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    February 14, 2020
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Business Insight Misdiagnosed? Not quite. Dermatology is a very particular and unique specialty. Everything in skin diseases seems to be seen by careful visual observation. You look at the patient and you can easily see if there are moles present, how dark they are, if there are scratch marks from itching, if there is puss or oozing present showing some signs of infection. Easy? You may think so but it is not so simple. First of all, many skin disorders are similar at the first sight and often, generally called eczema. This is a very simplified diagnosis because it means everything and nothing. The treatment prescribed is usually topical or systemic steroid and mild cases usually clear nicely until the next time. The true and critical point of proper diagnosis is to differentiate 'eczema' identifying certain types of cells, like as a disease: we see psoriasis, atopic melanoma. dermatitis, allergic reactions, all of them called eczema. Each of them should be treated in a different manner as their origin is different. Many of today's very difficult cases are discussed by known skin eczemas are of immune system origin and their wide-spread done to agree on circumstances and presence may require immune system opinions, all in order to find a common agents rather than frequently used and repeated steroids. Many of allergic reactions can increase with time if their like psoriasis not always respond to source of allergen is not eliminated every treatment in the same way. Each from the patient's life. In a similar way, moles are different may have some genetic disposition to from each other as well. We highly respond better to one type of treatment encourage patients to self-check their than to others. The most interesting moles and report changes or newly fact is, for instance, that some patients created moles to us but self-check is with psoriasis love receiving UVB not equal to a medical examination. therapy and clear on it nicely while And even a careful examination can be misleading and will require microscopic skin whatsoever. I wish I could answer confirmation. The tool dermatologists use as a confirmation of their visual assessment others Advil. is a biopsy. It is a simple procedure of collecting patients should not self-treat their a sample skin 'cut', done under local skin disorders, especially based on anesthetic, painless and often very computer pictures. Experimenting and short in time. The sample of skin is guessing diagnosis is the best way to be then examined by a pathologist, with misdiagnosed. utilization of some reagents, especially That pathological exam is formulated into a report with some further recommendations. At times, some a dermatologist and pathologist. It is denominator of the treatment. Even easily identified skin disorders patient is very much individual and others have no improvement to their why but we do not know. It is like with a headache: some like Tylenol and The most important fact is that Michael Bukhalo, MD Arlington Dermatology 5301 Keystone Court Rolling Meadows, IL 60008 Tel. 847 392 5440 | www.arlingtondermatology.net Business Insight Misdiagnosed? Not quite. Dermatology is a very particular and unique specialty. Everything in skin diseases seems to be seen by careful visual observation. You look at the patient and you can easily see if there are moles present, how dark they are, if there are scratch marks from itching, if there is puss or oozing present showing some signs of infection. Easy? You may think so but it is not so simple. First of all, many skin disorders are similar at the first sight and often, generally called eczema. This is a very simplified diagnosis because it means everything and nothing. The treatment prescribed is usually topical or systemic steroid and mild cases usually clear nicely until the next time. The true and critical point of proper diagnosis is to differentiate 'eczema' identifying certain types of cells, like as a disease: we see psoriasis, atopic melanoma. dermatitis, allergic reactions, all of them called eczema. Each of them should be treated in a different manner as their origin is different. Many of today's very difficult cases are discussed by known skin eczemas are of immune system origin and their wide-spread done to agree on circumstances and presence may require immune system opinions, all in order to find a common agents rather than frequently used and repeated steroids. Many of allergic reactions can increase with time if their like psoriasis not always respond to source of allergen is not eliminated every treatment in the same way. Each from the patient's life. In a similar way, moles are different may have some genetic disposition to from each other as well. We highly respond better to one type of treatment encourage patients to self-check their than to others. The most interesting moles and report changes or newly fact is, for instance, that some patients created moles to us but self-check is with psoriasis love receiving UVB not equal to a medical examination. therapy and clear on it nicely while And even a careful examination can be misleading and will require microscopic skin whatsoever. I wish I could answer confirmation. The tool dermatologists use as a confirmation of their visual assessment others Advil. is a biopsy. It is a simple procedure of collecting patients should not self-treat their a sample skin 'cut', done under local skin disorders, especially based on anesthetic, painless and often very computer pictures. Experimenting and short in time. The sample of skin is guessing diagnosis is the best way to be then examined by a pathologist, with misdiagnosed. utilization of some reagents, especially That pathological exam is formulated into a report with some further recommendations. At times, some a dermatologist and pathologist. It is denominator of the treatment. Even easily identified skin disorders patient is very much individual and others have no improvement to their why but we do not know. It is like with a headache: some like Tylenol and The most important fact is that Michael Bukhalo, MD Arlington Dermatology 5301 Keystone Court Rolling Meadows, IL 60008 Tel. 847 392 5440 | www.arlingtondermatology.net