Editors



Current Editors: Tim Allen and Keith Wagner



Past Editors: Kristyna Gleghorn, Dung Mac, Alex Acosta, William Tausend, Sheila Jalalat, Rebecca Philips, Chelsea Altinger, Lindsey Hunter, Alison Wiesenthal, Leslie Scroggins, Mara Dacso, Ashley Group, Fadi Constantine, Emily Fridlington, Joslyn Witherspoon, Tasneem Poonawalla.

Monday, October 28, 2013

UTMB Graduate Medical Education (GME) Program Granted 7 Year Institutional Accreditation by ACGME

UTMB GME was recently awarded a 7 year cycle for institutional accreditation from the Accreditation Council for Graduate Medical Education (ACGME). This is the maximum accreditation possible for an institution. The next reaccreditation is scheduled for 2020. UTMB currently trains 572 residents, 11 of them in the UTMB dermatology program. In July 2014, the dermatology program will increase by one permanent resident, for a total of 12. This additional dermatology residency position has already been filled through the 2013 NRMP, when UTMB matched with 4 applicants for PGY2 positions.

Sunday, October 27, 2013

St. Vincent’s WelFair: Volunteer Sign-Up

DIG is looking for volunteers for the St. Vincent’s WelFair 2013. DIG is hosting a table to educate people on the ABCDEs of skin cancer and how to properly use sunscreen to prevent sun damage. 

This event will be on Sat Nov 9, 10AM-2PM at St. Vincent’s Clinic 2817 Post Office St. Galveston, TX. 

Please sign up via this link:
 
Email dhmac@utmb.edu if you have any questions.
 
Thank you,
 
DIG officers

Wednesday, October 23, 2013

UTMB DIG President Publishes Case Report

Congratulations to Sheila Jalalat, our UTMB MS4 Dermatology Interest Group President, for her interesting recent case report about vitiligo associated with Gefitinib treatment that was published in the October 2013 (Volume 19, Issue 10) of Dermatology Online Journal. Her coauthor on this case report was Dr. Philip Cohen. This article is available online at: http://www.escholarship.org/uc/item/758988k7 

Dermatology Professional Office Attire Featured in Bloomberg Businessweek

The October 21, 2013 issue of Bloomberg Businessweek featured Dr. Peggy Fuller, a dermatologist in Charlotte, NC in their “What I Wear to Work” feature (page 95). She was wearing a yellow outfit from the Banana Republic with a stethoscope around her neck, but without a white doctor’s coat. Her shoes were Prada, and she also wore a Cartier ring, vintage bracelet and ear rings, and a Baum & Mercier watch. The interviewer, Arianne Cohen also asked, “Is the dermatology lifestyle as great as reputed?” In part, Dr. Fuller’s responded, “…you can be a physician but also have a life.” Dr. Fuller founded the Esthetics Center for Dermatology seven years ago.

What was your Interviewer’s Eye Color?

An article from the October 21st issue of Bloomberg Businessweek suggests that if you can’t recall your interviewer’s eye color, you may not be making enough eye contact (Jessica Grose, Look Away! Eye contact is overrated, page92 ). Of course, too much eye contact is not good either.

New UTMB Dermatology Research and Case Report Opportunities

Research and publications are important components of medical student applications for dermatology residency positions. With this in mind,  Dr. Lindsey Hunter-Ellul, PGY-3 UTMB Dermatology Resident, has created a “Dermatology Research and Case Report Opportunities” list of dermatology projects (i.e., research, case reports, posters, presentations, and resident scholarly projects) for UTMB and rotating medical students interested in pursuing dermatology research opportunities. The list provides a brief project description, the faculty and residents involved in the project, how much time the project will require, IRB requirements, and the number of students allowed per project. This list is available on the Resident Bulletin Board within the UTMB Department of Dermatology and will be updated weekly. This is also a great way for medical students to get involved and interact with dermatology faculty and residents. Medical students interested in a particular project listed on the bulletin board should contact the faculty and resident involved with the project for further information.
 
UTMB offers medical students several research electives for students to have protected time for scholarly activities in addition to the Honors Research Program. Research electives include: the UTMB Medical Student Summer Research Program (MSSRP) (an 8 week elective) between first and second years of medical school; DERU-4015 elective (4-8 week elective), which requires research elective committee approval 1 month prior to the rotation, and DERU-4004, a BSHS selective which requires a C-form. Students who wish to participate in the Honors Research Program must apply for entry by submitting a research proposal that has been approved by a Research Director, a full time faculty member under whom the student will perform the research. 

