Figure 1. Wood light illuminating the highlighter outlines on the back.
Figure 2. Highlighters with patient identification stickers.
Tip 1: Marking Your Markers
In our contact dermatitis clinic, we use the method of using a Wood light and glow in the dark highlighter to perform our final patch test reads (Figure 1).1 To assure single patient use of the markers, we affix a patient identification sticker to the highlighter and the surgical marker and tape these to the patients’ chart (Figure 2). This prevents cross-contamination between patients, as we have been able to culture staph from the markers after use on patients.
Elise M. Herro, MD
Sharon E. Jacob, MD
Linda Loma, CA
Reference
1. Jacob SE. Procedure pearl: patch testing, a light in the dark. Dermatitis. 2007;18(1):57-58.
Tip 2: Relieving Bruising After Fillers
Bruise relief gel goes on after holding pressure for all injectable fillers. This has reduced the severity and frequency of bruising. We also sell it in the office for post-procedure bruising or senile purpura. We purchase a large tub of bruise relief gel called CytoActive (https://www.cytoactiveonline.com/). In order to reduce bruising, I have been looking into topical tranexamic acid and had some compounded to try. The jury is out on that one.
Anna D. Guanche, MD
Calabasas, CA
Tip 3: Write Down Diagnosis for Patient
If I give a patient a diagnosis of lichen planus or granuloma annulare or morphea, or some other uncommon condition, I make it a point to not only tell them the diagnosis and a brief synopsis of its implications and management, but I also write the diagnosis down on a scrap piece of paper so patients can do their own “Google research.” We know that patients do not remember much of what we say, and certainly if the medical lingo is foreign sounding, the likelihood of remembering is even less likely. I find the patients are more informed and are less likely to call the office back with questions.
Benjamin Barankin, MD
Toronto, Canada
Tip 4: Prophylactic Antibiotics
In cases where a surgery might not typically require postoperative antibiotics (as we commonly do in some areas like a perinasal or perioral flap or graft), some of my totally unscientific and unstudied habits have evolved to consider postoperative antibiotics in patients who have dirt under their fingernails or dust all over their glasses. My thinking is if they cannot take care of these basic clean functions, I cannot expect them to be anything but cavalier about taking care of the surgical site. In addition, I do ask patients to trim their nails the night before their cutaneous surgery and explain to them that under the nail is a common area to harbor infection, and it would be best to take that out of the equation. Moreover, I ask them to ensure that the scissors they use to trim bandages at home are either brand-new or have been cleaned with the jaws open in the dishwasher and alcohol used to wipe before each use. So often patients seem to think that their bathroom drawer scissors seem to be fine to trim bandages with the truth being that those scissors are used to trim nose hairs etc. and could transfer bacteria that could lead to infection.
Joel Cohen, MD
Englewood, Colorado
Tip 5: Premedicating Patients Prior to Potentially Painful Procedures
Generally, I give 40 mg to 80 mg propranolol 1 to 2 hours before a painful procedure. This is very helpful and well-tolerated, no record keeping and storage hassles like sedatives and does not interfere with the patient’s ability to drive home. Do not give propranolol to people with asthma, or it will make their asthma flare-up.
Kevin C. Smith, MD, FRCPC
Niagara Falls, Ontario, Canada
Dr. Barankin is a dermatologist in Toronto, Ontario, Canada He is author-editor of 6 books in dermatology and is widely published in the dermatology and humanities literature.
Figure 1. Wood light illuminating the highlighter outlines on the back.
Figure 2. Highlighters with patient identification stickers.
Tip 1: Marking Your Markers
In our contact dermatitis clinic, we use the method of using a Wood light and glow in the dark highlighter to perform our final patch test reads (Figure 1).1 To assure single patient use of the markers, we affix a patient identification sticker to the highlighter and the surgical marker and tape these to the patients’ chart (Figure 2). This prevents cross-contamination between patients, as we have been able to culture staph from the markers after use on patients.
Elise M. Herro, MD
Sharon E. Jacob, MD
Linda Loma, CA
Reference
1. Jacob SE. Procedure pearl: patch testing, a light in the dark. Dermatitis. 2007;18(1):57-58.
Tip 2: Relieving Bruising After Fillers
Bruise relief gel goes on after holding pressure for all injectable fillers. This has reduced the severity and frequency of bruising. We also sell it in the office for post-procedure bruising or senile purpura. We purchase a large tub of bruise relief gel called CytoActive (https://www.cytoactiveonline.com/). In order to reduce bruising, I have been looking into topical tranexamic acid and had some compounded to try. The jury is out on that one.
Anna D. Guanche, MD
Calabasas, CA
Tip 3: Write Down Diagnosis for Patient
If I give a patient a diagnosis of lichen planus or granuloma annulare or morphea, or some other uncommon condition, I make it a point to not only tell them the diagnosis and a brief synopsis of its implications and management, but I also write the diagnosis down on a scrap piece of paper so patients can do their own “Google research.” We know that patients do not remember much of what we say, and certainly if the medical lingo is foreign sounding, the likelihood of remembering is even less likely. I find the patients are more informed and are less likely to call the office back with questions.
