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Health Enewsletter March 2016

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Management of Acne and Cysts

Walk to Cure Arthritis is Saturday June 4th 2016 - Shelby Farms Park - Memphis TN

Dr. Chapman Comments on Exercise

Dr. Woodbury visits the "Day on the Hill" in Nashville Tuesday March 1st 2016

Commenting on the FDA's Proposed Regulation Regarding Indoor Sunlamps

Rheumatology and Dermatology Associates
8143 Walnut Grove Road
Cordova TN 38018
1-901-753-0168; Rheuderm@Comcast.net
 

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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
Rheuderm@comcast.net
 

 Rheumatology and Dermatology's Health Enewsletter logo pulls upon the idea of doctors working with families to improve well being:
 
Acne can take a toll on one's self-image. Treatment options include topical medications and oral antibiotics.
 
Management of Acne and Cysts
Acne—also called folliculitis—is the result of clogging of the openings of the oil glands, resulting in comedones (blackheads and whiteheads), raised bumps (called papules and pustules), or sometimes even in actual cysts, which are deeper nodules in the skin. A skin cyst (epidermal cyst) is a benign nodule which sometimes develops when an oil gland gets clogged, and develops infection. These nodules are sometimes called sebaceous cysts. Acne starts in the teenage years due to changes in hormones. It affects many people into their 20s or 30s, or beyond. Acne is certainly worse in certain families—so we believe getting acne is partly a genetic tendency. And cysts are more common in those with acne.
 
Milder cases of acne can often be managed with over-the-counter benzoyl peroxide-containing washes of gels. It’s best though to get more severe cases evaluated medically, because even moderately severe acne can lead to scars. We dermatologists often use prescription topical antibiotics (i.e. on top of the skin) in combination with retinoid creams like adapalene or tretinoin.
More stubborn cases can benefit from one or several of the newer anti-acne agents, such as tazarotene gel, azelaic acid cream, or topical dapsone gel.


Acne really is more than skin deep. Acne often hurts one's self-esteem. Getting acne better can correspondingly help one's self-esteem, leading to better confidence in facing life's challenges. This child deserves to stay clear, complexion-wise, when he enters adolescence.

More severe acne also often benefits from courses of certain oral antibiotics. It’s essential to keep follow-up visits so we can develop a long-term strategy.
The goal of acne treatment with oral antibiotics is to develop a strategy whereby the patient gets off of the oral antibiotics as soon as possible, so as not to promote antibacterial resistance.
 
One sometimes also considers an oral medicine called isotretinoin (i.e. Accutane) if tapering off the oral antibiotics is difficult, or if scars are developing. Isotretinoin treatment offers the hope of clearing acne, but it does have significant side-effects: it must never be used by women who may be pregnant during the six months of isotretinoin therapy, due to the large risk of birth defects in the baby. It can also have effects upon the mood of teenagers, and it causes skin and mucous membrane dryness. So it’s only an option for more severe cases of acne because it has significant associated side-effects that require monitoring.
In fact, the United States now has a mandatory national registry for all patients going onto isotretinoin capsules – called IPledge®. The goal of this registry is to reduce pregnancies within patients on isotretinoin to zero. All patients being treated with isotretinoin capsules much be entered into this online registry – and the rules of being treatment require a monthly face-to-face visit with the treating physician – as well as laboratory confirmation that female patients under treatment are not pregnant.



This patient's cyst - the nodule on her left posterior neck - may respond to oral antibiotics - or it may have to be drained. We often consider a cyst the attempt by the body to wall off an infected hair follicle. But sometimes the walled off area starts to leak fluid - and then a more serious infection can get started. So prompt evaluation can allow the area to heal. 

Rheumatology and Dermatology Medical Assistants Vicki and Shirley are beckoning you to participate in the Arthritis Foundation’s
Walk to Cure Arthritis
Saturday June 4th 2016.

Generally 9:00 AM. (time pending)
Location: Shelby Farms, Memphis.
500 North Pine Lake Memphis TN
For more:  Michelle Dooner: mdooner@arthritis.org, or call 1-901-322-1517.

Rheumatology and Dermatology staff and friends participated in the Walk to Cure Arthritis, Saturday morning June 6th 2015, at Shelby Farms. We have been supporters of the Arthritis Foundation's events for more than 10 years. 





Dr. Cathy Chapman
shares an opinion on exercise:


OK, is Exercise
Really Good or Bad
for Arthritis?


Although it is known that injuries can predispose to arthritis, all forms of arthritis can benefit from exercise.  Range of motion exercises (stretching) as well as aerobic exercise helps improve mobility and decrease pain, stiffness, and swelling.  Often, just starting with a few extra minutes per day can help you get the exercise you need. Consider taking one flight of stairs up or two flights down, park at the back of the grocery store parking lot and walk in, or get a low impact video and do it at home. Water exercise such as aerobics is a great option. Classes are available at local athletic facilities such as the Germantown Athletic Club and the Jewish Community Center. It is okay if you are sore the day after you exercise the first few times, but if you have substantial pain then limit subsequent exercise. Get going and feel better soon!  - Cathy Chapman MD (03/18/2016)

Emily Woodbury designed our practice's grassroots logo to illustrate
that people benefit most when patients and healthcare personnel work together in a team-wise approach. Everything comes together in a big circle.
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Dr. Woodbury went to Nashville 03/01/16, for the Tennessee Medical Association’s “Day on the Hill.” Over 200 physicians met with legislators on healthcare bills and unfair Tenncare audits of primary care physicians.  Here Dr. Woodbury reviews healthcare-related legislaton with (left to right) Representative Steve McManus (Cordova-Tennessee District 96) and Representative Curry Todd (Collierville/Germantown-TN District 95).
 
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The Proposed FDA Regulation on Indoor Sunlamps:
 
A million Americans are daily users of indoor sunlamps, and 28 million are users of a sunlamp at least once a year. About 75,000 new cases of invasive melanoma will be diagnosed this coming year, and unfortunately 9700 Americans will die of melanoma this coming year. The ultraviolet light in a sunlamp is over 10 times more concentrated than that in ambient sunlight. The FDA has now reclassified sunlamps from Class I devices (low risk) to Class II devices (moderate risk). As dermatologists, we know that they are actually high risk devices.
 
  The FDA is receiving commentary on the proposed new regulation regarding indoor sunlamps, particularly the requirement that users of sun lamps be provided with a User Acknowledgement Form, and also that use of such lamps be restricted to patient 18 years of age and above. The American Academy of Dermatology Association’s web portal to facilitate commentary on the regulation is available at:
 
https://www.aad.org/advocacy/skin-cancer-and-indoor-tanning/stop-skin-cancer
 
  Be aware that the commentary period on this proposed regulation closes at 5:00 PM Eastern Time, on Monday 03/21/2016.
 
  I also plan to attend the Tennessee Medical Association meeting in Nashville, TN 04/28/2016 to 05/01/2016, and I shall present proposed resolutions to ban tanning below the age of 18 in Tennessee, and also to allow students time to apply sunscreen before recess activities in schools.

George Woodbury Jr. M.D. 03/18/2016
 

For questions, comments, or if you would like to
be added to our email list, please email “purplhealth@yahoo.com”or call 1-901-753-0168.
George Woodbury Jr. M.D. (03/19/2016)