photo credit: bettergov.org
The ABC’s. It’s one of the first things we learn as kids right? We even have a catchy little song to help make the alphabet easier to remember. It seems pretty simple….until it isn’t. In the field of dermatology the alphabet is used as an acronym for the clinical detection criteria of melanoma, the deadliest form of skin cancer. The conventional ABCDE’s of melanoma are A
olor variegation, D
iameter >6mm, and E
volution [any change in morphology or symptoms of the lesion]. A recent study
conducted through the University of California, San Francisco, has demonstrated that we need to learn some new ABCD’s. This retrospective study evaluated patients diagnosed before the age of 20, during the time period from 1984-2009. 60 pediatric patients with melanoma as well as 10 pediatric patients with ambiguous melanocytic tumors treated as melanoma (i.e. lesions had atypical clinical presentations and ambiguous microscopic features). The study patients were divided into group A for ages 0-10 and group B for ages 11-19. The conventional clinical ABCDE detection criteria was absent in sixty percent of group A patients and 40 percent of group B patients. What emerged from the study was a new set of ABCD’s common to diagnosis including A
melanosis (lack of pigment), B
leeding and “b
umps”, uniform C
olor, variable D
iameter and D
e novo development. Not only were the clinical features different from the conventional, but it was also found that current microscopic subtypes of melanoma could not be applied to 44 percent of cases.
What does this all mean? It means that more research will need to be done to expand upon this research to help determine the most appropriate clinical and microscopic detection criteria for melanoma as it relates to the pediatric population. The good news, is that it means that the field of dermatology continues to evolve and change as new information reaches the forefront to best diagnose and manage our patients. It also means that as parents and caregivers of children we need to have a heightened awareness of bleeding lesions, bumps and lumps both colored and colorless that have newly developed or recently changed and have them evaluated. It means we need to learn our ABCD‘s.
Ok, ok, so maybe it’s not the actual “fountain of youth”, but recent research has highlighted that daily sunscreen use can slow the signs of aging. For reals. The recent Annals of Internal Medicine study demonstrated that study participants (adults younger than 55) who used sunscreen daily showed no detectable increase in skin aging after 4.5 years. As another plug for daily sunscreen use, the study showed that skin aging from baseline to the end of the trial was 24% less in the daily sunscreen group compared to a group of adults using sunscreen at their discretion. As with most data, additional research should be done to further investigate results, but in the meantime if you are looking to maintain those youthful good looks, try adding sunscreen or moisturizer with sunscreen into your daily routine and make it a habit.
See you in the shade!
Today is a day of celebration. We celebrate our country. We celebrate the freedoms we enjoy as a result of our forefathers declaration of independence. We celebrate the special memories we get to create with family and friends as we gather around picnic tables, bonfires and watch Technicolor fireworks illuminate the sky in honor of this declaration. Sure, we celebrate a day off work and throw in some good sales too, why not? In the spirit of celebration and honoring amazing things, I wanted to share my adoration for Camp Korey. What is Camp Korey? I am so glad you asked! Camp Korey is an amazing haven that provides recreational programs for children and young adults with serious medical conditions who are unable to attend traditional enrichment programs due to their high medical needs. Camp Korey is a place that provides kids the opportunity to build self-esteem, meet friends that can relate to similar challenges and empower them to try new things rather than feeling isolated or limited as they might elsewhere. It is the place where pure joy is palpable.
I had the privilege of volunteering at Camp Korey as medical staff this past week. On a larger scale, the camp is part of the Serious Fun Children’s Network and in partnership with the American Academy of Dermatology hosts Camp Reflection, which is a camp specifically geared towards children with skin disorders and is held on the Camp Korey campus. As a dermatologist, I had the opportunity to oversee the medical care of children with both relatively common skin conditions such as atopic dermatitis to rare entities that most of us only read about during our training. The diversity of skin disorders at camp may have been vast, but the love of fun, camaraderie, mutual respect and unwavering support was homogenous. The kids had a blast, and no one was left behind or left out. From the beginning of camp where a young woman had such severe social anxiety that she wouldn’t utter a word to me, to the end of camp where she bestowed upon me a smile that could light up the darkest of skies, it was magical. Although I was there to serve in a professional capacity as a physician, I was gifted a profound personal re-awakening. Today is a day of celebration of our nation’s independence, but I would suggest that every day should be a celebration. The kids at Camp Korey reminded me that we can and should celebrate our abilities, but we should also celebrate our limitations to help catapult us beyond them to achieve true bliss. Happy 4th everyone!