Health Enewsletter October 2016

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Solar Keratoses: A Growing Problem

Legislative Conferences in Washington DC: American College of Rheumatology and the American Academy of Dermatology Association
Legislative Corner "To Do" List:  Alerting our federal senators to the FDA's proposed restrictions on compounding by physicians'  offices

Rheumatology and Dermatology Associates
8143 Walnut Grove Road
Cordova TN 38018

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Dr. George
Woodbury and Dr. Cathy Chapman
Rheumatology and Dermatology Associates
8143 Walnut Grove Road
Cordova, TN 38018
 (901) 753-0168

This patient developed several enlarging growths on her face, lesions which I diagnosed as solar keratoses, and which could be treated with cryotherapy, or freezing.

"Solar Keratoses: A Growing Problem"

If you have skin lesions which are enlarging or scabbing, or failing to heal, consider getting the lesions diagnosed. One possible cause is solar keratoses, also called actinic keratoses. These are areas of thickening of the skin—usually on the face, neck, arms, and back—due to accumulated, excessive sun exposure. At times such a lesion can also be an early skin cancer, so we dermatologists sometimes take a test called a biopsy to clarify the correct diagnosis.

  Solar keratoses are what are called benign lesions, meaning not causing harm. But between 5 and 20% of solar keratoses go on later in life to become malignant lesions called squamous cell skin cancers. Solar keratosis are benign, so they can be managed by the dermatologist by a freezing treatment in the office, called cryotherapy, involving application of liquid nitrogen to the lesions. At times, we have to cut out the lesions, particularly if they are deep or large. And at times, they can be managed with one of several prescription creams or gels, such as 5-fluorouracil, ingenol mebutate, or imiquimod.

  Solar keratoses are becoming an epidemic in the United States, especially in the South, possibly because of our love of the sun. In 2016, we will diagnose about 400,000 instances of squamous cell carcinoma, and many times that number of Americans will be diagnosed with solar keratoses. Fortunately, use of broad-spectrum sunscreen (the type of sunscreen that protects against both UVB and UVA rays) with an SPF rating of 30 or above provides protection. The old adage “an ounce of prevention is worth a pound of cure” holds true. Consider getting a total-body skin check-up.   
The photo below - courtesy of the American Academy of Dermatology  and used by permission - shows a patient with a scabbed lesion of the forehead which was found upon biopsy to be a skin cancer. This year, upwards of 400,000 cutaneous squamous cell skin cancers and two to three million basal cell skin cancer will be treated in the United States - and unfortunately that number is growing year by year.


This patient to the left developed what was found after a test called a biopsy to be a squamous cell cancer.We encourage people with bleeding or enlarging lesions to get them checked right away. Early treatment means a smaller scar. Photo courtesy of the American Academy of Dermatology.
Legislative Conferences: American College of
Rheumatology and the American Academy of
Dermatology Association:
09/11/2016 to 09/13/2016:

Dr. Chapman - flanked by Dr. Chris Morrison,
of Kingsport TN, and Senator Lamar Alexander, in Washington DC, on

Dr. Woodbury attended the American Academy of Dermatology's Legislative Conference, in
Washington DC, 09/11/2016 to 09/13/2016.
Here (left to right) are Gabi Brockelsby, Murfreesboro,
TN; Dr. Adrian Rodriguez, Nashville, TN; Dr. Albert Kattine, Murfreesboro, TN; Senator
Lamar Alexander; Dr. John Binhlam, Brentwood, TN; Ms. Brockelsby; and Dr. George Woodbury,
Cordova, TN, as part of "Tennessee Tuesdays," on 09/13/2016, wherein the legislative staff from our state
get to meet with constituents.

Key topics of discussion included
  *The 21st Century Cures Act, which would update funding for both the
  Federal Drug Administration and the National Institutes of Health
  *Proper accountability of correct provider panels within Medicare Advantage plans
  *Reducing administrative burdens within the Medicare program, including the MACRO program.


Rheumatology and Dermatology Medical
Assistants Vicki and Shirley encourage
everyone to use proper sun safety:
  *Make sure that your sunscreen is rated
  SPF 15 or higher and apply it every 90 minutes.
  *Make sure that your sunscreen protects against
  both UVB and UVA rays: that it's "broad-spectrum."
  *Get a skin check-up periodically.

Advocacy Corner: 

Compounding of medications is preparing medicines in a facility based upon rules about how these medications can safely be made up.  The Food and Drug Administration is considering establishing extensive new regulations that will define “compounding facilities” to include physician offices that mix up drugs for patients in-house. Since dermatologists and rheumatologists use local anesthetic that can be made less painful by mixing the lidocaine anesthetic in-house with a buffer called bicarbonate, these regulations would restrict our ability to continue to use these less-painful local anesthetics. Such regulations to be imposed upon doctor’s offices are neither necessary nor needed.
Kentucky Senator Rand Paul has authored a letter circulating in the federal Senate in opposition to these new regulations. Please contact your two senators' offices to ask them to promptly sign Senator Paul's letter to the FDA in opposition to these rules:

 Consider sending an Email to your senators: "please sign Senator Rand Paul's letter to the FDA against restrictions on physicians' offices ability to compound medications."

Tennessee:  Senator Lamar Alexander (1-202-224-4944 or 1-901-544-4224); Senator Bon Corker (1-202-224-3344 or 1-901-683-1910).
Mississippi:   Senator Thad Cochran: 202-224-5054: 662-236-1018; Senator Roger Wicker: 202-224-6253;662-429-1002;
Arkansas:  Senator John Boozman: 202-224-4843; 870-268-6925;;
Senator Tom Cotton: 202-224-2353;  870-897-7450.
Dr Woodbury 10/10/2016
-Dr. Woodbury 10/10/2016

For questions, comments, or if you would like to
be added to our email list, please email “”or call 1-901-753-0168.
George Woodbury Jr. M.D. (10/10/2016)


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Rheumatology & Dermatology Assoc, PC. · 8143 Walnut Grove Rd · Memphis, TN 38018 · USA