‘Tis the Dermatology Residency Interview Season

Sure, it’s the Holiday Season, but it’s also residency interview season! Some of you may be in the midst of interviews (granted, you’re probably catching a well needed break this week and neck).

Here’s a list of some FAQs that would be handy to be prepared for at your dermatology residency interview!

Why derm?
Why this program?
Why this city?
What are you looking for in a program?
What other programs are you considering?
If not derm, what would you do?
Tell me about yourself.
Tell me about a difficult situation you have been in.
Tell me about a medical case where an ethical problem came up.
Tell me about an interesting derm case.
What is the most interesting thing you have done?
Tell me about your research/project/case report.
Who are your role models?
Tell me about the last book you read.
Specific interests in derm?
Where do you see yourself in 5 years? 10 years?
When have you been a leader?
How are you a team player?
What achievement are you most proud of?
Any questions?

For research applicants:
Be prepared to give a 5 min synopsis of your research.
Be prepared to answer ?’s regarding literature surrounding your area of research.
Who are potential research mentors at this program?
If you don’t have a PhD, do you think you can be a successful physician-scientist?
What challenges do you envision as a physician-scientist?
Why do so few dermatologists do research or stay in academics and what makes you different?


Infantile hemangiomas grow early!

Courtesy of wikipedia user Zeimusu

In the August 2012 issue of Pediatrics, authors from the Mayo Clinic and UCSF described the growth patter of infants’ hemangiomas using photos that parents were asked to take.  Hemangiomas are the most common “tumor” in infancy. Now, often when people hear the word “tumor” they think of cancer, and malignancy. But by tumor, we simply mean an abnormal growth of a specific type of body tissue. In this case, the hemangioma is an abnormal growth of vessels.  Some people have also referred to this as a “strawberry hemangioma” (thus the front page photo) as the color and growth may be reminiscent of a strawberry.

These hemangiomas are common and are estimated to affect ~4% of Caucasian infants.  Our teaching from textbooks has said that these hemangiomas tend to have a rapid growth phase during the first 6 months or so.  However, previous studies haven’t really characterized how these hemangiomas grow during this early period.  That is what these authors sought to do.

They found that the most rapid growth occured between weeks 5.5-7.5 of age.  That means this growth happens early!  It raises the question of whether we should think about sending these babies for evaluation much earlier, before this rapid growth occurs.  Then, treatment could be started early.

Reference: Tollefson MM, Frieden IJ. Early Growth of Infantile Hemangiomas: What Parents’ Photographs Tell Us. Pediatrics. 130(2). Aug 2012.

Wet wraps for atopic dermatitis at the Mayo Clinic

In a follow-up post to September’s post on wet wraps, I thought we would review one of the articles from the Mayo Clinic on the use of wet wraps in pediatric patients with bad atopic dermatitis.

The Mayo Clinic has had a tradition of using wet wrap therapy for a multitude of skin conditions including atopic dermatitis.  In their paper in the July 2012 issue of the Journal of the American Academy of Dermatology (JAAD), the authors reviewed their medical charts as it pertained to the use of wet wrap therapy with steroids over a period of 30 years and in examining 218 patients.  Pediatric patients with severe atopic dermatitis were admitted to the Mayo Clinic where they received wet wrap therapy.  Patient were treated with topical steroids and moisturizer which were covered with wet wraps (with either water or vinegar soaks) which were then covered with dry wrappings and a warm blanket.  They had these applied 5-8 times a day, and had dressings removed every 3 hours for dressing changes (and so that the child could walk around, urinate, etc).  A number of these patients also did get oral antibiotics for skin infection over the eczema.  The authors found that many of their patients had good results. For instance, 45% were deemed to have 75-100% improvement.

This study highlights that wet wraps with topical steroids is an important potential therapy to consider. While there are limitations to the study design, it is worth educating patients, their families, and other providers about this therapy.

Physician and layman perceptions on the preferred provider for skin surgery and cosmetic procedures

In a presentation at this year’s 2012 annual American Society for Dermatologic Surgery (ASDS) meeting, Dr. Omar Ibrahimi presented his Cutting Edge Research Grant project. Dr. Ibrahimi studied physician and layman perceptions on the most optimal provider for cutaneous surgery, Botox injections and filler injections.  He conducted two internet surveys: one assessing the lay public’s preference for providers of certain procedures and one assessing primary care residents’ (physicians in training) on their preference of providers for certain procedures. Choices of preferred provider included dermatologists, plastic surgeons, and non-physician  providers.

Dr. Ibrahimi found that for skin cancer surgery, both the lay public as well as the primary care physicians preferred dermatologists to perform the surgery.  For Botox botulinum toxin injection, the primary care physicians preferred dermatologists although the lay public preferred plastic surgeons.  For fillers, again the primary care physicians preferred dermatologists although the lay public’s preference for dermatologists and plastic surgeons was roughly equivalent.

Dermatologists receive in-depth training on cutaneous surgery, botulinum toxin injections and filler injections, and Dr. Ibrahimi concludes that it is important to make the public aware that dermatologists are the experts in skin cancer surgery and other cutaneous surgical procedures .