Monday, October 21, 2013

395 Completed ERAS Applications Received for 4 UTMB Dermatology Residency Positions

Applications for UTMB’s four dermatology residency positions offered through the 2014 NRMP continue to increase prior to the November 1, 2013 application deadline. In addition, 5 additional applications have been received but were not complete last week. The UTMB dermatology selection committee will begin reviewing applications on Monday, November 4th  for outside students who did not take a dermatology elective at UTMB during 2013 and hope to send out invitations for a late January interview by the end of December.

Thursday, October 17, 2013

Texas Medical Board Considers Restrictions on Dermatology Practice


In a move that could adversely impact dermatology practice in Texas for patients, the Texas Medical Board (TMB) is considering a proposal that would limit the amount of local anesthesia used in dermatology offices across the state. The proposed amendments to §192.1 and §192.2 currently read:
 
CHAPTER 192. OFFICE BASED ANESTHESIA 22 TAC §192.1 The Board proposes amendments to §192.1, relating to Definitions. The amendment add language providing that the administration of certain local anesthesia, peripheral nerve blocks, or both in a total dosage amount that exceeds 50 percent of the recommended maximum safe dosage per outpatient visit is a level II service, in accordance with SB 978 (83rd Reg. Session).
 
CHAPTER 192. OFFICE BASED ANESTHESIA 22 TAC §192.2
The Board proposes amendments to §192.2, relating to Provision of Anesthesia Services in Outpatient Settings.
The amendment provides that rules under Chapter 192 do not apply to outpatient settings in which only local anesthesia, peripheral nerve blocks, or both are used in a total dosage amount that does not exceed 50 percent of the recommended maximum safe dosage per outpatient visit, in accordance with SB 978 (83rd Reg. Session)
 
These new regulations would restrict the use of local anesthesia to doses that are 50% or less of the maximum does, even though there is much evidence based medicine that the maximum does is safe in Level 1 outpatient settings (see Arch Dermatol 2004;140:1379-1382). According to the new proposal, local anesthetic in excess of half the maximum does would require additional patient monitoring (Level 2), that is not currently available in most dermatology offices. This new regulation could greatly limit the availability of Mohs surgery for Texans with skin cancer, since Mohs surgery may require multiple excisions under local anesthesia on the same day to completely remove the skin cancer and additional local anesthesia for the wound repair. Those interested in contacting the TMB about this matter may email them by November 29, 2013 at: Rules.Development@tmb.state.tx.us  The TMB will meet on December 5, 2013 about this new proposed regulation at the William P. Hobby Building, 333 Guadalupe Street, Tower 2, Suite 225, Austin, Texas, 78701. Those who want to voice their opinion at this public meeting to the TMB may signup to do so.

Wednesday, October 16, 2013

UTMB Dermatology Residents Achieve 70% Percentile Rank on 2013 Dermatology Certification Examination

According to the American Board of Dermatology, our three recent dermatology graduates achieved a percentile rank of 70 on the 2013 certification exam (“the boards”). This means that their examination score average was equal or higher than 70% of other dermatology programs participating in testing. There were 118 participating programs during 2013, including UTMB. Congratulations for our residents for doing so well!

Monday, October 14, 2013

Tougher Grading Standards Anticipated for Dermatology Resident Milestones

Presentations at the Association of Professors of Dermatology (APD) last month indicates that more stringent evaluation of dermatology resident milestone competencies are expected from those creating the evaluation tools that will be used starting in July 2014. Evaluation forms presented at the 2013 APD meeting had ratings ranging from “1” (“below expected first year”) to “9” and “10” (mastery level). It was clear from the educational presentation that most residents would never achieve mastery level during residency because the comparison is senior dermatology faculty. A rating of “8” denotes “ready for unsupervised practice” and has been the standard for program completion. Ratings of “6” or “7” are “senior resident performance.” PGY2 dermatology residents are expected to be achieve a rating of either “2” or “3” (“beginning resident level”).

2013 Texas Legislature Protects Texas Medical Schools

Medical schools in the Caribbean often need clinical clerkship positions in the US for their students and are willing to pay for them. According to an article in the October 2013 issue of Texas Medicine (Texas first: Legislature preserves training spots for Texans, pages 49-53), our 2013 legislature “… passed legislation barring foreign medical schools from buying up core clinical training spots at Texas teaching hospitals and institutions.” During 2013, 94%  of US allopathic MS4s matched for residency, while only about 50% of US citizens attending international medical schools were able to do so.

UTMB Dermatology Department hosted Texas Dermatological Society Fall Meeting Oct 4th-5th

The University of Texas Medical Branch Dermatology Department hosted the Texas Dermatological Society fall meeting October 4th-5th at the Moody Gardens Hotel. It was one of the largest meetings with over 200 registered attendees. 

