FIVE helpful tips for my future patients! --What I learned on my Dermatology Rotation!

July 12, 2017


For my elective, I spent my time at Lakeway Dermatology in Morristown under a handful of great providers. Dr. Fulk (pictured above) was my original preceptor but he thought it would be beneficial for me to learn everyones techniques and approaches in this field, and boy was he right because everyone does things just slightly differently! Anyway, here are 5 things I learned that are not too difficult to explain to someone that is not in the medical field, I hope you guys learn something. :) 

  1. Diflucan is an anti fungal medication, it is commonly used to treat yeast infections, ring worm and other fungal infections. For this medication to be properly absorbed, it needs an acidic environment. If you are on PPI’s (Nexium, Protonix, Prilosec) or H2 blockers (Zantac, Pepcid), you will have a hard time absorbing this medication and will not notice any relief after your completed treatment. Try dosing your medications at different times (try Diflucan in the AM and heartburn medications in the PM) and drink a nice acidic glass of orange juice to see maximum benefit! 

  2. If you are using a topical steroid (hydrocortisone) for psoriasis, eczema or poison ivy— DO NOT exceed treatment for over 2 weeks because it can cause skin atrophy (thinning) - there are a few exceptions to this rule but talk to your doctor before using it longer than two weeks. When your skin thins, you are more likely to cause damage (like cuts and bruises). 

  3. Ivory and Dial soap are the most drying soaps on the market, if your skin is always dry— change your soap! Consistently using drying soap on your hands will lead to irritated and cracked skin. Dove is a good alternative. (Soap needs to be basic to provide us with that squeaky clean feeling, but some soaps have such a high pH that they actually damage the skin- remember, only use soap when it is necessary and try not to use too much of it- even the least drying soap is still drying). Also, try to only wash your hands when it is necessary, if you can protect your hands from too much water (use gloves for dishes), you can prevent skin conditions like eczema! 

  4. If you are a patient over 50, and your primary care provider has been treating you with a topical cream for your eczema that has not improved your condition, it might be time to consider another diagnosis. Unfortunately, Multi Focal Basal Cell Carcinoma can look very similar to eczema, here are some ways to tell the difference!

    a) MFBCC is well demarcated, eczema usually follows a diffused/ nonspecific pattern

    b) MFBCC will look shinny/pearly (when observed closely, the lesion may also have superficial red vessels running through it) 

    c) MFBCC will not itch, eczema is usually itchy and will respond to steroid cream

  5. Do you suffer from cold sores? And do you sometimes find yourself biting your nails? Well, if you have ever experienced swelling of a digit right around the nail bed--this may be coming directly from the cold sore in your mouth! Crazy, huh? Herpes Simplex is the virus that causes cold sores in the mouth and it is also responsible for causing something called Herpatic Whitlow. When this virus gets into your finger, you are left with a very tender and throbbing condition that is going to leave you in agony. Analgesics (Motrin, Aleeve, Advil) may help this condition but if you don't notice any benefit within a couple days, you may need to see your doctor for an antiviral medication! 

    These were just a few thoughts that came to my head that were worthy of sharing! I'll do my best to add more when I get a chance. Send me an email if you have any questions or if something doesn't make sense to you. Thanks for reading. 

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