No Need to Leave the Stripfor SightseeingAnnual Meeting - October 26-30see pages 6-7

Dr. Cola Wraps Up First AOCDMohs Surgery Fellowshipsee page 18

DermLine

Financial Tidbits: Investingwith Money Managerssee page17

Dr. Kirby StartsSecond Season on‘Dr. 90210’see page 23

FALL

2008

Newsletter of the American Osteopathic College of Dermatology

CORPORATE SPONSORS

AOCD ANNUAL MEETINGOctober 27-30, 2008Las Vegas, NV

AOCD MIDYEAR MEETING 2009January 20-25, 2009Steamboat Springs, CO

Upcoming Events

DI A M O N D SP O N S O R S

Biopelle Inc.Dermpath DiagnosticsGlobal Pathology Laboratory ServicesMedicisNeutrogenaPharmaDermRanbaxy Laboratories, Inc.Stiefel

PL AT I N U M SP O N S O R S

Graceway PharmaceuticalsOrthoNeutrogena

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GaldermaSanofi-Aventis/Dermik Laboratories

SI LV E R SP O N S O R S

Coria

BR O N Z E SP O N S O R S

Abbott LabsAllerganCentocorCrystal Cove Wealth ManagementDermatopathology Laboratory of Central StatesIntendisTriax Pharmaceuticals

American OsteopathicCollege of DermatologyP.O. Box 75251501 E. IllinoisKirksville, MO 63501Office: (660) 665-2184

(800) 449-2623Fax: (660) 627-2623Site: www.aocd.org

PRESIDENTJay S. Gottlieb, D.O., FAOCD

PRESIDENT-ELECTDonald K. Tillman, D.O., FAOCD

FIRST VICE PRESIDENTMarc I. Epstein, D.O., FAOCD

SECOND VICE PRESIDENTLeslie Kramer, D.O., FAOCD

THIRD VICE PRESIDENTBradley P. Glick, D.O., FAOCD

SECRETARY-TREASURERJere J. Mammino, D.O., FAOCD

IMMEDIATE PAST-PRESIDENTBill V. Way, D.O., FAOCD

TRUSTEESDavid L. Grice, D.O. Karen E. Neubauer, D.O.Mark A. Kuriata, D.O. James B. Towry, D.O.

EXECUTIVE DIRECTORRebecca Mansfield, MA

UPDATE CONTACT INFORMATION

Is your contact information current? If not,you may be missing need-to-know newsfrom the AOCD.Visit www.aocd.org/members. Click on thered box on the right side of the screen toupdate your info. Should you have trouble accessing yourprofile, you can fax the new information tothe AOCD at 660-627-2623. Send the faxto the attention of Marsha Wise, residentcoordinator.

CONTRIBUTE TO DERMLINE

If you have a topic you would like to readabout or an article you would like to writefor the next issue of DermLine, contact RuthCarol, the editor, by phone at 847-251-5620, fax at 847-251-5625 or e-mail atRuthCarol1@aol.com.

CORPORATE SPONSORS

Page 3

It is said that time passes quickly, and that certainly is true of this yearbeing president of the AOCD. I must say that it has been smooth sailingand I appreciate all of the help that I have received from others withinthe AOCD. I feel like I just wrote my first letter stating my goals of beingpresident and now I am writing my last letter as the outgoing president.

So what have I learned this year? I have realized that we have a greatorganization. We must always strive to make it better and never becontent with the way things are. I have learned to be more tolerant ofothers and realize that everybody is doing the best they can, fromwhere they are, with what they have.

I have also come to realize how little time it really takes to make a difference in an organization and inothers’ lives. The best part of taking action and getting involved is the self-satisfaction and personal growththat I have experienced.

I encourage all of the members of the AOCD to take part, play a role, and make a difference. There are somany ongoing issues, and new ones popping up all the time, that require our efforts. That is what keeps us“green and growing” and from becoming “ripe and rotten.”

It is very easy to sit back and let others do the work. We have all rationalized why we don’t need to getinvolved in the AOCD: others will do it, the AOCD does not need us, and it will get done without us. Somemay even feel that their residencies are not up to par, so why bother? I suggest that these are all greatreasons TO get involved. Get on a committee or come to the Board of Trustees’ meeting. I guarantee thatyou, too, will find a great sense of satisfaction in being part of the AOCD leadership. It really takes so littletime!

It has been fun and an honor to serve as your president during the 2007-2008 year. I thank my friends andmentors who have helped me have the life that I have today. I want to recognize my friend and mentor, Dr.Stan Skopit, for all that he has done for me. Dr. Jere Mammino is always in the background and has been“the wind beneath my wings.” Drs. Ed Yob, Lloyd Cleaver, and Jim Del Rosso have done so much to help meand continue to work for you and the AOCD. Becky and Rick Mansfield and Marsha Wise run our organi-zation efficiently and professionally.

Remember that “thoughts become things,” so choose good ones. Thank you for allowing me to serve as yourpresident.

Sincerely,

Jay S. Gottlieb, D.O., FAOCDAOCD President, 2007-2008

Message from the President

Page 4

lectures, which will be held at theVenetian Hotel, and all of our otheractivities in Las Vegas.

Lecture topics include “The World ofCosmeceuticals: Exfoliators and Anti-Oxidents,” “CLIA Verification Update,”and “Great Cases from OsteopathicTeaching Programs.”

Midyear MeetingIt’s time to make plans for the 2009Midyear Meeting in Steamboat Springs,Co. Program Chair, Dr. Brad Glick, isdeveloping the program for the January21-24 conference, which will be held atthe Steamboat Sheraton Resort andConference Center.

Reservation information will be distrib-uted later this fall.

The AOCD staff welcomes yourcomments and suggestions that willimprove our organization.

AOA MeetingThe summer meeting of the AOA Boardof Trustees (BOT) and the AOA Houseof Delegates (HOD) was held July 17-20 in Chicago. These two meetingsestablish policy for the AOA organiza-tion, specialty affiliates, and stateaffiliates.

Prior to the opening of the BOTmeeting, several committees met todevelop recommendations to give tothe Board members and House dele-

gates. The Society of OsteopathicSpecialty Executives (SOSE), of whichthe AOCD is a member, met on July 14.All specialties are represented and havea vote. In addition to reviewing theproposed resolutions and makingrecommendations to the BOT andHOD, SOSE members can propose newpolicy. They also discussed issuesrelated to continuing medical education(CME) credits and suggestions toencourage members to attend osteo-pathic CME programs.

Dr. Lloyd Cleaver represents the AOCDat both the BOT and HOD meeting. Asa voting specialty delegate, he attendsall sessions of the House and referencecommittee meetings.

I encourage the membership to discussany issues that are of interest to theorganization and its members withAOCD delegates throughout the year.

Annual MeetingDr. Don Tillman has developed adiverse educational program that willbe of interest to our members. Iencourage all members to attend the

Executive Director’s Reportby Becky Mansfield, Executive Director

is aproud supporter

of the

Page 5

Dermatologists and dermatology residents whosustained physical damage to their property as aresult of the flooding in the Midwest this springare being offered financial assistance from theAmerican Academy of Dermatology (AAD).

For damage that is not covered by insurance,other forms of financial assistance, or other finan-cial resources, the AAD has made availablelow-interest loans through a special flood relieffund.

The loans will be for a maximum of $25,000 fordermatologists and $5,000 for dermatology resi-dents, according to the AAD.

In June, the Health and Human Services SecretaryMike Leavitt declared a public health emergencyin the flood-stricken states of Iowa and Indiana.

Dermatologists and dermatology residents whoare AAD members in good standing can apply fora loan on the Academy’s web site atwww.aad.org.

AAD Offers Financial Assistance toMembers in Midwest Floods

AOCD MembershipContinues to Grow

As of this July, the AOCD hasa total of 635 members.

The membership is brokendown as follows:

• 315 Fellows• 17 Life • 10 Affiliate • 32 Board Eligible• 98 Residents• 139 Students

The 10.6% cut in Medicare physician payments has been avertedthanks to an override of President Bush’s veto of H.R. 6331, the“Medicare Improvement for Patients and Physicians Act of 2008,” bya strong bipartisan vote in the U.S. House of Representatives andthe U.S. Senate.

The projected 5.4% cut for January 1, 2009 was also halted. In fact,physicians will be reimbursed at their current level for theremainder of 2008 and receive a 1.1% increase in 2009 as H.R. 6331now becomes law.

The final vote tally was 383-41 in the Houseand 70-26 in the Senate.

Correction of the Medicarepayment formula is expectedto resume after the 2008presidential election.

Medicare Physician Cuts Averted

Undoubtedly one of the glitziest four-mile stretches of road known tomankind, the Las Vegas Strip is hometo many of the largest hotel, casino,and resort properties in the world.

With each new casino comes an over-the-top façade designed to attractwalk-up customers. In fact, many ofthese entrances have become attrac-tions themselves.

