A study published last summer (but still getting media attention) in the Journal of the American Academy of Dermatology found that new patients seeking appointments for possible skin cancer had to wait an average of more than 5 weeks to see a dermatologist:
So a pair of California researchers decided to put these complaints to the test. Posing as patients concerned about a "changing mole" (aka skin cancer central), they called 851 dermatologists across the country to make appointments and reported the results in a 2006 study in the Journal of the American Academy of Dermatology.
The average wait time given them was 38 days, with doctors' offices in some cities taking much longer: 47 days in Syracuse, N.Y., 48 days in Phoenix and a whopping 73 days in Boston.
Several possible reasons were cited, including the increasing caseload of cosmetic dermatology, which is more lucrative than treating medical issues; the artificial limits put on the number of new doctors, even as our nation's population continues to grow; and other issues:
"Dermatologists are seeing an increase in demand for everything," says Dr. Jack Resneck, assistant professor of dermatology at University of California, San Francisco, and co-author of the 2006 study. "There are a lot of new treatments available for diseases like psoriasis and eczema, so those patients are coming in more. There's also been an explosion in the amount of skin cancer in the past couple of decades. Patients have become more educated about the warning signs, so a lot more people are coming in for skin checks."
For people with psoriasis, the study is a reminder that if you see your dermatologist regularly, it is wise to schedule those appointments well in advance. An article in the Boston Globe on the same study also noted that asking a primary care physician to help you schedule your derm appointment can help:
Meanwhile, doctors say patients who are concerned about waiting should try to get their primary care doctor to advocate for them -- although many primary care doctors say they're stretched to the limit, too.
Finally, we should note that this article had 'patients' cold-calling a new physician; some doctors give priority to existing patients. So have a dermatologist before you flare!
MedImmune, Inc. (Nasdaq: MEDI) today announced that it has initiated a Phase 1 trial with its monoclonal antibody (MAb) targeting interferon-alpha, known as MEDI-545, in patients with psoriasis.
It is also being investigated for lupus. According to the company:
A growing body of preclinical data suggests that type-1 interferons are involved in a range of chronic inflammatory diseases. Elevated type-1 interferon mRNA levels have been found in preclinical models of psoriasis, and inhibition of type 1 interferon in these models has been shown to block the development of psoriasis. Preclinical study results have also demonstrated that interferon-alpha-induced genes and proteins are over-expressed in the skin in animal models of psoriasis.
MEDI-545 (previously known as MDX-1103) is a fully human antibody. It was developed by Medarex, Inc. (Nasdaq: MEDX), and has a partnership with MedImmune for MEDI-545.
Hi-Tech Pharmacal Co. Inc. said the U.S. Food and Drug Administration has granted it tentative approval for the generic version of Warner Chilcott Ltd.'s treatment for psoriasis of the scalp.
Hi-Tech reported that Warner Chilcott's patent for Dovonex scalp solution (calcipotriene) is set to expire on Dec. 29, 2007, after which the generic would become available. So it looks like barring a legal dispute over the patent expiration date, there may be a less expensive calcipotriene scalp treatment by New Year's.
NALP1 'vitiligo' gene on chromosome 17p13 may impact psoriasis
A new study published today has identified a gene that may play an important role in vitiligo as well as many other immune system diseases including psoriasis. Vitiligo is a pigmentation disorder that results in white patches developing on the skin in various parts of the body.
The study found that the NALP1 gene on chromosome 17 appeared to play a role in predisposing people to a variety of immune diseases. While some degree of exaggeration typically seems to creep into media reports describing findings like this, we are allowing ourselves to be encouraged by this news:
The pinpointed region of chromosome 17, called NALP1, could be a new target for treatment, said the authors of a study in the March 22 issue of the New England Journal of Medicine.
"This part of the immune system may respond to triggers coming from the environment, like bacteria or viruses, and there are indications that you can turn it off. So, we're very, very hopeful that there may be drugs that allow us to do that," said the study's senior author, Dr. Richard A. Spritz, who directs the Human Medical Genetics Program at the University of Colorado at Denver and Health Sciences Center.
Spritz added, "That's not going to help people with childhood diabetes, where the damage is already complete. But, for a number of chronic autoimmune disorders, like lupus and vitiligo, if you turn off the autoimmune process, the body could repair itself." ...
But NALP1 is probably only part of the picture.
"This can't be the whole story," Spritz said. "This is one of probably many genes that predispose to autoimmunity, but it looks like it may be involved in a pretty big way, which is why we were able to find it."
The gene is connected to the body's primitive immune system, which is involved with the earliest responses to outside attacks.
"It probably has a big effect, and it probably interacts in some complex way with other genes and other risk factors," Spritz pointed out. "We know a lot about this gene. It was not an anonymous gene that you would have to start from ground zero studying. We know that it's part of the surveillance system for attack by bacteria or viruses, part of the innate immune system."
"All diseases are complex, the result of different genes and environmental risk factors acting together in concert," said Dr Spritz.
"But if NALP1 turns out to be one of the major genes involved in numerous autoimmune diseases, and if we can interrupt its negative effects, we may have the chance to treat many different chronic autoimmune disorders like vitiligo, lupus and psoriasis and perhaps eventually eliminate them altogether."
Subscribing to our podcasts is easy. Just visit our podcast page to learn more about subscribing, or to listen directly to our previous podcast programs. Topics have included treating children with psoriasis, and hand and foot psoriasis.
Those who follow this page regularly know we have been chronicling the media's great interest in home remedies for psoriasis. Today's entry comes from our friends in Scotland. This article is particularly noteworthy because it combines an excellent introduction with a sizable list of "complementary" treatments for psoriasis. (The alternative remedy articles don't usually describe the disease accurately.)
Psoriasis can be physically and psychologically scarring for sufferers, but there are an increasing number of treatments for this chronic condition. ...
There are also seven natural compounds that you should look for in complementary psoriasis remedies. They are: * Bishop's weed. The ancient Egyptians rubbed red, scaly skin patches with plants containing psoralens. Psoralens are chemical compounds occurring in the Psoralea corylifolia species of plants and they inhibit cell division, slowing down skin shedding. Bishop's weed contains a high concentration of psoralens. Available from a medical herbalist, best if the fresh herb is used. ...
* Licorice contains glycyrrhetinic acid (GA), which functions as a natural hydrocortisone, soothing inflamed skin, reducing any potential swelling, and decreasing the frequency of outbreaks.
The article also suggests oats, red pepper/capsicum, and Brazil nuts. If you are looking for alternative/complementary treatments, this article is worth a look.
The connection between heart disease and psoriasis has been in the news in recent months, and continues to be of great interest to psoriasis patients. We address it in depth in this new article.
Podcast series resumes with program on hand and foot psoriasis
Our free podcast series has resumed with a program on treating hand and foot psoriasis. Psoriasis on the hands and feet often proves to be highly resistant to treatment, while interfering with a patient's quality of life. The free podcast is available from our website (click on the link above) or through iTunes.
Subscribing to our podcasts -- mini-audio programs that typically consist of one or two interviews with leading physicians and patients -- is easy. Just visit our podcast page to learn more about subscribing or to listen directly to our previous podcast programs. Topics have included treating children with psoriasis, and the future of psoriasis treatment.
Psoriasis Cure Now's free podcast series returns on March 12. Now would be a good time to make sure you have subscribed to our podcasts through iTunes (search 'psoriasis cure') or via feedburner.com. Of course, you can always listen to our podcasts directly from our podcast page.