Benjamin Barankin, MD
Toronto, Canada
Tip 4: Prophylactic Antibiotics
In cases where a surgery might not typically require postoperative antibiotics (as we commonly do in some areas like a perinasal or perioral flap or graft), some of my totally unscientific and unstudied habits have evolved to consider postoperative antibiotics in patients who have dirt under their fingernails or dust all over their glasses. My thinking is if they cannot take care of these basic clean functions, I cannot expect them to be anything but cavalier about taking care of the surgical site. In addition, I do ask patients to trim their nails the night before their cutaneous surgery and explain to them that under the nail is a common area to harbor infection, and it would be best to take that out of the equation. Moreover, I ask them to ensure that the scissors they use to trim bandages at home are either brand-new or have been cleaned with the jaws open in the dishwasher and alcohol used to wipe before each use. So often patients seem to think that their bathroom drawer scissors seem to be fine to trim bandages with the truth being that those scissors are used to trim nose hairs etc. and could transfer bacteria that could lead to infection.
Joel Cohen, MD
Englewood, Colorado
Tip 5: Premedicating Patients Prior to Potentially Painful Procedures
Generally, I give 40 mg to 80 mg propranolol 1 to 2 hours before a painful procedure. This is very helpful and well-tolerated, no record keeping and storage hassles like sedatives and does not interfere with the patient’s ability to drive home. Do not give propranolol to people with asthma, or it will make their asthma flare-up.
Kevin C. Smith, MD, FRCPC
Niagara Falls, Ontario, Canada
Dr. Barankin is a dermatologist in Toronto, Ontario, Canada He is author-editor of 6 books in dermatology and is widely published in the dermatology and humanities literature.
Figure 1. Wood light illuminating the highlighter outlines on the back.
Figure 2. Highlighters with patient identification stickers.
Tip 1: Marking Your Markers
In our contact dermatitis clinic, we use the method of using a Wood light and glow in the dark highlighter to perform our final patch test reads (Figure 1).1 To assure single patient use of the markers, we affix a patient identification sticker to the highlighter and the surgical marker and tape these to the patients’ chart (Figure 2). This prevents cross-contamination between patients, as we have been able to culture staph from the markers after use on patients.
Elise M. Herro, MD
Sharon E. Jacob, MD
Linda Loma, CA
Reference
1. Jacob SE. Procedure pearl: patch testing, a light in the dark. Dermatitis. 2007;18(1):57-58.
Tip 2: Relieving Bruising After Fillers
Bruise relief gel goes on after holding pressure for all injectable fillers. This has reduced the severity and frequency of bruising. We also sell it in the office for post-procedure bruising or senile purpura. We purchase a large tub of bruise relief gel called CytoActive (https://www.cytoactiveonline.com/). In order to reduce bruising, I have been looking into topical tranexamic acid and had some compounded to try. The jury is out on that one.
Anna D. Guanche, MD
Calabasas, CA
Tip 3: Write Down Diagnosis for Patient
If I give a patient a diagnosis of lichen planus or granuloma annulare or morphea, or some other uncommon condition, I make it a point to not only tell them the diagnosis and a brief synopsis of its implications and management, but I also write the diagnosis down on a scrap piece of paper so patients can do their own “Google research.” We know that patients do not remember much of what we say, and certainly if the medical lingo is foreign sounding, the likelihood of remembering is even less likely. I find the patients are more informed and are less likely to call the office back with questions.
Benjamin Barankin, MD
Toronto, Canada
Tip 4: Prophylactic Antibiotics
In cases where a surgery might not typically require postoperative antibiotics (as we commonly do in some areas like a perinasal or perioral flap or graft), some of my totally unscientific and unstudied habits have evolved to consider postoperative antibiotics in patients who have dirt under their fingernails or dust all over their glasses. My thinking is if they cannot take care of these basic clean functions, I cannot expect them to be anything but cavalier about taking care of the surgical site. In addition, I do ask patients to trim their nails the night before their cutaneous surgery and explain to them that under the nail is a common area to harbor infection, and it would be best to take that out of the equation. Moreover, I ask them to ensure that the scissors they use to trim bandages at home are either brand-new or have been cleaned with the jaws open in the dishwasher and alcohol used to wipe before each use. So often patients seem to think that their bathroom drawer scissors seem to be fine to trim bandages with the truth being that those scissors are used to trim nose hairs etc. and could transfer bacteria that could lead to infection.
Joel Cohen, MD
Englewood, Colorado
Tip 5: Premedicating Patients Prior to Potentially Painful Procedures
Generally, I give 40 mg to 80 mg propranolol 1 to 2 hours before a painful procedure. This is very helpful and well-tolerated, no record keeping and storage hassles like sedatives and does not interfere with the patient’s ability to drive home. Do not give propranolol to people with asthma, or it will make their asthma flare-up.
Kevin C. Smith, MD, FRCPC
Niagara Falls, Ontario, Canada
Dr. Barankin is a dermatologist in Toronto, Ontario, Canada He is author-editor of 6 books in dermatology and is widely published in the dermatology and humanities literature.