Walk Right UpThe most well-known attraction is theTreasure Island Sirens. The actionbegins with a 17th century clashbetween a group of beautiful, temptingsirens and a band of renegade pirates.The sirens use a mesmerizing andpowerful song to lure the pirates totheir cove, stir up a tempest strongenough to sink a ship, and transformSirens’ Cove into a 21st century party.This event occurs four times anevening at the front entrance of theTreasure Island Hotel and Casino.

In keeping with a water theme, theFountains of Bellagio offer one of themost ambitious, choreographicallycomplex water features combined witha clever concert of opera, classical, andBroadway tunes. This aquatic displayoccurs on the half hour during the dayand every 15 minutes in the evening infront of the Bellagio Hotel and Casino.

Escape to the tropics surrounded bypalm trees and lush foliage at theSecret Garden & Dolphin Habitat at theMirage Hotel and Casino. It is home toseveral Atlantic bottlenose dolphins, aswell as Siegfried and Roy’s white tigers,lions, panthers, and leopards.

The famed volcano at the Mirage maybe reopened by the annual meeting.

Currently under renovation, thevolcano has been a Las Vegas signatureattraction since the resort opened in1989. The thunderous volcano is situ-ated on three water-covered acres. It is54 feet high and circulates 119,000gallons of water per minute.

Every night, people gather on the side-walks in front of the casinos to watchthe various free attractions. Fortunately,several footbridges have been installedto keep pedestrian traffic runningsmoothly at these popular intersections.

Go InsideMore exotic attractions await when youventure inside the hotels/casinos. Mostnotable are those at the Forum Shopsat Caesar’s Palace.

Located in the Roman Great Hall, theLost City of Atlantis Show consists of anenormous fountain that comes to life atregular intervals as the wrath of thegods is unleashed on the city ofAtlantis. Fire, water, smoke, and specialeffects combine into an extravaganza aslife-like animatronic charactersincluding Atlas, Gadrius, and Aliastruggle to rule Atlantis. Surrounded bya 50,000-gallon saltwater aquarium, themythical sunken continent rises andfalls before your eyes. Show times areevery hour from 10 a.m. to 11 p.m.daily.

The Festival Fountain is a seven-minutespecial effects show featuring monu-mental sculptures of mythologicalRoman gods coming to life. WhenBacchus, god of merriment and wine,wakes up and decides to throw himselfa party, he enlists the power of Apollo,Venus, and Plutus in preparing therevelry. These characters conjure up amyriad of choreographed mythological

images and designs. Music, soundeffects, special light effects, lasers,animatronics and special scenic projec-tions on the dome, combine togetherwith a computer controlled waterscapeeffects and theatrical lighting for adazzling finale.

One of the newest attractions is theAtlantis Aquarium, the 50,000-gallonsaltwater aquarium that provides thebackdrop for the Atlantis Show. Fivehundred individual fish from more than100 species call the aquarium home.They are both solitary and schoolingfish, which are normally found aroundcoral reefs. They range in size from twoinches to four feet. The aquariumcontains a variety of tropical marinefish including puffer, butterfly, andtrigger fish. The most notable speciesare the sharks and sting rays. Plan yourvisit to coincide with one of the twodaily dive feeds at either 1:15 or 5:15p.m. Below-the-scenes tours are offeredat 3:15 p.m., Monday through Friday.

ShoppingOnly in Vegas is the art of entertain-ment combined with the art ofshopping.

In addition to its many attractions, theForum Shops feature more than 150boutiques and shops as well as 15specialty restaurants. The most recentexpansion added 175,000 square feetand additional levels that extend themall onto the Strip and a grand pedes-trian plaza, the signature entrance forthe shops.

The Grand Canal Shoppes at theVenetian Resort-Hotel-Casino—aunique, Italian-themed promenade—ishome to more than 80 shops thatfeature jewelry, footwear, designer

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No Need to Leave the Strip for Sightseeing

Page 7

clothing, and home accessories.Between stores, enjoy an authenticgondola ride or a snack at one of thecafes along the cobblestone walkway.Talented performers serenade you asthey stroll along the Grand Canal.Performances are held at various timesthroughout the day, seven days aweek.

Shopping at the Castle Walk Shops atExcalibur Hotel and Casino is as mucha show as it is a shopping experience.Between stores, see live medievalplayers jousting in King Arthur’s Tour-nament, or entertain yourself withmidway style games and rides.

Head to the Circus Circus Shops atCircus Circus Hotel, Casino and ThemePark to explore an impressive collec-tion of sports memorabilia, apparel,gifts, and collectibles along the 40,000square foot cobblestone promenade.

Find Balinese carvings and Picassoprints, sportswear and magazines in theboutiques that comprise MandalayPlace at Mandalay Bay Resort & Casino.

Enjoy a taste of Paris at the Rue de laPaix where you will find an array ofauthentic French boutiques, including agarden shop, wine and cheese shop,

and high-end clothing stores in ParisLas Vegas.

The Star Lane Shops at MGM GrandHotel and Casino feature a variety ofsouvenir and travel shops decorated ina 1950s Hollywood motif. Visit theEmerald City for costume jewelry,luggage, pearls, magic tricks, souvenirs,candy, and beverages.

Dining OutDon’t expect dinner to be any lessspectacular than the attractions andshopping you may have an opportunityto experience while in Sin City. Today,Las Vegas is recognized as one of theworld's great dining destinations, with along list of renowned chefs and restau-rants known for their lavishness,architecture, and creativity.

In 1992, the highly respected Austrianchef, Wolfgang Puck, opened Spago atthe Forum Shops, escalating Las Vegasinto a dining league of its own. Pucknow owns and operates three otherupscale local eateries: Chinois, also inthe Forum Shops; Café de Lupo atMandalay Bay; and Wolfgang Puck Caféand Grille at the MGM Grand.

The list of celebrity chefs here readslike a who's who in the world of fine

dining. Emeril Lagasse opened Emeril'sNew Orleans Fish House at the MGMGrand, and later, Delmonico at theVenetian. Thomas Keller, owner ofFrench Laundry in California's winecountry, opened Bouchon at theVenetian. Bradley Ogden has his ownself-named haute American cuisinemasterpiece at Caesar’s.

That's just for starters. Charlie Palmeropened Aureole at Mandalay Bay andCharlie Palmer Steak is next door at theFour Seasons. Nobu Matsuhisa openedNobu inside the Hard Rock Hotel &Casino. Michael Mina of San Francisco'sAqua opened Seablue and Nobhill atthe MGM Grand and New York'sMaccionis family opened another LeCirque inside the Bellagio.

Homegrown chefs who have also madenames for themselves include AndréRochat, of André's at the Monte Carloand downtown Las Vegas and Alizé atthe top of the Palms; and Michael andWendy Jordan with Rosemary's a fewmiles west of the Strip.

Las Vegas is also home to a largenumber of the world's top sommeliers.One of the best known is AndrewBradbury, who has become internation-ally renowned for the more than 4,000

Getting Around TownWith so many attractions around the Strip and downtown, transporta-

tion options are numerous.

Walking is an option, but sometimes distances between hotels can bedeceiving. The Las Vegas Monorail runs on the east side of the Strip from

Tropicana Avenue to Sahara Road. Double decker buses—known as theDeuce—stop at most major resorts and continue north to downtown and the

Freemont Street Experience. A tourist trolley service travels up and down theStrip and stops at various, but not all, hotels. Two small, free cable-pulled

trams operate on the Strip. One runs between Treasure Island and the Mirage,while the other provides service to Mandalay Bay, Luxor, and Excalibur. Taxis can

only stop at hotel entrances and designated spots, so when planning to get some-where be sure to ask which is the closest hotel. Free shuttles sometimes require a

room key from an affiliated casino.

Page 8

wines available at Aureole insideMandalay Bay. Aureole features athree-story wine tower that "wineangels" ascend via climbing harnessesand ropes to retrieve the bottle of yourchoice.

Stepping OutAfter dinner, you can head back toyour hotel or head to a nightclub orlounge.

PURE Nightclub in Caesar’s Palace isthe newest nightlife venue. The 2-storynightclub is 36,000 square feet,boasting three separate experiences.The main room features oversizedbeds, three bars, and a VIP area thatoverlooks the dance floor, not tomention a balcony with an incredibleview of the Strip.

Mandalay Bay is home to two amazingbars on the top floors of its towers. The

House of Blues Foundation Roomoffers a Moroccan-infused view of theStrip, while Mix, atop its companiontower, THEHotel, is a modernistmasterpiece with an amazing view.Ghostbar atop the Palms is a wonderfulplace to rub elbows with the A List.

The New York-New York and Harrah'sboth tout popular dueling piano barswhere the suds and songs just keep ongoing.

Located in the heart of downtown, 3rdStreet is quickly gaining popularity asone of the newest dining and entertain-ment hotspots in Vegas. New York'sfamous Hogs & Heifers opened with itsunique brand of entertainment wherebartenders wear halter tops and leatherpants and are armed with megaphonesto keep the mood as raucous aspossible. Next door, Triple George Grillfeatures not only great food, but also a

classic lounge where patrons can relaxin oversized leather armchairs, smokecigars, and banter with the pianist. Nextto Triple George is Celebrity Nightclub,which features live music regularly, andSidebar, an intimate bar specializing inclassic cocktails.