The meeting transported attendees to the UTMB Dermatology Clinic Saturday morning for 12 live patients viewing and 9 virtual cases.
Patient Cases Included:
1.Inflammatory Eruptive Porokeratosis
Rebecca C. Philips, M.D. and Bernard R. Gibson, M.D.

2.Nail-Patella Syndrome
Rebecca C. Philips, M.D., Ashley Group, M.D., Bernard Gibson, M.D., and Sharon Raimer, M.D.

3.Alopecia Mucinosa
Brandon Goodwin, M.D. and Sharon Raimer, M.D.

4.Lepromatous Leprosy Presenting as a Reactional State
Brandom Goodwin, M.D. and Ashley Group, M.D.

5.Darier Disease
Jason K. Jones, M.D., and Erica Kelly, M.D.

6.Congenital Erythropoietic Porphyria
Jason K. Jones, M.D. and Michael Wilkerson, M.D.

7.Diffuse Plane Xanthoma
Tanya Trynosky, M.D., and Michael Wilkerson, M.D.

8.Refractory Prurigo Nodularis Treated with Lenalidomide
Tanya Trynosky, M.D., Erica Kelly, M.D., prepared by Amber Gill, M.D.

9.Infantile Digital Fibromatosis
Helen Malone, M.D., and Ashley Group, M.D.

10.Infantile Perianal Pyramidal Protrusion
Helen Malone, M.D., and Ashley Group, M.D.

11.Erosive Pustular Dermatosis
Megan Moody Neill, M.D. and Brent Kelly, M.D.

12.Transient Myeloproliferative Disorder of Infancy
Megan Moody Neill, M.D., Bernard Gibson, M.D., and Brent Kelly, M.D.

13.Lymphomatoid Papulosis Type C
Samantha Robare-Stout, M.D., and Brent Kelly, M.D.
14.Inflammatory Vitiligo
Samantha Robare-Stout, M.D and Sharon Raimer, M.D.

15.Reed Syndrome
Janice Wilson, M.D. and Ashley Group, M.D.

16.Kaposi Sarcoma
Janice Wilson, M.D., Michael Wilkerson, M.D., prepared by Amber Gill, M.D.

17.Adult Onset Still’s Disease
Lindsey Hunter-Ellul, M.D., and Sharon Raimer, M.D.

18.Acquired Spiny Keratoderma
Lindsey Hunter-Ellul, M.D., and Bernard Gibson, M.D.

19.Telangiectasis Macularis Eruptiva Perstans
Lindsey Hunter-Ellul, M.D., and Ashley Group, M.D.

20.Morphea in Osteogenesis Imperfecta Type 1
Audra Clos, M.D., Brent Kelly, M.D., and Michael Wilkerson, M.D.

21.Brooke-Spiegler Syndrome
Audra Clos, M.D and Aaron Joseph, M.D.

UTMB Resident and Faculty presentations included:
Great Pediatric Cases
Sharon Raimer, MD

When Better is Small
Michael Wilkerson, MD

What’s New in Non-Prescription Skin Care
Erica Kelly, MD

An Evidence-Based Approach to Brittle Nails
Alma Berlingeri, MD

Oral Care for Patients with Oral Dermatosis
Tanya Trynosky, MD

Internal Medicine: The Skin and the Kidney
Brent Kelly, MD

UTMB Medical Student (MS4) Podium Presenter
Exacerbation of Bullous Pemphigoid After Hand, Foot, and Mouth Disease
Sheila Jalalat, BS
Case with: Lindsey Hunter-Ellul, MD, and Michael Wilkerson, MD
The Department of Dermatology, The University of Texas Medical Branch, Galveston, TX

UTMB Poster presentations
Linear IgA Dermatosis Secondary to Amlodipine
Tanya Trynosky MD, Adrian Subrt BA, Conner Chan MD, Ramon Sanchez MD, Carlos Nousari MD

A Rare Case of Cutaneous Metastases from Cholangiocarcinoma
Lindsey Hunter-Ellul MD Kathrene Tajnert, Brent Kelly MD, Vicki Schnadig MD, Ranjana Nawgiri MD

1st  place podium presentation:
Serving the Underserved: How to make a low cost sunscreen with natural ingredients
Maria Elena Miyar, MD
University of Texas Southwestern
Austin, Austin, TX

1st Place Poster
Development of new melanomas and progressive dysplasia in pre-existing nevi in patients undergoing BRAF-inhibitor therapy
Lotika Singh, MD
UT-Houston

2nd Place Poster
Chronic erosive pustular dermatosis of the scalp: emphasizing frequent follow-up and low biopsy threshold for the practicing dermatologist
Rod Mahmoudizad, MD
Scott & White Healthcare

3rd Place Poster
Efficacy and Safety of Field Treatment With Ingenol Mebutate Gel After Cryosurgery for Actinic Keratosis: Comparison With Phase 3 Results for Ingenol Mebutate Monotherapy
Whitney LaPolla, MD
UT Houston


We would like to thank those who helped make this meeting a success. A special thank you also goes out to the DIG members who volunteered their time to help direct meeting attendees around the UTMB campus.  

Thinking about Practicing Medicine in Texas?

It is never too early for our medical students and residents to learn about the medical licensing requirements for Texas. On Wednesday, October 16, 2013 representatives from the Texas Medical Board will make a presentation from 2-4 pm in the Levin Hall Main Auditorium about medical licensing in Texas.

Tuesday, October 08, 2013

Increased Numbers of Dermatology Residency Applications at UTMB

Although the application deadline for dermatology applicants is not until November 1, 2013, the UTMB Department of Dermatology has already received 377 applications. This is an increase from the number of applications received by the deadline last year (355). Four dermatology PGY2 positions will be offered through the NRMP in 2014. Five visiting medical students who took 4 week rotations in the UTMB dermatology department have already been interviewed for residency positions.  Internal UTMB applicants are interviewed in December through January, and outside applicants who did not do rotations are scheduled for interviews at the end of January 2014.

Concerns about Dermatology in the House of Medicine

The October 2013 online issue of Dermatology World has an important article about perceptions of dermatologists by other physicians (“A Matter of Perception,”  http://www.aad.org/dw/monthly/2013/october/a-matter-of-perception ). The American Academy of Dermatology (AAD) surveyed physician leaders from other specialties about dermatology to learn their views. These leaders recognized the  significant contributions made by dermatologists in skin cancer prevention and treatment, as well as their role in the management of chronic skin diseases. However, these physicians voiced several concerns about dermatology as well. Limited patient access, preference for surgical dermatology, nonacceptance of insurance, cosmetic emphasis, and lack of participation in community service and medical societies were identified. Now that the AAD has identified these issues, it is working toward solutions.

Monday, October 07, 2013

Think Tank Advocates Demise of Specialty Medicine in United States

Citing poor efficiency, high cost and equivalent outcomes without high tech medical interventions, authors Shannon Brownlee, Joseph Colucci, and Thom Walsh from the New America Foundation (“Productivity and the Health Care Workforce,” October 2013, see http://growth.newamerica.net/publications/policy/productivity_and_the_health_care_workforce) recommend no federal funding for additional graduate medical education residencies. They also propose that fee-for-service healthcare models should diminished or eliminated.

Wednesday, October 02, 2013

UTMB Dermatology Film Class Award Leads to Publication

Dr. Alex Holliday, previously recognized in this blog for his 2012 UTMB SOM Graduation Award for the best Skin Disease Depicted in Film essay during the 2011-2012 academic year, has published an article co-authored by UTMB dermatology faculty Dr. Richard Wagner. The article, “Kaposi’s Sarcoma in Film” reviews 10 US films released from 1985 to 2008 that depicted Kaposi’s sarcoma. The article was published in volume 9 of the Journal of Medicine and Movies. The article is available at: http://revistamedicinacine.usal.es/index.php/volumenes/volumen9/num3/748 

Tuesday, October 01, 2013

UTMB Dermatology Faculty Promoted, Tenured and Receives Professorship

Congratulations to Dr. Michael Wilkerson, who was recently promoted to professor with tenure at UTMB. He was also named as the first recipient of the Sharon and Ben Raimer Professorship in Dermatology.

Texas Dermatological Society Meeting Volunteers Needed!

The UTMB Department of Dermatology will be Hosting the Fall Meeting of the Texas Dermatological Society on October 4th and 5th. Volunteers are needed on October 5th at 7:30 AM to prepare the Dermatology clinic. This is a great opportunity to interact with residents, faculty, and community dermatologists from throughout the state of Texas. By volunteering, you will be allowed to attend meeting events (lectures, podium presentations, and posters).  If interested please email Sheila Jalalat (szjalala@utmb.edu) or William Tausend (wetausen@utmb.edu). 

UTMB Dermatology Residents Score Well on 2013 American Board of Dermatology Certification Examination

As previously reported on this blog, UTMB dermatology residents had a 100% pass rate on the 2013 certification examination given by the American Board of Dermatology (ABD) during July 2013. In addition, according to the ABD,  the 3 graduating UTMB residents taking the test in 2013 achieved the 70th percentile for dermatology residency programs out of the 118 reporting! Congratulations on this outstanding academic achievement!