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A New DNA Test For Skin Cancer: Scotch Tape?

“I hate needles.” Patients say this to me everyday. When you think about it, who “likes” needles?

Skin biopsies are relatively painless, but they still involve the dreaded needle and always leave scars. The trouble is we dermatologists cannot guarantee that a mole isn’t skin cancer without sending a biopsy for pathology. That is, until now.

Although it is not available in clinic yet, an almost incredible new innovation might allow us to determine if a mole is cancerous by testing the DNA of the mole. It sounds like it’s from an episode of CSI, but it’s real.

Melanomas have DNA (messager-RNA to be exact, but it’s a little complicated) that differentiate them from normal moles, so testing the mole for melanoma requires only a tiny sample of skin. Fortunately, no needles are needed — in fact, no sharp objects are necessary at all. Read more »

*This blog post was originally published at The Dermatology Blog*

Can You Catch Genital Herpes When There Are No Lesions?

The answer might seem obvious, but I get this question often in clinic. In particular, patients want to know if genital herpes is contagious even if they or their partner is not having an outbreak.

The answer is yes. Genital herpes is a common sexually transmitted disease and is highly contagious. Although the risk of infecting someone else is much higher if you’re having an outbreak, it is still possible to transmit the virus, called HSV, even if you have no symptoms. About 1 in every 6 adults has genital herpes.

Once you have herpes, there is way to cure it. It is common to have recurring outbreaks especially in the first year, but in most people these lessen over time.

The only way to ensure you won’t get herpes is to abstain from sexual contact or to be in a monogamous relationship with a partner who is not infected. Wearing a condom can reduce the chances of infection, but it’s still possible to be transmitted. Taking anti-herpes medication such as acyclovir can reduce the amount of virus and minimize the risk of transmitting it.

April is STD awareness month. If you’re thinking you might need to get tested, then you need to get tested.

*This blog post was originally published at The Dermatology Blog*

Chest Pain: It’s Hard To Figure Out Which Patients Have Dangerous Pathology

Seems like I’ve been on a real run of chest pain patients lately.  Which is fine — it’s part of the gig.  I did have a very interesting pair the other night.  They were seen in sequence, right next to one another, in room 7 and room 8.  They were both totally healthy women in their mid-fifties.  And they were both over-the-edge, crazy, crawling-out-of-the-gurney anxious.

Anxiety is an awful red herring in the work-up of chest pain.  People who are having an anxiety attack often if not always manifest some chest pain (pressure, tightness, whatever) as a prominent symptom of their anxiety.  On the other hand, someone having a heart attack who is experiencing chest pain will also be anxious — and for good reason! Read more »

*This blog post was originally published at Movin' Meat*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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