Also downtown, Binion's Steak Houseis known for its breathtaking, south-facing view of the Stratosphere andStrip. Try the Stratosphere's Top of theWorld Lounge just before twilight towatch the city turn on from 100 storiesup.

So after a long day of educational andinformative presentations, AOCDmembers can venture to mythicalplaces and lands across the ocean, feastlike the gods, or just relax and unwindwithout venturing far from their hotel.

The AOCD Annual Meeting, slated forOctober 26-30 in Las Vegas, promisesto be an educational experience withinthe confines of an adult playground.

This year's meeting will be held at theall new Palazzo, which is the sisterresort to the Venetian Resort-Hotel-Casino.

For residents, the event will begin withthe In-Training Examination and busi-ness meeting on Sunday. The AOBDExam/CAQ Exam on dermatopathologyand Mohs Micrographic surgery willalso be given that day. The AOCDExecutive Committee will be meeting,as well.

The Welcome Reception will be heldfrom 6:30-8:30 p.m.

Guest SpeakersSpeakers (listed with their topics)scheduled to present lectures onMonday between 9:15 a.m. and 1 p.m.are as follows:

Donald K. Tillman, D.O., FAOCDProgram Chair, AOCD President-ElectOpening Remarks & Introductions

Elliott MilsteinPresident & COO, Biopelle, Inc.The World of Cosmeceuticals: Exfoliators andAnti-Oxidants

Daniel Morris, D.O.General Vascular Surgery Laser Approach to Cutaneous SuperficialVaricosities

Professor Eggert Stockfleth, M.D.Chair, Skin Cancer Center Charite in Berlin The Role of Evidence Based Medicine

Gregory G. Papadeas, D.O.Advanced Dermatology Skin Cancer & Laser SurgeryCenterCLIA Quality Assurance Test

Following the alumni lunches, theAOCD Business Meeting will be heldfrom 3-5 p.m.

The President’s Reception Banquet willbe held from 6-10 p.m. A dessert recep-tion will follow.

Speakers (with their topics) scheduledto present lectures on Tuesday between7:30 a.m. and 3:30 p.m. are as follows:

Cindy Hoffman, D.O.Program DirectorNYCOM/St. Barnabas HospitalGreat Cases from Osteopathic Teaching Programs

James Del Rosso, D.O., FAOCDProgram DirectorTUCOM/Valley Hospital Medical CenterSo Many Drugs, So Little Time

Joseph Bikowski, M.D.Director of Dermatologic Education The Medical CenterChallenging Cases in Dermatology

Leon Kircik, M.D.Mohs Micrographic Surgery & Cutaneous OncologyDermatologic Surgery, Baptist East HospitalManagement of Challenging Cases in Psoriasis-Handling Prior Authorization

Elias Lopez-HakimianCEO, Crystal Cove Wealth ManagementAsset Protection

Rick Lin, D.O., FAOCDDermatology Clinic of McAllenPlanning and Implementing Your PaperlessDermatology Office with Full Integration of theElectronic Medical Record

Michael B. Morgan, M.D.Professor of Pathology, U.S.F. College of MedicineTropical Dermatology - Know YourMycobacterioses

Resident SpeakersResident speakers (listed with theirtopics) scheduled to present lectureson Wednesday between 7:50 a.m. and4 p.m. are as follows:

Speakers Address Challenging Cases at Annual Meeting

Page 9

John Minni, D.O.Board CandidateDermatopathology Scholarship Case PresentationsNeonatal Lupus Case Report

Ramona Nixon, D.O., 3rd YearO’Bleness Memorial Hospital, Zanesville, OHErythema Nodosum Leprosum

Dan Hansen, D.O., 3rd Year Oakwood Southshore Medical Center, Warren, MISuccessful Treatment of Progressive En Coup deSabre

Marcus Goodman, D.O., 3rd YearNSU-COM/BGMC, Hollywood, FLBetamethasone Dipropionate & Calcipotriene as aTreatment for Erythema Annulare Centrifugum

Billie Casse, D.O., 3rd YearSt. Joseph Mercy Health System,Clinton Township, MIFollicular Mucenosis

Lawrence Schiffman, D.O., 3rd YearSt. John’s Episcopal Hospital, Far Rockaway, NY Genital Porokeratosis

Brooke Sliger Bair, D.O., 2nd YearSt. Joseph Mercy Health System,Clinton Township, MIAmyloid Elastosis

David Cleaver, D.O., 2nd YearSt. Joseph Mercy Health System,Clinton Township, MILeukemic Vasculitis and Cutaneous Manifesta-tions of Acute Myelogenous Leukemia

Matthew Elias, D.O., 2nd YearNSU-COM/BGMC, Hollywood, FLPigmented Epithelioid Melanocytoma

Allison Schwedelson, D.O., 3rd YearNSU-COM/BGMC, Hollywood, FLStaph Scalded Skin Syndrome-A Rare Presentationin an Adult

Reagan Anderson, D.O., 2nd YearOakwood Southshore Medical Center, Warren, MI Diagnostic and Therapeutic Dilemmas in an NF-1Patient

Aaron Bruce, D.O., 3rd Year NSUCOM/Largo Medical Center, Port Richey, FLPrevalence of Community-Acquired Methicillin-Resistant Staphylococcus Aureus in a PrivateDermatology Office

Marianne Carroll, D.O., 3rd Year Wellington Regional Medical Center, Margate, FLRituximab in the Treatment of PemphigusVulgaris: A Case Report

Brandon Miner, D.O., 2nd YearOakwood Southshore Medical Center, Warren, MIAn Unusual Case of Kaposi’s Sarcoma

Michelle Foley, D.O., 2nd YearPontiac/Botsford Osteopathic Hospital, FarmingtonHills, MINeonatal Lupus

Amara Sayed, D.O., 2nd YearColumbia Hospital, Palm Beach, FLSpiradenocarcinoma: A Case Report

Danica Alexander, D.O., 3rd YearColumbia Hospital, Palm Beach, FLMerkel Cell Carcinoma Mimicking a Cyst

Elliot Love, D.O., 3rd YearRichmond Medical Center, Cleveland, OHCongenital Dermatofibrosarcoma Protuberans

Todd Kreitzer, D.O., 3rd YearRichmond Medical Center, Cleveland, OHHypohidrotic Ectodermal Dysplasia

Mollie Jan, D.O., 3rd YearFrankford Hospital, Allentown, PACongenital Leukemia Cutis in the Setting of AcuteMyelogenous Leukemia

Patrick Keehan, D.O., 2nd Year Northeast Regional Medical Center #2,Duncanville,TX Acrokeratoelastoidosis: A Case Report and Litera-ture Review

Chris Buatii, D.O., 2nd YearGenesys Regional Medical Center, Grand Blanc, MIA Unique Case Report of Atrophoderma of Pasiniand Pierini in an Adolescent

Brad Neuenschwander, D.O., 3rd YearPontiac/Botsford Osteopathic Hospital, FarmingtonHills, MIEhlers-Danlos Case Presentation

Patty Klem, D.O., 3rd YearWellington Regional Medical Center, Margate, FLLovenox Treatment in Erythema DyschromicumPerstans

Emily Rubenstein, D.O., 2nd Year NSU-COM/BGMC, Hollywood, FLA 42-Year-Old Female with Erythematous Plaques

Prethi Sundaram-Mohip, D.O., 2nd YearWellington Regional Medical Center, Margate, FLLeprosy Case Presentation & Review

Joe Laskas, D.O., 2nd Year Frankford Hospital, Allentown, PAEruptive Kaposi’s Sarcoma in an HIV NegativePatient

Mindy Conroy, D.O., 2nd YearFrankford Hospital, Allentown, PAMultiple Minute Digitate Hyperkeratoses

Jason Mazzurco, D.O., 2nd YearSt. Joseph Mercy Health System,Clinton Township, MIMycosis Fungoides of the Nail

Krina Chavda, D.O., 2nd YearSt. John’s Episcopal Hospital, Far Rockaway, NYOsler-Weber-Rendu Disease

Nicole Bright, D.O., 2nd YearFrankford Hospital, Allentown, PACutaneous Manifestations of Crohn’s Disease

Andleeb Usmani, D.O., 2nd YearNSU-COM/BGMC, Hollywood, FLAxillary Granular Parakeratosis: A Case Study

Derrick Adams, D.O., 2nd Year Pontiac/Botsford Osteopathic Hospital, FarmingtonHills, MIUVB Treatment of Osteomalacia: A Case Reportand Review

Tony Nakhla, D.O., 3rd YearWestern University/PacificHospital, Torrance, CAMalar Butterfly Flap for DorsalNasal Defects

Sanjay Bhambri, D.O., 3rdYearTUCOM/Valley HospitalMedical Center,Las Vegas, NVCalciphylaxis

Christopher Weyer, D.O.,2nd YearNortheast RegionalMedical Center,Kirksville, MO Aplasia CutisCongenita Associatedwith In-Utero TwinDeath

Daniel Marshall, D.O.,3rd Year Northeast RegionalMedical Center, Kirksville,MOWorkhorse Flaps in NasalReconstruction

Roger Sica, D.O., 3rd YearNSUCOM/Largo MedicalCenter, Port Richey, FLPrevalance of MRSA in theSetting of DermatologicSurgery

Saira Momin, D.O., 2nd YearTUCOM/Valley Hospital Medical Center,Las Vegas, NVDermatological Applications in Vitamin D Defi-ciency

Christopher Buckley, D.O., 3rd YearNSU-COM/BGMC, Hollywood, FLMinocycline Induced Hyperpigmentation-A CaseReport and Review

David Judy, D.O., 1st YearNSUCOM/Largo Medical Center, Port Richey, FLAtrophie Blanche: Specific Disease or PhysicalFinding?

