today I got a fill of the awesome Lebanese baklava she brought!

In my lecture to the residents, I showed pictures of both common and rare conditions the laser can be used for. I had one great case where I made a big difference. A woman in her 30’s had avoided any relationships because Kaiser told her she had a stubborn case of genital warts. A colleague of mine had diagnosed her with another condition. It just didn’t look or sound right to me. Turns out after I biopsied her, she had a very rare condition called vulvar syringomas, which are benign growths of the vulva. After several treatments, her vulva looks normal again and hopefully this will brighten her outlook on life. I am working on publishing this case in the medical literature with one of my former employees who is now in medical school. I hope someone out there with this condition finds this post so someone can help them!

Many patients have acne scars which they are ashamed about. Luckily, these lasers have made a big difference in their lives.

Lasers are not a cure all for everything, but thank god for them! (Thank you also to R. Rox Anderson, MD, the laser genius in Boston for inventing them)

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A bit late, but too cute not to share

Thursday, March 21st, 2013

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Back from Vacation! Lindsay Vonn, I am not…

Thursday, March 7th, 2013

Apres ski, toddler style


Help!


Naughty girl :(


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I made it back in one piece from Deer Valley! We had a great time overall, however I hadn’t been skiing for at least 7-8 years (last trip to Vail/Beaver Creek with my derm friend). Needless to say, I was quite rusty and even the bunny hill scared me the first day. It didn’t help that the next green run was really blue in parts and though DV bans snowboarders, a reckless skier plowed me down on Success (a green run) on my first day. Luckily I was OK, though I hit the ground so hard my ski popped off and my head hurt. The perpetrator did not apologize (for which I told him off) and luckily a good samaritan/witness asked me if I wanted to turn him into ski patrol. I let it go. I think I was the only person I saw getting remotely angry in all of Utah the entire time I was there!

I finally got my groove back the next day after some fresh powder came down, but got a little too confident when I went down Solid Muldoon, a blue trail that I swear would be called double blue at other resorts. I literally was looking down a cliff at the end and had to take a photo as I was so proud of myself for making it down (well I had no choice, I was by myself!). It doesn’t look as daunting in the photo as it did in person!

Though 4 friends of mine had just returned from DV, none of them could give me any advice on the better blue cruisers at DV, so here goes: Hawkeye, Lost Boulder, Hidden Treasure (my favorite). Turns out I later found out Solid Muldoon is the steepest blue next to the double blue trails. The service was great there and it was a fabulous mountain. The Children’s Ski School was great. Just so glad I am an intermediate skier already. I would not recommend DV for beginners even though they have great instructors. I remember Park City resort, which I visited 18 years ago, was much more tame. Basically I’ve concluded I’m a Beaver Creek girl! Can’t afford to fall and hurt myself anymore! Poor Doc B, he would not listen to me and of course, fell off the chairlift. I pleaded with him to not go down Success and he did anyway with his son. As usual, he admitted I was right! It was also a treat because even another friend of mine was staying in DV the same week (albeit at the Montage!) and I got to see her and her family. Then we came back and found out a patient of ours was there the same week and I probably skied right next to his condo! Click on the link below the blog title for some tubing fun! (sorry for the formatting problem!). If you want to see me go down Roamer as the world’s most slow and cautious skier (Lloyd’s of London, I need R arm insurance!) click on the other link.

I love the picture of Didi. She reminds me of the adorable snowboarder Louie Vito, from the last Winter Olympics!

My poor dog ran out of the house Sunday and got hit by a car. Well, at least all we know is she has a hairline fracture of her back paw. Poor Gigi! My fault for leaving the door open. We’re lucky it wasn’t worse.

It has been a busy time in the office. I’ve seen a lot of patients who have not been back for years. Or have left me and come back (just like my ex-boyfriends, haha JK. Actually, not!). Happy to be back to stamping out skin cancer where I can!

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