Taxing cosmetic procedures in the states!

In a surprising move  The White House and Senate Democrats announced “Botax.” they want to tax cosmetic procedures  like Botox, tummy tucks, nose jobs and lifts to pay for costly health care .
it is estimated that  it would earn Uncle Sam about 5.8 billion over the next decade.
Skin-smoothing Botox injections could be hard-hit. There were some 4.7 million last year [...]

diabetic with ulcers

 
an 80 year old female, who has advanced dibetes with blindness, gastric paresis and renal failure on dialysis complained of ulcers on her lower extermeties for the last few weeks. they were on the knees, legs and feet. some were painful. on examination she had multiple shallow ulcers of varying sizes, with sorrounding erythema. it was [...]

facial rash

33 year old indian with 9 month history of this recurrent rash which improves promptly on topical steroids only to relapse after stoping treatment. he works indoors, his only exposure to sun is when he is going to or from work. rash it asymptomatic, no joint pain or history of mouth ulcers. on examination he [...]

when to biopsy?

this was sent from my freind. i know the pic is blurred (mobile pic) he noticed this lesion for 3 weeks not painful no hx of trauma before , it started as such, no previos lesion.
so somone told him that it needs to be biopsied  (it could be cancer)! he was worried . since he s living in [...]

Do you have a name for it?

are these fordyce spots?
and how would you treat it?
i thought about electrocautery but am afraid of scarring especially in this area.
what would you do?

what do you think of the local brand of topical steroids?

hey guys,
i have been using theses local creams (ELICA) manufactures here or in nieboring countries. and patients just swear they not getting the same results like with ELOCOM , is it just my patients or are you haveing the same problem.
 what about other treatments? i herd there is indian roacutane …they complain about that too?and hairgrow, do [...]

beware of the killer!

50 year old female had a dark mole for years. it started to get bigger since 2 years, she went to a private clinic got it exised only to recur after 18 moths. it wasnt sent for biopsy at that time!!we did a biopsy it came melanoma in situ, but that was taken fom th [...]

puzzling rash

our patient is 18 yrs old with her complain starting since the age of 4. she always had it on the knees and the elbows, used many creams over the years , improved sometimes clearing but she always had a relapse. there were times when it improved without treatment. she also these lesions are asyptomatic. [...]

a neck lesion?

A 19 years old man came to us with a lesion on his neck that started since he was 4 yrs old (or ealier he s not sure) , the lesion stabilised . its asymptomatic and theres nt a simillar lesion elswhere.
on examination he had a brownish well defined patch covering the left side of [...]