Ramona Nixon, D.O., 3rd YearO’Bleness Memorial Hospital, Zanesville, OHEccrine Agiomatous Hamartoma

Brian Stewart, D.O., 3rd Year St. Joseph Mercy Health System,Clinton Township, MIAlagille Syndrome

Angela Combs, D.O., 2rd YearNSU-COM/BGMC, Hollywood, FLGraft-Versus-Host Disease in a Liver TransplantPatient with Graft Dysfunction

Heather Volkman D.O., 2nd YearRichmond Medical Center, Cleveland, OHLisinopril-Induced Pemphigus Foliaceus

Page 10

Support the AOCD and its Foundationfor Osteopathic Dermatology (FOD) aswell as honor Drs. Jay Gottlieb (currentpresident) and Don Tillman (incomingpresident) by placing an ad in the 2008Ad Journal.

In addition to honoring AOCD officers,an ad in this publication can serve torecognize College members, includingresidency program directors and resi-

dents. Placing an ad can even serve tomarket one’s practice and staff.

Monies raised through the submissionof ads support the FOD established in2004. The FOD’s goal is to improve thestandards of the practice of osteopathicdermatology by raising awareness,providing public health information,conducting charitable events, andsupporting research through grants andawards given to those applicants under

the jurisdiction of osteopathic derma-tology physicians.

The 2008 Ad Journal will be presentedat the Presidential Banquet during theannual meeting in Las Vegas.

For further information about submit-ting ads, contact Shirley Gottlieb atshirleygottlieb@aol.com or 954-963-5862.

Honor Members by Placing Ad in 2008 Journal

Reagan Anderson, D.O., MCS,MPH, a second-year resident atOakwood Southshore MedicalCenter in Trenton, Mich., repre-sented osteopathic medicine at theUS Army’s Health Promotion andPreventive Medicine Conferenceheld last month.

The 11th annual conference, whichis attended by active duty osteo-pathic physicians, was held inAugust in Albuquerque.

Osteopathic PhilosophyDr. Anderson was asked by theAOA to speak about the osteo-pathic philosophy. Surprised andhumbled by the request, he wasthrilled to accept it. “I was surprised toget the call because out of the thou-sands of osteopathic physicians whohave served in the armed forces, theAOA asked me to represent the profes-sion,” says Dr Anderson, who is underthe directorship of Steven Grekin, D.O.,FAOCD.

“The military recognizes the uniquephilosophy osteopathic physiciansbring to those under their medical priv-ilege and they want to teach all of theirproviders how to be more holistic,” hesays. “My job at this conference, in thespace of one hour, was to plant theseeds of osteopathic medicine into theminds and imaginations of the militaryphysicians so that they get a glimpse of

how to treat a patient's mind, body,and spirit.”

To that end, Dr. Anderson’s speech wasentitled, “Mind, Body, and Spirit ofCombat Medicine.”

“I attempted to go through the uniqueperspective an osteopathic physicianbrings to every patient encounter andshow through story and metaphor howdoctor-patient interactions can be somuch more than just treating the symp-toms of a disease,” he says. “I tried toshow that a patient encounter is notcomplete until all aspects of a personare honored with attention and time:nobody is a symptom; a diagnosis isnever isolated to a solitary cause; andno disease can ever be fully treated by

focusing on just the complaint andnot addressing that whichcontributed to the disease in thefirst place.”

Art Imitates LifeEarlier this summer, the cable tele-vision channel HBO began airing anew series called “Generation Kill,”which follows the battalion inwhich Dr. Anderson served duringhis two tours of duty. During theinvasion of Iraq, a reporter fromRolling Stone magazine wasembedded within the 1st Recon-naissance Battalion. The reporterwrote a book of the same namethat HBO turned into a mini-series.

Although Dr. Anderson arrived at thebattalion after the reporter had alreadyleft, he says it is a very accurateportrayal of what he experiencedserving as the battalion surgeonbetween June 2004 and September2006 in the Al Anbar province. ”Forthose who ask me what I did in themilitary, this series is a very accuraterepresentation of what my job entailed,the operational tempo in which I wasa physician, and the challenges thatwere faced while trying to serve thisbattalion of marines,” he says, adding,“The images and situations are actedout so accurately that I often feel like Iam over there again while watching it.”

Dr. Anderson Presents Osteopathic Philosophy to Military

Page 11Page 11

We are dedicated to helping patients

attain a healthy and youthful appearance

and self-image.

© 2007 Medicis Pharmaceutical Corporation MED 07-003 01/30/08

Dr. SchwarzeAppointed toAOA TaskForce

Robert Schwarze, D.O.,FAOCD, has beenappointed to the newlycreated Certification FeeTask Force by AOA PresidentPeter Ajluni, D.O.

The purpose of the taskforce is to facilitate ACGME-trained DOs in obtainingAOA certification.

The Midyear Meeting in Steamboat Springs, Co., slatedJanuary 21-24, 2009, promises to be an exciting event.

Expect phenomenal lectures presented by attending derma-tology faculty from the finest osteopathic and allopathicinstitutions, including a Psoriasis Forum led by the esteemedFrancisco A. Kerdel, M.D., of the Florida Academic Derma-tology Center at the University of Miami Hospital. As always,there will be an excellent panel of osteopathic dermatologyresidents providing lectures on a variety of current topics indermatology and dermatologic surgery.

Of course, the City of Steamboat Springs can’t be beat. With itslegendary Champagne Powder® snow, this western town ishome to world-class skiing, snowboarding, Nordic skiing,snowmobiling, and snowshoeing. For those of you who preferviewing the slopes, do so from a private balcony or whilerelaxing and keeping warm in front of a beautiful fireplace atthe Sheraton Steamboat Resort, the city’s only ski in/ski outconference resort.

Access to Steamboat Springs has never been easier with jetservice to a larger and more efficient Steamboat SpringsAirport.

So join us for a tremendous educational experience and allaround great time. For further information, contact Becky orMarsha at the AOCD home office, 660-665-2184,becky_aocd@yahoo.com or marsha_aocd@yahoo.com.

See you in Steamboat!

Mark Your Calendar for Midyear Meeting

Page 12

Hello Everyone,

What happened to thesummer? By now youshould have receivedthe 2008 AOCDMembership Directory.Please remember tokeep your address ande-mail address current. If you experience problems loggingon to www.aocd.org/members, please let me know.

Both the In-Training Examination for the residents and theBoard Examination are being held at 7 a.m. on Sunday,October 26. Resident lectures for the annual meeting will beheld Wednesday, October 29. It will be a full, informativeday. Lectures are scheduled from 8 a.m. to 5 p.m. and covera wide variety of topics.

Intent-to-Lecture applications for the 2009 midyear meetingare now being accepted. We have a limited number of spots,so get your application in as soon as possible. Residentlectures will be held on Wednesday, January, 21. The facultydisclosure statements and Intent-to-Lecture forms can also bedownloaded from our web site at www.aocd.org/qualify.

Grand Rounds OnlineBe sure to check out the Dermatology Grand Rounds on ourweb site at www.aocd-grandrounds.org. Each residencyprogram has been asked to submit a case.

This month, TUCOM/Valley Hospital Medical Center(Program Director: James Del Rosso, D.O., FAOCD), and

UHHS Case Western University, Richmond Heights Hospital(Program Director: Joan Tamburro, D.O., FAOCD) areexpected to submit cases.

The schedule for the rest of the year is as follows:• October, Wellington Regional Medical Center (Program

Director: Bradley Glick, D.O., FAOCD) and WesternU/COMP/Phoenix Area Dermatology (Program Director:Stephen Kessler, D.O., FAOCD);

• November, Western University/Pacific Hospital (ProgramDirector: David Horowitz, D.O., FAOCD) and NSU-COM/BGMC (Program Director: Stanley Skopit, D.O.,FAOCD).

Residents’ BirthdaysResidents celebrating their birthdays in September are asfollows: Drs. Adam Weiner, Jack Griffith, Marcus Goodman,Bo Rivera, Shari Sperling, Andrea Baratta, Peter Morrell,Roger Sica, Patrick Keehan, and Lela Lankerani.

Those who will celebrate their birthdays in October are asfollows: Drs. Melinda Conroy, Joseph DelPriore, MichelleBruner, Danica Alexander, Alice Do, and Risa Ross.

Residents who will celebrate November birthdays includethe following: Drs. Carlos Gomez-Meade, Tony Nakhla,Jessica Flowers, John Laska, Shannon Campbell, MichelleFoley, and Emily Fibeger.

Residency Program Continues to GrowSince the last newsletter, four more residents have joined theAOCD residency programs. We now have a total of 97 resi-dents as of July 1.

Residents Updateby Marsha Wise, Resident Coordinator

The NYCOM/St. Barnabas HospitalResidency Program held its firstseminar and reunion this past May.

Approximately 16 NYCOM alumniattended the seminar held at Mt. SinaiMedical Center in New York City. Atotal of 20 residents have graduatedfrom the program since it began in1993.

The seminar offered five hours ofcontinuing medical education (CME)credit approved by the AOA presentedby faculty from both St. Barnabas andMt. Sinai Medical Center. Topicsincluded common skin diseasespresented by Charles Gropper, M.D.;hair shaft disorders by Michael Scott,

D.O.; pediatric dermatology by SourabChoudhury, D.O.; melanoma and otherskin cancers by Deborah Daly, D.O.;surgical fat transfer by Cindy Li, D.O.;dermal filler by Carissa Summa, D.O.;and surgical landmarks by MitchellFisher, D.O.

An alumni dinner followed the presen-tations at the famous Opia Restaurantin Manhattan.

“We believe that this is the first seminarand reunion of its kind in the history ofthe osteopathic dermatology residencyprograms,” says Michael Scott, D.O.,FAOCD, who served as event co-chairwith Shaheen Oshtory, D.O., who waschief resident prior to her graduating in

July. “It will be planned as a recurringevent every three years to enhance therewarding relationships and training ofthe faculty, staff, residents, and alumniof the NYCOM/St. Barnabas program.”

“Everyone participating had a grandtime making new friends, seeing thedepartment, meeting the current resi-dents, and renewing old friendships,”he notes.

Adds Program Director, Cindy Hoffman,D.O., FAOCD, “I enjoyed the reunionbecause it was great to see how wellmy graduates are doing and the careerpaths they have taken. All of them arevery successful.”

NYCOM/St. Barnabas Holds First Reunion

Page 13

The following is a list of the 36 new residents who beganthis past July:

• Amy Adams, D.O. (MWU/AZCOM)• Andrea Baratta, D.O. (St. John's Episcopal Hospital,

South Shore)• Angela Brimhall, D.O. (UHHS Case Western University,

Richmond Heights Hospital)• Michelle Bruner, D.O. (Oakwood Southshore Medical

Center)• Joseph DelPriore, D.O. (Western University Pacific

Hospital)• Laura DeStefano, D.O. (Columbia Hospital)• A. Nicole Edwards, D.O. (St. Joseph Mercy Health

System)• Rachel Epstein, D.O. (Largo Medical Center)• Emily Fibeger, D.O. (St. Joseph Mercy Health System)• Jessica Flowers, D.O. (Largo Medical Center)• Gwyn Frambach, D.O. (St. Barnabas Hospital)• Carlos Gomez-Meade, D.O. (NSU-COM/BGMC)• David Judy, D.O. (Largo Medical Center)• Francisca Kartono, D.O. (Pontiac Osteopathic Hospital)• Susun Kim, D.O. (TUCOM/Valley Hospital Medical

Center)• Brent Loftis, D.O. (Northeast Regional Medical Center

#2)• Sarah Maggio, D.O. (St. Joseph Mercy Health System)• Julian Moore, D.O. (NSU-COM/BGMC)• Peter Morrell, D.O. (Northeast Regional Medical Center

#2)• Payal Patel, D.O. (Genesys Regional Medical Center)• Autumn Potaracke, D.O. (UHHS Case Western Univer-

sity, Richmond Heights Hospital)• Zaina Rashid, D.O. (MWU/AZCOM)• Rupa Reddy, D.O. (NSU-COM/BGMC)• Brooke Renner, D.O. (Pontiac Osteopathic Hospital)• Albert Rivera, D.O. (Northeast Regional Medical Center)• Leah Schammel, D.O. (Oakwood Southshore Medical

Center)

• Maryam Shahsavari, D.O. (Western University, PacificHospital)

• Thomas Singer, D.O. (Wellington Regional Hospital)• Shari Sperling, D.O. (St. John's Episcopal Hospital, South

Shore)• Amy Spizuoco, D.O. (Western U/COMP/Phoenix Area)• Jennifer Stead, D.O. (St. Joseph Mercy Health System)• Sean Stephenson, D.O. (O'Bleness Memorial Hospital)• John Stoner, D.O. (Frankford Hospital)• Jacqui Thomas, D.O. (Columbia Hospital)• Sabrina Waqar, D.O. (Columbia Hospital)• Adam Wiener, D.O. (Wellington Regional Hospital)

All residents are asked to provide the following documents:• A copy of your medical school diploma (and exact date

of graduation)• A copy of your internship diploma (exact dates of atten-

dance and name and address of school)• A copy of your state license• 2 passport size photos• A current CV

Information should be sent to the AOCD at P.O. Box 7525,Kirksville, MO 63501.

Karthik Krishnamurthy, chief resi-dent at the NYCOM/St. BarnabasHospital Residency Program,recently won third place in theNew York Academy of MedicineAnnual Resident Competition inthe dermatology division.

All New York dermatology residency programs areinvited to submit one presentation from theirprogram, of which 10 are chosen to present at theactual competition. Twelve other allopathicprograms competed in the competition, which washeld in June.

Dr. Krishnamurthy was the only osteopathic residententered in the competition. He presented a casereview on blood root necrosis.

“I am very excited and honored to be recognizedamong the academic institutions in New York andproud to represent my residency program, whichhas given me the opportunity to learn and practicedermatology,” says Dr. Krishnamurthy. “I would alsolike to thank my program director, Dr. CindyHoffman, who encouraged me to enter the competi-tion, and for always being supportive.”

Dr. Krishnamurthy Wins3rd Place in Competition

Jon Keeling, D.O., third-yearresident at WellingtonRegional MedicalCenter in West PalmBeach, Fla., and hiswife, Julie,welcomed a babyboy.

John Thomas "Jack"Keeling was born on July13 at Morton Plant Hospitalin Clearwater, Fla. He was 7 lbs 8 oz, and 20.5 inches tall.

Dr. Keeling WelcomesBaby Boy

RESI

DEN

TSSPOTLIGHT

With four osteopathic dermatologyprograms in the state, residents at theOakwood Southshore Medical CenterResidency Program in Trenton, Mich.,have a large sense of community.

Additionally, there is an allopathicdermatology residency program affili-ated with Wayne State University atOakwood with which the osteopathicdermatologists routinely interact.

Adding to that expanded sense ofcommunity is the fact that ProgramDirector, Steven Grekin, D.O., FAOCD,is the sixth dermatologist in hisfamily—the most dermatologists in anyone family—who often calls on rela-tives to offer unique electives for theresidents. As an example, his cousin,Roy Grekin, M.D., is the chief ofDermatologic Surgery at the Universityof California, San Francisco, where theresidents do a rotation.

Similarly, they do a pediatric derma-tology rotation with Amy Paller, M.D.,at Northwestern Memorial Hospital inChicago, although Dr. Paller is notrelated. “Our residents get the opportu-nity to study with the thought leadersof our specialty,” says Dr. Grekin, whohas served as program director for thepast five years.

Established in 1991, the Oakwoodprogram has graduated 12 residents todate. Six residents are currently in theprogram. Interestingly, Dr. Grekin wasthe first resident to graduate from theoriginal program.

The four osteopathic dermatologyprograms, which have a total of 25 resi-dency spots, comprise a statewideconsortium that offers six didacticsessions on the campus each year. As aresult, Oakwood residents are able toparticipate in some different and inter-esting didactic sessions. As an example,a cadaver lab modeled after the Scrippscourse is presented every other year.

In addition to conducting grand roundswith the allopathic program, the twodermatology residency programs alsoshare resources.

Oakwood Southshore is funded as anosteopathic program through the allo-pathic hospital system, explains Dr.Grekin. As a result, the program doesnot have funding issues. Oakwood resi-dents receive book allowances andreimbursement for attending confer-ences. “Our long term goal is tocombine with the Wayne Stateprogram, which will provide ourprogram with a full-time teachingfaculty paid by the university,” he says,adding that the two programs are indiscussions.

Academic LifeResidents attend academic didacticsevery Monday morning and Fridayafternoon during which they discusstopics from authors Bologna, Andrews,and Spitz, among others. On Tuesdaysand Thursdays, they are with attend-ings. Residents conduct grand roundson Wednesday mornings. Afternoonsare reserved for dermatopathology andclinic. Friday morning is clinic.

