Photo from Wikipedia, author Alanna Ralph
Photo from Wikipedia, author Alanna Ralph

Growing up, my mom had told me the story of a kid whose parents practiced cupping on him.  Turns out that bruises which were left behind from the cuping and these bruises were noticed at school.  The parents were called in to investigate potential child abuse!

So what is this practice of cupping? (Does it involve a cup?)

Cupping is an alternative medicine practice most commonly seen in Eastern Asian countries such as China.  Suction via “cups” placed on certain areas (often the back) is thought to mobilize important components such as blood in the body.  Sometimes, this suction is created via a pump, and other times by heating the air in the cup before placement onto the body.  (Remember from middle school and high school that as a gas cools, it compresses, so then you get suction.)  The cups are then removed after a period of time.  Sometimes, bruising is left behind but not always.

I’ve actually tried this cupping procedure before where the cups were heated before placement.  They did feel hot when placed, but then cooled down.  I could feel the skin being sucked into the cups.  All in all, it was not terribly uncomfortable.

I’m curious, how many of you have heard of cupping, had cupping, or have had friends who have had cupping?

Candle in your ear?

Ear candling. Debris accumulates from the lighting of the candle.
Ear candling. Debris accumulates from the lighting of the candle.

Years ago, a relative of mine introduced me to the practice known as ear candling.  I didn’t have it tried on myself, but she was keen on trying it on an elder relative.

First, the idea of putting a lit candle anywhere near the face let alone inside the ear seems a little scary to me.  As it should to you too.  This practice is one that is practiced by people with the hope of improving health and sometimes to remove ear wax.  However, it is likely ineffective for both.  A hollow wax candle or cylinder of waxed cloth is lit and the non-lit end is placed in the ear of the individual.  The ear being treated is facing upwards.  Often, the candle is placed through a paper plate with a hole cut in it in order to catch any dripping wax or ash.

Studies have not shown any health benefit and in fact, trauma to the ear has occurred during this procedure.  The debris that is thought to be from inside the ear is debris that gathers just from lighting of the candle (whether or not it is placed in the ear or not.)  So just as your doctor warns you again sticking a qtip into your ear, don’t go sticking a candle in your ear!

Name that syndrome: Can’t see, can’t pee, can’t climb a tree

Findings of the feed associated with Reiter's Syndrome
Findings of the feet associated with Reiter’s Syndrome

So do you know which syndrome goes with the findings of conjunctivitis (inflammation of the eyes), urethritis (inflammation of the urethra), and arthritis (inflammation of the joints)? An additional clue is the photo on the left of keratoderma blenorrhagicum, the fancy name for these red- brown plaques, bumps and pus bumps that can occur on the soles of the feet.  Additionally, another finding in men are circular red spots on the penis called circinate balanitis which is almost diagnostic of this condition.

We’re talking about Reiter’s Syndrome.  Reiter’s Syndrome classically is described as a triad of conjunctivitis (can’t see), urethritis (can’t pee), and arthritis (can’t climb a tree).  It often develops as a reaction to an infection such as Chlamydia in the urethra or cervix, or gastrointestinal infections from Campylobacter, Shigella, Salmonella, Yersinia or Ureaplasma.  Interestingly, there’s also a genetic predisposition to getting this.  Individuals who get this are more likely to have a genetic factor called HLA-B27.

So what to do if you have Reiter’s Syndrome? Well, hopefully you made your way to a doctor already who made the diagnosis.  Your physician will treat the underlying infection if one is found, and will manage the symptoms that you have individually.

Highlights from the AAD 2013, Miami: Advances in Melanoma

An exciting talk from this year’s American Academy of Dermatology Meeting (AAD 2013) in Miami was the annual Marion B. Sulzberger Memorial Award and Lectureship given by Dr. Hensin Tsao.  Dr. Tsao talked about “Melanoma and Its Metaphors,” drawing parallels between the machinery behind melanoma to the machinery behind cars.  While problems can arise with cars, so can the biological machinery that drives cells to go out of control and develop into melanoma.  Dr. Tsao discussed tumor suppressor and proto-oncogenes.  Likening them to faulty brake systems, Dr. Tsao discussed how tumor suppressor genes are like the brakes in cells, and when messed up, the cell keeps going, dividing out of control.  On the other hand, if the accelerator of the car gets stuck in the down position, the car keeps going as well. Proto-oncogenes, or oncogenes, are accelerators of melanoma.

In the realm of melanoma therapy, we’ve made some great strides in directed therapy.  Among these are the drugs that target a very specific mutation that 60% of melanomas have (the V600E mutation).  These are drugs like vemurafenib and dabrafenib.  Although some of the tumors then find ways around these drugs when given alone, researchers and physicians have then added an additional drug, tramatenib (a MEK inhibitor) to the cocktail.  Two hits against the melanoma!  And there’s even more exciting stuff to come.

In short, in these past few years, we have seen major advances in melanoma therapy and I hope that with the direction we’re going, we’ll be able to put a permanent halt to melanoma!

Highlights from the AAD 2013 in Miami

Alas, the 2013 annual meeting of the American Academy of Dermatology is nearing its close.  It’s been a great 4 days in Miami — albeit a little colder and cloudier than expected, but hey, we’re all indoors enjoying the sessions anyways right?

courtesy of Flickr user ceiling
courtesy of Flickr user ceiling

After a jam-packed schedule, I now have a little bit of time to give you an update on the meeting.

This has been an exciting year in dermatology and yesterday’s Plenary Session attested to that.  Dr. Daniel Siegel gave remarks as his term draws to a close and as Dr. Dirk Elston  looks towards his incoming presidency of the AAD. Dr. Siegel remarked on some of the challenges that we have as dermatologists as the government continues to look at the proper way of reimbursements for all of medicine including dermatology.  Dr. Siegel was optimistic about his forecast for the  coming years of dermatology, predicting advances in science and technology which would allow for personalized treatment for the deadly cancer melanoma and “biopsies” without having to cut the skin.  He also called for us to continue to work together as a group as dermatologists continue to be the expert group that provides skin care.

It’s been an exciting year under Dr. Siegel’s direction, and of course, we will always remember his getting his head shaved at the Summer AAD in Boston afterSkinPAC raised more than 1 million dollars!