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!

What SPF are you really getting in your sunscreen?

Image courtesy of Wikipedia user Axelv.
Image courtesy of Wikipedia user Axelv.

So what SPF (sun protection factor) should you really be using when you look for sunscreen?  The American Academy of Dermatology (AAD) recommends SPF 30 or higher.

But in a recent article by Yang, et al in the Journal of the American Academy of Dermatology (JAAD), researchers found that the actual SPF that is getting onto the skin is less.  Why is this? While we recommend to our patients to use 2 mg/cm^2 of skin (e.g. a shot glass full to cover the entire body), practically it gets applied unevenly and people use much less and don’t reapply the sunscreen as frequently as they should.  So, instead, these authors suggest that applying a sunscreen with higher SPF like 70+ is a good idea to account for potential under-application of sunscreen.  Interestingly, the cost of high SPF sunscreen is often about the same price as the lower SPF sunscreens, so hey, why not?

Summer AAD 2011

I spent this past weekend in New York City at the Summer American Academy of Dermatology (AAD) conference. What a nice well-run set of events the AAD put together. Although smaller in size compared to the annual meeting, there was a good selection of forums and events. It’s always nice to see everyone catching up at these conferences and working together to promote knowledge and innovation in the field. What continues to strike me is how diverse dermatology is. Dermatologists are interested in skin cancer, surgeries, cosmetic procedures, pediatrics, etc. Going to the AAD conference is like being a kid at the fair — you get to take sample talks in all these different parts of dermatology.

The other aspect of the conference that struck me is that people are really paying attention to the patient’s experience and talking about it. How do we blend quality care with customer service and patient satisfaction at the same time? The patient-doctor relationship is a complex one. The patient of course is no mere customer. But sometimes physicians can be overly focused on the medicine and forget that patient needs transcend purely medical needs. We need to communicate with patients and understand that personalization of the patient-doctor relationship makes it a successful relationship. And we need to be able to step back and assess when we aren’t doing the best job that we can do and improve upon that. It’s great to see people talking directly about it and coming up with solutions.