With COVID-19 officially being classified a pandemic, we as a healthcare facility need to act appropriately and carefully to protect our compromised patients, staff, and every person for that matter. Effective immediately, Midlands Clinic kindly asks that all patients experiencing flu like symptoms or who have traveled overseas or to infected areas in the last 14 days call our clinic at 605-217-5500 to receive instruction on how to move forward with any appointments.
Right now, during the outbreak of COVID-19, we need your help to protect our ability to take care of you, your family and the patients who need us the most. We are continuing to explore ways to practice social distancing at our office and will continue to update you of these practices. One of those practices being implemented is telehealth visits.
Midlands Clinic now offers virtual visits! If you have an upcoming appointment, our providers may be able to continue your care via a secure virtual visit. We will use a platform called Doxy.me. Doxy.me is a secure site that allows you to have a video appointment with your provider through your desktop, tablet, or smartphone. It is extremely simple and easy to use for both clinicians and patients.
If you have an upcoming appointment, a representative from our office may reach out to you and offer a virtual or telehealth visit if they feel this is a good alternative for you. If you need an appointment or would like to reschedule your appointment, you may call us at 605-217-5500, Opt. 8, to see if you would be a candidate for a virtual or telehealth visit.
We are right in the middle of summertime, and that means sunny days and warm weather. People are outside in the sun with their skin exposed trying to soak up the rays. As they shed the layers of clothing, it often prompts people to take a closer look at their skin and what they should do to protect it and could do to improve it. Throughout the summer I am going to post a bit of advice on ways to protect and enhance your skin.
Take a look at the photo above. Does one photo automatically make you think that person is happier, friendlier and even more beautiful? Did you have a check list you went through to determine which photo one was more attractive than the other? Our minds subconsciously recognize aspects of people’s faces and bodies that allow us to make the decision that something is considered beautiful. It is the eyes, mouth, cheekbones- all in the right proportions and balanced….natural.
CORRECTION: The video states that the KYBELLA™ procedure costs “around $5,000.” The correct price is $1200.
There’s a new treatment to melt away “double-chin fat,” and you don’t have to go under the knife for it.
The Kybella procedure is an FDA approved non- surgical injection, which eliminates fat below the chin.
Midlands Clinic Dermatologist Dr. Indy Chabra is one of the first dermatologists in Siouxland to offer the fat removing treatment.
“The product works by dissolving fat cells and releasing the fat, so it works in a permanent manner. So the number of injections really depends on the degree of submental fullness, how much fat there is underneath the chin. So it varies person to person. In this patient, it was 20 injections.”
The procedure costs $1200. Chabra says his patients experience visible results around their chin and areas around the neck.
April 11, 2014 11:28 am • DOLLY A. BUTZ email@example.com (Photograph by Dawn J. Sagert)
Indy Chabra’s patients often think the red, itchy rashes on their skin are related to something they ate. They don’t usually suspect that the things they wear, touch or clean themselves with could be causing the problem.
“They waste so much money going to the allergist and getting prick testing,” the Dakota Dunes dermatologist said.
Nickel is the most common cause of allergic contact dermatitis in the United States. But everything from sofas made in China to volleyballs and formaldehyde-based products, Chabra said, can cause rashes which are often treated with a strong topical steroid.
“If you look at the back of shampoo bottle or any product, it’ll say DMDM hydantoin or a bunch of other allergens,” he said. “When you’re allergic to any of this stuff you often have cross allergies.”
Annually, the American Contact Dermatitis Society selects a contact allergen of the year. The 2013 allergen of the year is Methylisothiazolinone (MI), a powerful preservative increasingly found in cosmetics and toiletries, including wet wipes.
Infants and young children present at Midlands Clinic, 705 Sioux Point Road, with rashes after parents have tried numerous over-the-counter treatments. Chabra asks them if they’ve been using wet wipes. They stop. The rash clears up.
“Every time they use it, that’s when the rash comes. You stop it, the rash goes away,” he said.
Chabra asks patients suffering from allergic contact dermatitis if they’ve recently changed skin or hair care products. The answer is often, “No.”
“Companies change the specific ingredients of products without telling people,” he said. “Second, our immune system changes. Third, the skin changes. If the skin is broken down, the chances of it developing an allergic contact dermatitis is higher.”
Chabra performs a T.R.U.E. test or epicutaneous patch test, to help him diagnose allergic contact dermatitis. The test’s sticky panel, which is applied to the patient’s upper back, contains tiny amounts of 35 allergens. Substances a person isn’t allergic to, won’t cause a skin reaction.
Gold, Chabra said, is the most common cause of eyelid dermatitis in women.
“Because the gold rings — and a lot of the facial products they use have sunscreen in them — have zinc and titanium. Titanium is a metal that upgrades little particles of gold. You’re putting this on your face every day, and eyelid skin is some of the thinnest skin in the body. That’s why you get eyelid dermatitis.”
A women visited her ophthalmologist multiple times to rid herself of an eyelid rash, before coming to Midlands Clinic. Chabra performed a patch test, which he said “lit up for gold.”
“Then we realized that the glasses have 14-carat gold,” he said. “She changed them and she was fine.”
Chabra also patch-tested a high school volleyball player suffering from a facial rash. It turns out that the teen is allergic to rubber accelerants used in the manufacturing process.
“To make rubber you take the sap and vulcanize it. Otherwise rubber is very gooey, and so you use all these accelerants in it,” Chabra explained. “She was allergic to all of those.”
Chabra contends that the teen is in a tough situation. He instructed her to wash her hands immediately after playing volleyball, and not to touch her face before she does.
“Allergic contact dermatitis is one of the more rewarding areas,” he said. “You can figure it out and fix it.”
Osteoma cutis is the formation of bone in the dermis or subcutis. Depending on the context, these de novo ectopic bone lesions may be classified as primary or secondary osteoma cutis. Primary osteoma cutis is the idiopathic formation of bone. In contrast, secondary osteoma cutis, which is much more common, is bone formation as a potential complication of several acquired disorders, such as severe acne; connective tissue disease; or inherited disorders such as Albright’s hereditary osteodystrophy.
Read the rest of this article featuring Dr. Chabra here.
Although the classic location of gouty tophi is the great toe (podagra), gouty tophi of the ear also is common and is worth including in the differential diagnosis in patients presenting with ear lesions. Other entities presenting as papules or nodules on the ear include chondrodermatitis nodularis helicis (CNH), actinic keratosis, basal cell carcinoma, squamous cell carcinoma, verruca vulgaris, amyloids, rheumatoid nodules, and elastotic nodules. If tophaceous gout is suspected, alcohol fixation of the biopsy specimen is preferable, as it enables visualization of characteristic needle-shaped urate crystals.
Read the rest of this article featuring Dr. Chabra here.