September 2014 archive

Rotation 2: Dermatology – In the Eye of the Beholder.

website here During the summer following my first year of medical school, I had the opportunity to participate in Camp Discovery, a program that offers a unique summer experience to young people living with chronic skin conditions. After spending just a few days with the campers, my eyes (and heart) were opened and I realized just how narrow my original view of “dermatology” had been. While no one can deny the high prevalence of acne, it is but one of more than 2,000 skin conditions. The amazing young people I had the privilege of working with live with skin conditions far more complex and devastating, and, as a result, suffer from higher rates of psychological distress, social withdrawal, lack of confidence and depression.

livial reviews uk Since my summer experience at Camp Discovery, I have spent a lot of time reflecting on the visual indications and ramifications of disease. More specifically, I have been intrigued by the subtle difference between wearing signs of disease for all to see (i.e. an insulin pump for a diabetic, a midline scar for someone requiring open heart surgery) and disease actually being what you see.

Throughout the course of my 3-week dermatology rotation (a rotation not originally in my schedule but added at the last minute due to my recent, newly discovered fascination in procedural-based medicine), I had the opportunity to further explore this idea of disease actually being what you see. Unlike the majority of specialists, dermatologists (as well as pathologists and radiologists) are unique in their heavy reliance on pattern recognition in order to establish a diagnosis. In other words, dermatologists see a pattern with their eyes; they use the morphology of the primary lesion as well as its color, pattern of configuration and distribution in order to recognize and diagnose the 2,000+ possible skin conditions. As 25 skin conditions account for 75% of all office visits, arriving at the correct diagnosis 100% of the time is not as easy feat; it takes a certain eye to be able to recognize something you may have only seen in a book, once, at some point in time.

While I enjoyed working with the dermatology residents, learning how to use my eyes and the patterns I saw in order to diagnose actinic keratoses, basal and squamous cell carcinomas, seborrheic keratoses and psoriasis, I found I was more interested in the process and in acquiring the skill than in skin itself. Although an incredibly useful rotation and one I would highly suggest, dermatology might not be the right fit for me. But only time will tell!