There are 13 training faculty with awide variety of interests from Mohssurgery to dermatopathology. Dr.Grekin is looking to add a pediatricdermatology attending in-house.Informal presentations are given dailyby attending staff while on service.

“We get to work with a diverse spec-trum of dermatologists, some in largeclinical settings and others in commu-nity practices,” notes Brandon Miner,D.O., second-year resident. Eventhough there are a lot of large hospitalsin the state, the residency program is ina unique location allowing residents tosee a variety of patients. “We see a highvolume of patients and a lot of diversedisease, such as 4-centimetermelanomas with lupus and strangecutaneous infections,” he adds. Often-times, patients do not come in fortreatment until their skin conditionshave become quite extensive. Thegreater Detroit area has one of thehighest rates of community-acquiredmethicillin-resistant staphylococcusaureus in the nation, as well.

Other didactic sessions include weeklydermoscopy reviews, clinical unknownpresentations, pathology slide reviewswith clinical and pathologic correlationat Hilbrich Dermatopathology Labs,and lectures presented by attendingstaff.

The dermatopathology training isextensive, says Dr. Miner. Not only doresidents spend time at the scope witha dermatopathologist, but they arerequired to review histopathologicunknowns posted on a group web siteevery week and must come preparedwith their answers as they reviewWeedon’s Histopathology of the Skin, hesays. Oakwood residents are requiredto do an additional dermatopathologyrotation with the Wayne State programdirectors who are dermatopathologists.

Oakwood Southshore also offers a divi-sion of clinical research that quicklyindoctrinates residents into researchprotocols. Between five and ninestudies are running at all times at theGrekin Skin Institute, notes Dr. Grekin.Studies have covered such topics astinea, psoriasis, acne, cosmetic andinjectable fillers, as well as novelcosmetic devices. Residents learn aboutevidence-based medicine and see first-hand the lengthy process involved ingetting drugs approved by the Foodand Drug Administration.

An added bonus is that residents areable to enroll uninsured or underin-sured patients into the trials, Dr. Mineradds.

MeetingsIf this grueling academic schedule isnot enough, Oakwood residents arerequired to attend all of the annualMichigan Dermatology Society meet-ings. Because it is one of the largestdermatology societies in the country,the full-day meetings are very wellattended by practitioners and residents,and commonly host world-renownedlecturers. The osteopathic residentshost one of these meetings, with therest hosted by the allopathic residents.In preparation, residents must bring 30-plus unique cases to present. Two of

Oakwood Southshore Residents Thrive in ‘Community’

Page 14

the meetings are reserved for lecturesonly.

Residents are also required to attendthe Michigan Osteopathic Associationmeetings, which always include adermatology subspecialty breakoutgroup, and the Michigan OsteopathicDermatology Society meetings. Thenthere are the Michigan State Universitycampus lectures that typically addresspractice management issues.

Don’t forget about journal club everythird Tuesday of the month. Three ofthe four osteopathic programs partici-pate in the journal club. Each programis responsible for presenting an addi-tional lecture series throughout the yearat the Michigan State campus.

“There’s a really good academic feelwith all of the programs here,” says Dr.

Miner. “We get together in an academicsetting, share lecture materials, andstudy for boards.”

For the last three years, some of theOakwood residents have had thehighest scores on the mock in-trainingexamination. They have also publishedin journals, including Journal of theAmerican Academy of Dermatology, theArchives of Dermatology, and Dermato-logic Surgery, among others.

Legacy ProjectThe residents’ accomplishment that Dr.Grekin is most proud of, however, isthe Legacy Project. Started three yearsago, the project is a means to improvethe program while improving the carefor patients in the community. “Insteadof the residents spending three years inthe program just taking, they have to

give something back,” explains Dr.Grekin.

Every year, each resident creates a newway to contribute. As an example, oneresident developed educational mate-rials for cosmetic procedures per-formed in the residency program, oneresident developed a review guide fordermatopathology questions on theboards, and one created a cosmeticclinic that offers discounts for hospitalemployees when residents perform theprocedures. This year, the residents arelecturing at several local high schools.

“These projects get handed down yearto year and the program’s legacy growbigger and bigger,” Dr. Grekin adds.“It’s a way of giving back for futuregenerations.”

Front row (left to right): Drs. Michelle Bruner, Steven Grekin, Heather Higgins, Michael Whitworth, and Reagan AndersonBack row (left to right): Leah Schammel, D.O.; Jan Prusinowski, PA-C; Daniel Hansen, D.O. MPH; and Brandon Miner, D.O.

Page 16

Erik Austin, D.O., MPH, was recentlyvoted as the “Best Physician for 2008”in the annual readers’ poll for northSan Diego County.

The poll includes readers of the CarmelValley News, the Del Mar Village Voice,and the Rancho Santa Fe Review, whichrepresent three key communities innorth San Diego County. Nearly 50,000people reside in these three communi-ties, with approximately 200,000 peoplein the surrounding areas, which areserved by several hundred physiciansacross all specialties. The north countyresidents voted in the annual Readers’Choice poll conducted this pastsummer.

“Austin Dermatology Center has beenopen a little more than one year. Tohave this kind of community support isvery nice and I am very pleased toserve these fine folks,” says Dr. Austin.

In recognition of his “best” status, Dr.Austin received a certificate and anarticle about his practice published ineach of the three newspapers. Hethanked the readers who selected him,saying “I truly appreciate this recogni-tion and will endeavor to live up to thishonor. I will always remain enthusiasticabout providing patient-centered medi-cine, so that my patients will reachtheir optimal health.”

From being in print to reviewing it, Dr.Austin wasrecentlydrafted bythe AOA toreview arti-cles in theareas ofderma-tology,publichealth,envi-

ronmentalmedicine,and preventivemedicine for theJournal of theAmerican OsteopathicAssociation (JAOA).

“I am looking forward tothis opportunity. I like to beof assistance whenever I can and ampleased to be selected,” he says. “Inaddition, I am proud to represent theAOCD in some small way in thisendeavor,” says Dr. Austin, whobelieves that it is important to havesomeone representing the College onthe JAOA staff of peer reviewers.

He is equally passionate about seeingthe JAOA meet its professional andscientific destiny and continue itsgrowth in the definitional areas ofresearch, education, and clinical prac-

tice cited by Felix Rogers,D.O., associate editor, in his recentJAOA editorial.

Dr. Austin responded to a call for peerreviewers in the June issue. The adver-tisement requested applications fromosteopathic physicians, basic scientists,and others in the biomedical profes-sions. He submitted a letter of interestand curriculum vitae for the search,which was conducted by GilbertD’Alonzo, D.O., JAOA editor-in-chiefand professor of Medicine, PulmonaryDisease Section, Temple UniversitySchool of Medicine.

Dr. Austin graduated from the Texasresidency program under the directionof Bill V. Way, D.O., FAOCD, in affilia-tion with KCOM Northeast RegionalHospital. He is the medical director ofAustin Dermatology Center and amember of the Dermatology faculty atWestern University of Health Sciences.

Dr. Austin Chosen “Best Physician” in North San Diego

The following are a few rules on investing and using money managers:

• Don’t ask a money manager where to invest. Rather, you should determine how to invest. For example, if Anheuser-Busch sells for $50 a share that means tens of thousands of money management analysts have determined that is theright price for the stock. If one thinks it is worth more, they are saying that many smart individuals are wrong (ie, themarkets don’t work). If, however, you had foreknowledge on its buyout, and thus know the true value of the stock, notonly would you have the opportunity to significantly increase your portfolio, you might be incarcerated if the govern-ment deemed it insider trading.

Moreover, remember that more than 80% of all trades are done by professionals at institutions. Consequently, they canmanipulate the market by mass day trading with the truncated speed of a gazelle. A good example is when you hear“there doc run on a stock,” meaning heavy buying or selling.

The Efficient Market Hypothesis maintains that it is impossible to beat the market because prices already reflect all therelevant information regarding a company. Thus, it is futile to search for undervalued stocks or try to predict markettrends through fundamental or technical analyses. Studies have verified that when relevant information about acompany changes, the information is reflected in its stock price within 40 seconds.

• Most folks cannot better the market, yet you meet many advisors who think they are special. While there is only oneTiger Woods, there are 20,000 Tiger want-to-bes out there claiming to be the best. Of course, you have no way ofknowing which one is the best at any point in time.

Large houses have the money to hire the best Tigers or money managers. Even with all that strength, 93% of the timemoney managers fail to best a passive basket of “index” funds made up of 60% stocks and 40% bonds, based on a 10-year average. Let me know if you meet the other 7% of managers.

• An index fund blindly buys every stock in a defined index with a goal of accepting a return equitable to the generalmarket. This is a low expense concept since there is no significant trading that occurs. Often these indexes replace apoorly performing company with a better one over six months or so, avoiding financial disaster within the portfolio. Asthe number of pure index fund filters increase, a fund realizes the potential to outperform a price index fund and itbecomes less of a pure index fund (ie, dimensional fund advisors are an example of an active, not passive, approach toindex funds).

• Don’t get involved in the “losers game.” Be sure to watch the performance of your overall portfolio, not just a fewwinners.

• Regarding risk, you should decide how much risk you want to take early on and make that clear to your advisor. Don’ttell your advisor, or determine on your own, that your personal goal is to have a 20% annual return without any risk, asthis is impossible. Generally speaking, the higher the return rate desired, the higher the risk.

• Avoid situations in which excessive trading occurs (ie, when you realize less than half of your return on your account).This means someone is trying to time the market, which is impossible according to Peter Lynch, one of the greatestinvestors of our time. Always get a performance report showing a cumulative history—or returns—for one or two yearsor as long as five years.

Financial TidbitsInvesting with Money Managersby Robert Schwarze, D.O., FAOCD

Page 17

Although Carol Cola, D.O., FAOCD, isexcited to resume her practice back inPottstown, Penn., she is appreciative ofwhat the last year as the first Mohsmicrographic surgery fellow within theosteopathic profession has meant.

“It was a wonderful and pleasant year,”says Dr. Cola, who took a leave ofabsence from her practice to accept thefull-time fellowship at DermatologyAssociates of Tulsa, which is the prac-tice of Edward H. Yob, D.O., FAOCD.Serving as the program director, Dr.Yob was instrumental in getting thefellowship approved by the AOA in2007.

Dr. Cola applied for the fellowship inorder to add Mohs surgery to the serv-ices offered by her practice, whichincludes three other dermatologists andone physician assistant. “If it wasn’t formy wonderful partners and staff backhome, it wouldn’t have been possibleto do this fellowship,” she says, adding,“They were so gracious as to cover meand my patients while I was gone.”

Although Dr. Cola performs themajority of surgeries in the practice, shewas never trained in Mohs. Whenpatients needed such surgery, theywere referred elsewhere, sometimesrequiring them to travel as much as anhour away. Many of these patients areelderly and transportation is an issuefor them, she says.

Because Dr. Cola interviewed for thefellowship toward the end of the appli-cation process, she had to movequickly, literally

“Normally people have a year to getready for this type of opportunity,” shesays. “I had eight weeks.” That is, eightweeks to obtain an Oklahoma medicallicense, make arrangements for her partof the practice, get her children off tocollege, and help settle her mother inan assisted living facility after movingfrom the house she had lived in for 40years. “I got all of that done and puteverything in my car and came out.”

“I’ve really enjoyed working with Dr.Yob and his staff,” says Dr. Cola. “Itwas exciting to learn new procedures.It was also a challenge, but sometimeswhen you do the same thing all thetime, you look for a challenge.”

In some ways, it was easier than beingin practice, she notes. “In retrospect, asa resident it might seem like hard workgoing through it. But after you’ve hadthe opportunity to manage your ownpractice and see patients on a dailybasis, it’s a welcome break,” says Dr.Cola who opened her own office 15years ago after graduating from anAOCD preceptorship in the Philadel-phia area.

“We all appreciate what Dr. Yob hasdone for us by starting this fellowship,”she adds. “It’s the first one for theosteopathic profession and I know heput a lot of time and effort into it.”

Dr. Cola Wraps Up First AOCD Mohs Surgery Fellowship

Page 18Page 18

Drs. Cola and Yob perform Mohssurgery on a patient.

Beginning October 1, the second phase of the tamper-resistant prescription pad requirements issued by the Centersfor Medicare and Medicaid Services (CMS) takes effect.

The law requires that all handwritten and/or computer-generated printed prescriptions for Medicaid outpatientdrugs must comply with federal and/or state guidance fortamper resistance.

Currently, a handwritten or computer-generated printedprescription must contain at least one of the following threecharacteristics to be compliant. By Oct. 1, handwritten orprinted prescriptions must contain all three of the followingcharacteristics:

• One or more industry-recognized features designed toprevent unauthorized copying of a completed or blankprescription form,

• One or more industry-recognized features designed toprevent the erasure or modification of informationwritten on the prescription by the prescriber, and

• One or more industry-recognized features designed toprevent the use of counterfeit prescription forms.

The National Council for Prescription Drug Programssuggests the following best practices to meet the tamper-resistant requirements:Category 1:

• Photocopied “COPY,” “ILLEGAL,” or “VOID” pantograph Category 2:

• An erasure revealing background (resists erasures andalterations)

• Quantity check off boxes• Refill indicator (circle number of refills or “no refill”)

Category 3:• Security features and descriptions listed on the prescrip-

tion

While the law specifies “prescription pad,” these require-ments also apply to computer-generated prescriptions thatare printed using paper inserted into the printer, accordingto the CMS. Special paper may be used to achieve copyresistance, but the agency says it is unnecessary. Computer-generated prescriptions may be printed on plain paper andbe fully compliant with the regulations provided that theycontain at least one feature from each of the three cate-gories.

The tamper-resistant requirement does not apply under thefollowing circumstances:

• When a prescription is communicated by the prescriberto the pharmacy electronically, verbally, or by fax;

• When a managed care entity pays for the prescription;or

• In most situations when drugs are provided in desig-nated institutional and clinical settings.

In addition,emergency fills with anon-compliant written prescription areallowed as long as the prescriber provides a verbal, faxed,electronic or compliant written prescription within 72 hours.

New Tamper-Resistant Prescription Pads in Effect

Page 19

Page 20

New products that claim to be longlasting and safe continue to flood thefiller market. While Collagen and Resty-lane have been used for several yearswith excellent safety and efficacy, anewer dermal filler deserves mention.

Radiesse is a new generation dermalfiller that was originally used as asterile implant for vocal augmentation,maxillofacial augmentation, and radi-ographic tissue marking. The productconsists of smooth calcium hydroxylap-atite microspheres that are suspendedin a water-based gel carrier. It wasapproved by the Food and DrugAdministration (FDA) to treat nasolabialfolds. The product is easy to inject as abolus and then massaged into the skinor it can be used in a linear retrogrademanner and is quite forgiving. Itseffects last nearly one year and it isarguably the safest of all the injectablefillers.

However, there is some stigma associ-ated with Radiesse. Some practitionersbelieve that due to its longer lastingduration, a mistake or overcorrectionwill be more lasting than those associ-ated with the typical filler. Theymaintain that all longer lasting fillershave a higher granuloma rate, despitestudies that prove otherwise. Also, thepain associated with Radiesse injectionscan be a negative for some practi-tioners and patients alike, necessitatingthe use of nerve blocks.

The reality is that Radiesse has a lowerincidence of granulomas than Resty-lane. The manufacturer reports thenumber of granulomas <1:50,000 ascompared with collagen (1:2,500) orRestylane (1:2,600). Pain with injectioncan be minimized using a topical anes-thetic or mixing 2% lidocaine directlywith the material using a luer lockadaptor. Furthermore, Radiesse allowsfor more volume to be delivered withone syringe than the competition.Radiesse can “volumize” areas such asthe hollows associated with HIV lipoat-rophy and even sunken cheekbonesassociated with aging.

When working in areas that are verymobile, such as the sphincter actingmuscles of the eyes or lips, Radiesse isnot an ideal filler due to clumping orbumping. These bumps are not granu-lomas, but rather are a collection of thematerial brought together by themuscles’ action. Either Restylane orJuvederm is a better suited filler forthose areas.

In conclusion, manycaveats existwhen choosinga dermal filler.But practi-tioners shouldnot bedissuaded fromusing a longerlasting filler,such as

Radiesse. If used for the FDA approvedsites, the injection of this filler isrewarding to both the patient andphysician. While it should be theproduct of choice for areas that requiremore volume, it is also versatile enoughto use in the fine lines of certainlocales.

New Dermal Filler Deserves a Tryby Igor Chaplik, D.O., FAOCD

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Updated guidelines on interactions with healthcare profes-sionals from the drug industry’s trade and lobbyinggroup—the Pharmaceutical Research and Manufacturers ofAmerica (PhRMA)—will go into effect in January, 2009.

The 36-page document comprising 15 rules addresses inter-actions with respect to marketed products and relatedpre-launch activities like its predecessor published in 2002.The Code on Interactions with Healthcare Professionals wasdeveloped to ensure that pharmaceutical marketing practicescomply with the highest ethical standards, and that interac-tions with physicians are professional exchanges designed tobenefit patients and enhance the practice of medicine.

Among its changes, the revised code:• Prohibits distribution of non-educational items to health-

care providers and their staff. These include pens, mugs,and other “reminder” objects typically branded with acompany or product logo. The Code acknowledges thatsuch items, even though of minimal value, “may fostermisperceptions that company interactions with health-care professionals are not based on informing themabout medical and scientific issues.”

• Prohibits company sales representatives from providingrestaurant meals to healthcare professionals, but allowsthem to provide occasional meals in healthcare profes-sionals’ offices in conjunction with informationalpresentations.

• Reaffirms and strengthens previous statements thatcompanies should not provide any entertainment orrecreational benefits to healthcare professionals.

Other revisions include more detailed standards regardingthe pharmaceutical company support for continuing medicaleducation (CME); principles on the responsible use of non-patient identified prescriber data; and additional guidancefor speaking and consulting arrangements with healthcareprofessionals, including disclosure requirements for health-care providers who are members of committees that setformularies or develop clinical practice guidelines and whoalso serve as speakers or consultants for a pharmaceuticalcompany. For example, companies can still provide fundingfor CME events, but they are prohibited from paying formeals directly. However, “a CME provider at its own discre-tion may apply the financial support provided by a companyfor a CME event to provide meals for all participants.” Therevised code does not prohibit companies from offering“reasonable compensation…and reimbursement for reason-able travel, lodging, and meal expenses” incurred byphysicians who serve as consultants or speakers.

Companies that comply with the voluntary guidelines arebeing requested to train their representatives about theindustry codes of practice, in general, and assess them peri-odically to ensure that they are abiding by the PhRMAguidelines.

Updated PhRMA Code Effective 2009

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SPOTLIGHT

When Jonathan Richey became amember of the National Psoriasis Foun-dation (NPF), he never envisioned thatit would require a good pair of walkingshoes.

Dr. Richey, an intern at GenesysRegional Medical Center in GrandBlanc, Mich., and graduate of theKirksville College of Osteopathic Medi-cine, first learned about the NPF whenhe was diagnosed with the skin condi-tion at age 19. “I had already decidedthat I wanted to be a dermatologistlong before this happened and wassurprised to have developed a skincondition myself,” he says.

In 2004, when Dr. Richey enteredmedical school, he became a memberof the NPF, which offers informationabout the chronic disease and treat-ment options. Given his chosenprofession, keeping updated on thecutting edge treatments and research isimportant, he says.

Walk OnThree years later, Dr. Richey signed onas a volunteer after learning that theNPF was kicking off its inaugural Walkfor Awareness to be held the daybefore the AOA Convention in San

Diego. After the SanDiego walk, he volun-teered as chairman forthe walk in Ann Arborheld this past June.

The purpose of thewalks is to raiseawareness about psori-asis and psoriaticarthritis as well as raise money for theNPF's education, advocacy, andresearch programs. Each walk has twolengths—1k and 5k—to accommodateeveryone involved. The NPF walks donot offer sponsorship for the amount ofwalking that a participant does, butrather team captains and members askfor one-time donations from friends,family, and associates. Team captainsare encouraged to get at least threeindividuals to join the team and raise$100 in donations. Members help theteam achieve the donation goal, whichcan be changed by the individual teamsto raise more money. In fact, someteams have raised thousands of dollars,says Dr. Richey.

At the San Diego walk, he served as acommittee member and team captain.As a committee member, Dr. Richeywas involved in motivating walkers and

staffing the education booth, the laterof which entailed teaching peopleabout psoriasis and available treat-ments.

“Organizing the walk was a uniqueexperience,” he says. “At times, theorganizing committee and I wonderedif we were going to be successful.Working with so many great individualsand seeing everyone's effort wasencouraging and satisfying.”

For the Ann Arbor walk, Dr. Richeyserved as committee chairman. In addi-tion to meeting regularly with othercommittee members to plan the event,he served as a liaison with the nationaloffice staff in charge of the walks.Activities to encourage participation ranthe gamut from being a spokespersonpublicizing the walk in the local mediato requesting corporate donations.

Raising Awareness About Psoriasis One Step at a Time

The JAOCD serves to better the contin-uing education needs of the AOCDmembers, residents, and the derma-tology community at large.

We asked the JAOCD sponsors why theychose to support the AOCD specifically bysponsoring the journal. Additionally, weasked how valuable a journal is to amedical society such as the AOCD.

Ann Deren-Lewis, vice president ofProfessional Relations at Stiefel Labora-tories, responded as follows:

“AOCD's goals are very familiar toStiefel Laboratories and we share in theAOCD's mission to improve the stan-

dards of the practice of dermatology,and stimulate the study and extendknowledge in the field of dermatology.Sponsoring the journal is a wonderfulway for us to partner on these commongoals.

Stiefel has a deep appreciation for, andan insight into, the needs of the derma-tology community. We have long-standing relationships with societies,such as the AOCD, that are based onmutual trust and true collaboration.This journal is only one example ofhow we can partner to advance educa-tion and the overall field ofdermatology.

The journal plays an integral role inserving to support continuing educa-tion needs for AOCD members,residents, and the dermatology commu-nity overall. For more than 160 years,Stiefel Laboratories has establisheditself as [one of] the most valued andrespected dermatology company in theworld by investing in educational tools,such as journals, that are a foundationto communication about innovations inpatient care.”

Future issues of DermLine will featurewhat other JAOCD sponsors had to say.

JAOCD Sponsors Show Support

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The effort seems to have paid off. TheSan Diego walk raised more than$35,000 with upwards of 200 partici-pants. Despite the torrential downpourtoward the end, the Ann Arbor walkraised $18,000—$8,000 more than thecommittee anticipated—and stillcounting as individuals continue tomake donations following the walk.The latter had more than 100 partici-pants. The route, which was downMain Street, was lined with signs. Itgave maximum visibility to the causeand drew a lot of attention from thecommunity, says Dr. Richey. In 2007,the first year of the walks, the NPFraised more than $500,000.

Beyond the WalkMeeting people who have psoriasis orfamily members, friends, and co-workers of people with the skindisorder is what Dr. Richey enjoys mostabout his volunteer efforts. “I enjoyhearing about each of their experi-ences. In addition I enjoy educatingpatients, family members, and friendsabout psoriasis,” he says. Becausepsoriasis commonly causes red scalypatches that are very noticeable, peoplecan be put off by what they see andconcerned that they will catch it.Helping people understand that psori-

asis is immune-mediated and notcontagious is satisfying and helps makepeople less judgmental about individ-uals who have psoriasis, adds Richey.

Ironically, psoriasis patients are someof the only patients that dermatologiststell to get sun exposure as light therapyis a common treatment. But because ofthe psoriatic plaques that frequentlyoccur on the skin of the elbows andknees, psoriasis patients often wearlong sleeves and pants, even in thesummer months, to hide the disease.

Dr. Richey is confident that the walkshave indeed raised awareness aboutpsoriasis. This is evidenced by recentlegislation introduced to Congress toincrease research funding. Recentresearch has lead to discoveries such asthe fact that there are more co-morbidi-ties associated with psoriasis thanpreviously thought. He is hopeful thatsuch research will lead to a cure oneday.

Being involved in the NPF has alsoraised awareness about osteopathicdermatologists, says Dr. Richey. “DOsare frequently associated with primarycare. But there are 635 DO dermatolo-gists registered with the AOCD in the

US treating theskin conditionsof many Ameri-cans,” he says,adding, “As Iwas interviewedby radio andnews stations, Iwas able toshare with themwhat a DO isand our qualifi-cations todiagnose and treat diseases of the skin,hair, and nails.”

Dr. Richey encourages AOCD membersto look for Walks for Awareness in theirarea and participate by sponsoring aparticipant, telling their psoriasispatients about it, or creating a team towalk. Eleven walks throughout thecountry were scheduled in 2008. TheNPF has even created a Virtual PsoriasisWalk for Awareness for people toparticipate in, no matter where theylive. The goal is to raise $20,000 byNovember 21.

For more information about psoriasis,the NPF, or upcoming Walks for Aware-ness, visit the NPF web site atwww.psoriasis.org.

Will Kirby, D.O., FAOCD, will be theonly dermatologist featured on E!Entertainment Television's “Dr. 90210”this season slated to air in September.

Last season, he joined the cast of thecable Tv series that showcases plasticsurgeons—and now an osteopathicdermatologist—who work in BeverlyHills. The series chronicles the doctors’social lives, their interactions withpatients, and the patients’ lives. Thisseason, Dr. Kirby’s story line willfeature lip augmentation and a liquidface-lift.

In addition, Dr. Kirby filmed a guestspot in the season finale of ComedyCentral’s “Reality Bites Back,” anotherepisode of TLC’s “LA Ink,” and anappearance on TVTropolis’ “RealityObsessed,” a Canadian show. All ofthese television appearances are sched-uled to air this fall.

After graduating from the PacificHospital/Western University ResidencyProgram in 2007, Dr. Kirby opened hisown practice in Beverly Hills.

Dr. Kirby Starts Second Seasonon ‘Dr. 90210’

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Journal of the American Osteopathic College ofDermatology-JAOCD.

We are now accepting manuscripts for the publicationin the upcoming issue of the JAOCD. ‘Information forAuthors’ is available on our website at www.aocd.org.Any questions may be addressed to the Editor atjaocd@aol.com. Member and resident member contri-butions are welcome. Keep in mind, the key to havinga successful journal to represent our College is in thehands of each and every member and resident memberof our College. Let’s make it great!

- Jay Gottlieb, D.O., FAOCD

American Osteopathic College of Dermatology1501 E. IllinoisKirksville, MO 63501

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