Dealing With Apremilast Adverse Reactions

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Any views and opinions expressed are those of the author(s) and/or participants and do not necessarily reflect the views, policy, or position of The Dermatologist or HMP Global, their employees, and affiliates. 

Say Goodbye to GI Side Effects

Seventeen percent of patients taking apremilast experience secretory diarrhea in the first 1 to 2 weeks of treatment. Although this usually resolves spontaneously with continued apremilast use, some patients stop treatment due to the gastrointestinal (GI) adverse events. If apremilast is the treatment of choice, dietary supplemental zinc 50 mg daily eliminates the medication induced diarrhea and 1 teaspoon of peanut butter taken with apremilast will reduce nausea.

Wayne Fujita, MD
Aiea, HI

Accommodating Patients

Sometimes I have friends, relatives, or neighbors who ask me if they can visit me in my office. I do not always agree. But when I do agree, one of my favorite responses is, “Sure. Maybe come tomorrow at 12 noon and we can meet over my lunch break.” Similarly, if a referring physician calls and asks me to see one of their patients urgently, I like to offer the next day “at 12 noon, so we can meet over my lunch break.” The statement often has several effects.

First, the person would have been happy to be invited to meet with me at any time of day, such as 9 am or 2:30 pm. But the suggestion that it is specifically over my lunch break often engenders a special level of appreciation and gratitude that seems to enhance the friend/relative/neighbor/referring physician connection. The referring physician will be quite loyal in referring patients to our practice in the future.

Second, if the patient was tempted to bring in a laundry list of medical complaints or a stack of documents for me to review, the knowledge that I am meeting with them over my lunch break often discourages them from doing so.

Lastly, it indirectly suggests to the patient or referring physician that my appointment bookings are full for days or weeks to come. That we can accommodate the patient on short notice “over the lunch break” should not be taken as an indication that this type of scheduling is our norm.

Norman Wasel, MD
Toronto, ON, Canada

Q-tips Less Scary Than Cryospray Near the Eyes

Sometimes patients are apprehensive about liquid nitrogen (LN2) treatments around the eye. To alleviate this fear and help with precise placement of the LN2 while minimizing excess peripheral treatment, use a cotton tipped applicator (CTA). Spray the LN2 on the CTA, then touch the patient with the CTA until desired frosting is obtained.

Debbie Adams Hauser, MHS, PA-C
Winston-Salem, NC