Dermatologist/internist @ MGH- Love complex/onco-dermatology & MedEd | Harvard Derm APD | Dad | Husband | Recovering a cappella nerd. Tweets are mine & ≠ advice
7 added to My Authors
Jun 27 • 4 tweets • 2 min read
Reminder for our new resident peers:
If you find yourself in the role of a consultant, be kind. The person paging you is asking for help from you, the expert. It's an opportunity to help & educate.
Remember how nervous you might've been the 1st time you called a consult!
Yes, all those "silly consults" add up to be more work. But remember, you are the expert now, and what is "silly" to you may be truly confounding to the primary team. Something that might seem so simple to you is only that way because of your training, and that's pretty great.
Just a few years ago, Sezary Syndrome (SS) was thought to be the leukemic variant of Mycosis Fungoides (MF). We basically thought people had MF, it would keep getting worse, and then it would turn into SS.
Did you know that in Wilson Disease, despite high ALT/AST/bilirubin, Alkaline Phosphatase (AP) stays normal or low?
It made me ask "why," & so, I present the answers I found in #tweetorial form.
A rare non-derm, #medtwitter 🧵
Let's start by establishing that Wilson Disease is a multisystem process wherein copper deposits in various tissues (liver, brain, eyes) because of improper transport.
A mutation in ATP7B causes this, and the depositional process leads to disease manifestations. 2/
May 31 • 18 tweets • 9 min read
With Memorial Day behind us, we're getting into the summer months, so time for a #tweetorial on:
First of all, I have no COIs with any makers of sunscreen! Even so, I'm going to avoid talking about any brands. Instead, we'll focus on the different factors you should consider when picking your favorite.
What is your current preference for sun protection (if any)?
How is this different than Pemphigus Vulgaris (PV)? Why do we not see blisters often? What's the desmoglein compensation theory?!
Read this #MedEd/#FOAMEd#thread & get your learn on! 2/ The "pemphigus" part of the name means we are similarly dealing with an EPIDERMAL blistering disease, much like it's better known cousin, "pemphigus vulgaris" (PV).
If you haven't had a chance yet, take a look at my prior #tweetorial on PV:
What color do you expect to see when you hear NXG?
2/ Yes, yellow! Whenever you hear something is “xanthomatous,” expect to see something yellow on exam! Kudos to all of you who guessed some form of a xanthomatous process on our prior mystery diagnosis tweet!👇
Let's start ourselves off with a question: Which one of the following conditions will lead to scarring?
2/ The correct answer is Pyoderma Gangrenosum! This illustrates a quick first point - scarring only occurs if you damage the skin into dermis and beyond. Epidermal damage heals without scarring, which is why the first 3 don't lead to scarring!
This is THE most common nail condition- so follow along!
Education from @naildisorders #medstudenttwitter#medtwitter#meded#FOAMed2/
Onychomycosis is more common in adults than kids.
Trauma, diabetes, immunosuppression, tinea pedis, psoriasis, and family history are some risk factors
Pro tip- check the feet for tinea pedis if you suspect onychomycosis!
Among BOTH males and females in the US, how common is melanoma?
2/ Melanoma is the 6th most common malignancy (that's tracked) for BOTH men & women. Basal cell carcinoma is actually the MOST common cancer in the US, but we don't track it.
While melanomas are 6th, in certain groups (eg: women age 25-30), it is the #1 cause of cancer death!
AKA: "How a dermatologist approaches a rash!"
pc:@AADskin2/ So what exactly is a reaction pattern? It's an organizational way to think about rashes so that we can bucket them. There are FIVE main reaction patterns: