Sandra B. Cox, Nurse Practitioner, Joins Owensboro Dermatology

Sandra B. Cox, ARNP-C

Sandra B. Cox, ARNP-C, a certified and licensed nurse practitioner, has joined Owensboro Dermatology Associates.

Cox, a native of Owensboro, Kentucky, graduated magna cum laude from the University of Kentucky with a Bachelor of Science of Nursing degree. She received her Master of Science from University of Southern Indiana. She is also certified as a Family Nurse Practitioner from the American Nurses Credentialing Center, and certified in Advanced Cardiac Life Support from the American Heart Association.

Cox said, “Dermatology is an exciting and ever-changing medical specialty. My education didn’t stop after earning my degree.”

Along with learning from hands-on dermatology seminars, she said she gains additional knowledge from professional publications and communicating with her peers about the latest medical developments.

“These activities, in conjunction with my memberships to professional organizations, ensure that my patients receive the best treatment founded on evidence-based, time-proven medicine,” Cox said.

Cox is a member of the Nurse Practitioner Society of the Dermatology Nurses Association, the American Academy of Nurse Practitioners, the Kentucky Coalition of Nurse Practitioners/Nurse Midwives, the Coalition of Advanced Practice Nurses of Indiana, the American Nurses
Association, the Kentucky Nurses Association, the Indiana Nurses Association, and the Sigma Theta Tau International Honor Society of Nursing.

“I love being a nurse practitioner in dermatology, because I have the unique opportunity of being able to work with patients from a medical and surgical perspective,” she said. “Combining diagnostic skills and patient care with the more technical expertise gives me great satisfaction. I enjoy the personal aspect of getting to know my patients and caring for them.”

Nurse Practitioners are registered nurses with advanced academic and clinical experience, which enables him or her to diagnose and manage most common and many chronic illnesses either independently or as a part of a health care team. Nurse practitioners are health professionals licensed to practice medicine exercising autonomy in medical decision making and providing a broad range of diagnostic, therapeutic, preventive and health maintenance services. As a nurse practitioner for Owensboro Dermatology Associates, Cox will provide many patient services including diagnose and treat chronic skin conditions; perform some cosmetic procedures; perform physical exams; prescribe medications; freeze lesions with liquid nitrogen; provide education; and administer phototherapy treatment. Cox will also help treat patients for skin cancer, acne, eczema, rosacea, psoriasis, warts, and other common skin disorders.

New Clinical Trial for Pre-Cancer in Owensboro

Two of Owensboro’s leading healthcare facilities have once again teamed up to bring an important clinical trial to the region. Pedia Research and Owensboro Dermatology are now conducting a clinical trial on actinic keratosis (A.K.) Commonly referred to as solar keratosis, A.K. is a skin condition where rough, scaly patches may be found on the skin of your face, lips, ears, back of your hands, forearms, scalp or neck. The major cause of A.K. is long-term exposure to the sun. Actinic keratosis can be a serious condition. Up to 5% of cases develop into skin cancer. Board certified dermatologist Dr. Artis P. Truett III is leading this research study. With a combined 43 years experience in dermatology, Dr. Truett and his team at Owensboro Dermatology continue to be the area’s leading dermatology specialists. This research study involves completing 5 outpatient visits over a period of 24 weeks. Participants must be age 18 or older. There is no cost for the study and medical insurance is not required. The study medication is a topical cream for the possible treatment of A.K. Qualified study participants may receive at no cost: study-related exams, investigational study medication, and compensation for time and travel. If you have any questions or would like more information about the study, please call Pedia Research at 270-685-4589. You may also visit the Pedia Research website at www.pediaresearch.com or the Owensboro Dermatology website at www.OwensboroDerm.com.

Local Dermatologists Renew Fellowship

Dr. Artis Truett, III

Dr. Michael Crowe

Dr. Artis Truett, III, and Dr. Michael Crowe, Board Certified Dermatologists with Owensboro Dermatology Associates, successfully completed the American Society for Mohs Surgery (ASMS) proficiency testing to renew their Fellowships. Doctors Crowe and Truett have maintained their Mohs Fellowships for 8 years each. The ASMS safeguards standards of Mohs Surgery through continuing education and proficiency testing to help insure the highest quality patient care.

Mohs Micrographic Surgery, an advanced treatment procedure for skin cancer, offers the highest potential for recovery—even if the skin cancer has been previously treated. This procedure is state-of-the-art treatment in which the physician serves as surgeon, pathologist and reconstructive surgeon. It relies on the accuracy of a microscope to trace and ensure removal of skin cancer down to its roots.

The proficiency testing involved the excising tissues, completing microscopic examination of the excised tissue by systematic use of horizontal frozen sections, supervising and directing the laboratory preparation of the frozen sections, and microscopic examination of the tissue. This data is then evaluated through the ASMS Peer Review Program.

The cure rate for Mohs Micrographic Surgery is the highest of all treatments for skin cancer—up to 99 percent even if other forms of treatment have failed. This procedure, the most exact and precise method of tumor removal, minimizes the chance of regrowth and lessens the potential for scarring or disfigurement. This procedure allows dermatologists, trained in Mohs Surgery, to see beyond the visible disease, and to precisely identify and remove the entire tumor, leaving healthy tissue unharmed. This procedure is most often used in treating two of the most common forms of skin cancer: basal cell carcinoma and squamous cell carcinoma.

Dr. Crowe earned his medical degree from University of Southern California School of Medicine in Los Angeles, CA. He has published numerous abstracts in publications including the American Journal of Contact Dermatitis, The International Journal of Dermatology, and Aging Arkansas. He is a member of the American Academy of Cosmetic Surgery, American Medical Association, Kentucky Medical Association, Kentucky Dermatology Association, and Daviess County Medical Association among others.

Dr. Truett earned his medical degree from Duke University School of Medicine. He was an adjunct clinical instructor for the Department of Medicine at Vanderbilt University School of Medicine. He is a member of the American Academy of Dermatology, the American Contact Dermatitis Society, the American Society for Mohs Surgery and the American Society for Laser Medicine and Surgery, among others.

Free Skin Cancer Screening Offered at Henderson Dermatology

A free skin cancer screening will be held from 8 a.m. to 11:30 a.m. on Friday, October 5, 2007 at Henderson Dermatology located in the Atkinson Medical Building, 1413 North Elm Street, Suite 202. Individuals must call 1-888-337-6722 extension 4788 to schedule an appointment. Individuals will be seen by appointment only.

Dr. Trey Truett, Board Certified Dermatologist with Henderson Dermatology, said, “Last year’s end of the summer screen was so successful, we decided to host another fall screen. Sun exposure causes skin damage, and the effects of it can easily be seen at this time of year. The timing also provides a great opportunity to educate participants about the importance of year-round sunscreen protection.”

Skin cancer is the most common form of cancer in the United States, affecting 1 in 5 Americans, and more than 1 million new cases are diagnosed each year. Of these cases, more than 105,750 are melanoma which claims 7,770 lives each year. A 2007 survey from the American Academy of Dermatology (Academy) found that while four out of five survey respondents (80%) are concerned about skin cancer and feel it is important to protect themselves, more than half (54%) have never been screened for skin cancer by a health care provider and nearly one-quarter (23%) never examine their own skin for changes to moles and other blemishes.

These results have served as a call to action for dermatologists to teach their neighbors to Be Sun Smart and provide free skin cancer screenings in their communities. Academy members continue to offer free, skin cancer screenings year-round to the general public. Since 1985, dermatologists have screened more than 1.7 million people and detected more than 171,200 suspicious lesions, including approximately 20,000 suspected melanomas.

Dr. Truett said, “If there are any changes in the size, color, shape or texture of a mole, the development of a new mole, or any other unusual changes in the skin, you should see a dermatologist.”

According to the Academy everyone – young, old, fair-skinned, dark-skinned – needs to be careful before spending time in the sun. The Academy encourages people to conduct regular skin self-examinations, use sunscreen, wear protective clothing, avoid peak sun hours, and practice other sun-safe behaviors. Skin self-examinations consist of regularly looking over the entire body, including the back, scalp, soles of feet, between the toes, and on the palms of the hands.

“The key to the successful treatment of most types of skin cancer is early detection and treatment,” Dr. Truett added. “With melanoma, early detection is achievable because the signs are visible on the surface of the skin. It is our hope for those individuals who have never had their skin checked, that they will use this opportunity to have one of our specialists look for possible, suspicious lesions.”

At the screen participants will receive information about how to conduct a self examination and other educational materials. To make an appointment for the free skin cancer screening on Friday, October 5, call Henderson Dermatology at 1-888-337-6722 extension 4788.

Be Sun Smart

Sun exposure is the most preventable risk factor for skin cancer. The American Academy of Dermatology recommends that everyone “Be Sun Smart.” Here’s how to do it:
• Generously apply sunscreen with a Sun Protection Factor (SPF) of at least 15 that provides broad-spectrum protection from both ultraviolet A (UVA) and ultraviolet B (UVB) rays. Re-apply every two hours, even on cloudy days, and after swimming or sweating;
• Wear protective clothing, such as a long-sleeved shirt, pants, a wide-brimmed hat and sunglasses, when possible;
• Seek shade when appropriate, remembering that the sun’s rays are strongest between 10 a.m. and 4 p.m.;
• Get vitamin D safely through a healthy diet that includes vitamin supplements. Don’t seek the sun;
• Avoid tanning beds. Ultraviolet light from the sun and tanning beds causes skin cancer and wrinkling. If you want to look like you’ve been in the sun, consider using a sunless, self-tanning product, but use sunscreen with it.

To gauge their sun smarts, the public can visit the Academy’s Web site to take the survey. Upon completion of the survey, respondents will receive their own personalized sun-smart profile with lifestyle tips.

Local Dermatologist’s Photos Showcased

Dr. Artis Truett, III

The photos captured are not clinical in nature but are of nature and people. Photographs taken by Dr. Artis Truett, Board Certified Dermatologist with Owensboro Dermatology and Henderson Dermatology, will be displayed during the last three weeks of September in the Welcome Center of the Western Kentucky Botanical Garden, located at 25 Carter Road in Owensboro, Kentucky. Photos by Bob Morris, publisher of the Messenger-Inquirer, will also be a part of the exhibit.

Dr. Truett will discuss his photography exhibit at the presentation “Faces in the Garden” at 11:30 a.m. on Tuesday, September 18 at the Welcome Center. Seating is at capacity at this time, but individuals interested in placing their name on a waiting list should call 270-852-8925.
The Welcome Center and the gardens are open from 9 a.m. until 3 p.m. CST Monday through Friday or by special appointment by calling 852-8925. Self-guided tours are available to anyone visiting the Garden. Guided tours are available by calling or visiting the director at the Welcome Center.

Killer tan: Quest for bronze skin carries great risk--even for the young

Related Document: killer_tan.pdf

(Reprinted with permission from The Gleaner)
You say you're dying for a really deep, dark tan?So was a sadder but wiser Laci Hanley, who now realizes a person can literally die for the sake of staying tanned.Laci, only 26, is fine. But had she waited much longer to have a suspicious mole examined, she likely wouldn't have been so lucky.The local resident, an HCC pre-nursing student and part-time employee in the school's financial aid office, learned a few weeks ago that the mole on her mid-chest had cancer cells present.It was melanoma -- the deadliest of the three types of skin cancer.Laci, who is sounding the warning about unprotected exposure to ultraviolet rays, said the cancer hadn't penetrated the entire depth of the mole and was in its earliest stages.Looking back, she says had she known five or six months ago what she knows now, she would have rushed to the doctor when she first realized the mole was beginning to change color.It gradually transformed from the dark brown it had been since childhood to purple, "and yet, I kept on going to the tanning bed every day," said the divorced mom of Abbi, 5, and Ashton, 3. "I thought it was so important to have a tan."She also sunbathed, and spent hours in a boat on Kentucky Lake. Not only did she not wear a speck of sunscreen, but sometimes used "tanning accelerator.

"I'd heard about skin cancer, but didn't think it would happen to me."Laci, who has dark blond hair and naturally fair skin, was at the vacation home belonging to her mom and stepfather, Joni and Darrell Smith, in latter May and relaxing with Joni on the deck when she decided to have her mother take a look at the mole.

"I go by what my mom tells me," Laci said. "She looked at the mole and said, 'Oh, yeah, Laci, you need to get that checked out!' "She made an appointment right away and the mole was biopsied. Laci had a feeling that the news would be bad, and it was. Surgery followed, with a wide excision intended to catch any stray cancer cells.Then Laci sweated bullets waiting three days for the results of tests on the excised tissue.

"I couldn't sleep. I couldn't focus in class, and my children could tell something was wrong," she said. She faced the grim possibility that they would grow up without her.But the report was good. There was no melanoma in the excised tissue. "They tell me I have a 97 percent chance that it won't come back because we caught it so early," she said.I asked Angela Mills, a physician's assistant with Henderson Dermatology, what might have happened had Laci waited another five or six months before seeing a doctor.

"If she had delayed, she could have been in a much worse situation," Angela said, and might have required chemotherapy and radiation in addition to surgery.It could have been a "life or death situation" had she waited, Angela said. "You can't predict how fast the cancer will progress."Laci felt she had escaped a death sentence, and was so jubilant upon hearing that she was OK, decided to keep the kids home from pre-school and have an all-day celebration.These days, she wears nothing less than a sunscreen with a protective factor of 70, and she keeps the children covered in sunblock, too. She will be examined every three months for a time to make sure there's no recurrence.Laci learned the hard way that youth and general good health don't provide immunity against trouble. "You don't think about it until something like this happens," she said.

"It was a reality check for me."She no longer thinks there's anything wrong with being fair-skinned. "I don't mind as long as I'm alive," she said, smiling. "I've got kids to raise."
By Judy Jenkins
The Gleaner

Skin Cancer...Guaranteed

Related Document: Article Skin Cancer Guaranteed PDF.pdf

Summer 2007

10 ways to ensure you get America's most common form of cancer

Ever been told you're one in a million? It may not be good news. According to the National Cancer Institute, about a million people in the United States learn they have skin cancer each year. In fact, half of all new cancers are skin cancer, making it the most common type of the disease.

The trend for skin cancer is gaining momentum. Over the past 30 years, the rate of melanoma (the deadliest form of skin cancer) has tripled among Caucasians. And according to current estimates, 40 to 50 percent of Americans who live to age 65 will have skin cancer at least once.

Still want to be one in a million? The following are ways to increase risks of being diagnosed with skin cancer.

1. Pretend you're a dark-eyed brunette. If you have fair skin; blond, red or light brown hair; and blue, green or gray eyes; you're 20 to 30 times more likely to develop skin cancer. People with less pigment (melanin) in their skin have less protection from the sun's damaging ultraviolet (UV) rays. (UV radiation is the main cause of skin cancer.) Ignore your genetics – the ones that gave you the freckle-prone skin and light eyes-and you become a prime candidate for skin cancer. “It’s important to know that regardless of your skin type and ethnicity, everyone needs to use sunscreen,” says Dr. Michael Crowe, board certified dermatologist with Owensboro Dermatology. “More than 90 percent of all skin cancers are caused by sun exposure, yet fewer than 33 percent of adults, adolescents, and children routinely use sun protection.”

2. Apply sunscreen once, then forget about it. Healthcare professionals advise applying sunscreen every day to protect the skin, and reapplying it often.
So how often should someone apply sunscreen? “Remember to reapply sunscreen more often when swimming or during strenuous exercise,” Crowe adds. “Waterproof sunscreens are tested to last for up to 80 minutes and should be reapplied at regular intervals if you’re in the water for prolonged periods of time. Sunscreens labeled “water resistant” should be reapplied every 40 minutes.”

3. Count on your makeup bag to protect you. Many moisturizers and lipsticks now contain SPF. However, convenience can lull you into a false sense of security: A study in the Journal of the American Academy of Dermatology reported that facial foundation containing SPF was only effective for two hours, and even less for those with oily skin. For continued protection, the product must be reapplied or covered with another sunscreen.

4. Wrap yourself in a wet T-shirt. Physical barriers can offer good protection from the sun, unless the clothing is wet: The sun's rays pass through wet clothes more easily than dry. Lightweight, loose-fitting, long-sleeved shirts, pants or long skirts made out of a tightly woven cloth provide the best sun protection. Showing more skin increases risk.

5. Pick your shades for style only. The ideal sunglasses don't have to be expensive, but they should block 99 to 100 percent of UVA and UVB radiation—the two types of ultraviolet radiation—to protect your eyes from sun damage. Check the label. If there's no label, don't buy the glasses, advises the Food and Drug Administration. (Darkness of the glass is not a factor.) Also apply sunscreen around the eyes and eyelids to protect sensitive skin.

6. Skip the siesta. The tradition of resting indoors during the hottest part of the day is not only civilized, but also doubles as a mechanism for skin cancer prevention. The UV radiation from the sun is at its strongest between 10 a.m. and 3 p.m. Avoiding exposure during those peak hours reduces the opportunity for sun damage.

7. Fire up the tanning bed. The UVA rays emitted by tanning beds and sunlamps can be more dangerous than those from the sun. Food and Drug Administration researchers found using a sunlamp can increase the melanoma-inducing radiation a person is exposed to by up to 24 times. “According to the American Cancer Society, aside from the fact that skin cancer is the number one cancer in men over age 50, ahead of prostate, lung and colon cancer, in the past 30 years, skin cancer has tripled in women under age 40,” says Dr. Artis Truett, M.D., a board certified dermatologist with Owensboro Dermatology. “Then, consider that on an average day in the U.S., more than one million people tan in tanning salons; 70 percent are Caucasian women aged 16-49.”

8. Let the temperature gauge your risk. You don't have to be sweating on a beach to need sun protection. "Cool" activities such as skiing and sailing carry a higher risk for skin damage from the sun because UV rays intensify when they reflect off snow and water. Similarly, a cloudy day does not eliminate UV radiation. Clouds only screen out 20 percent of the UV radiation.

9. Act like a kid. Remember spending all day at the beach or pool during the summer? No wonder more than 80 percent of lifetime sun exposure occurs before age 18. Although skin cancer can take 10 to 15 years to appear, protecting your skin offers more immediate results. Studies show that one or more severe, blistering sunburns as a child or teenager can increase the risk for melanoma. Part of being an adult means using sunscreen and practicing moderation when it comes to the sun. “However, another responsibility as an adult is protecting your children from sun exposure,” Truett says. “This includes a combination of applying sunscreen on them as recommended, keeping them out of the sun in the middle of the day; covering them up with a hat and t-shirt; and putting sunglasses on them.”

10. Join the leisure class. The national rise in skin cancer rates may be linked to affluence. Those who have more time off for vacations can spend more time in the sun. Although outdoor activities can improve health, there is nothing healthy about tanning.

Know Your ABCDs

The cure rate for skin cancer could be 100 percent if it is detected and brought to a doctor's attention before it has the chance to spread, according to the National Cancer Institute.

Regularly performing a simple skin self-exam can improve your chances of finding skin cancer promptly. Check your skin in a well-lighted room using a full-length mirror and a handheld mirror.

Learn where your birthmarks, moles and blemishes are and what they usually look like. Check for anything new. Use the "ABCDs" to evaluate any blemish or mole:

A-Asymmetry: Common moles are round and symmetrical.
B-Border: Skin cancers may have uneven borders.
C-Color: Watch for varied shades of brown, tan or black and also red, white and blue.
D-Diameter: If a spot is larger than a pencil eraser (¼" or 6 mm), it could be trouble.

Skin cancer takes many forms. Anything that changes, grows or fits any of the ABCDs should be taken seriously and examined by a doctor.

Vim & Vigor Magazine

Sun Sense

Related Document: Sun Sense article from Gleaner_03-31-2007 (2).pdf (Reprinted with permission from The Gleaner)

Breakers' temptation to get tan ill-advised

Numerous local Spring Breakers will be hitting the Florida beaches this week, and while Dr. Artis Truett doesn't want to dampen their fun, he does have some advice he hopes they'll heed.

“There's nothing wrong with the color of the skin God gave you," says the dermatologist who practices here and in Owensboro. "You should do everything you can to keep that skin healthy." By "doing everything you can" he means avoiding tanning and burning by routinely using a broad spectrum sunscreen with a protective factor of at least 30 and never, ever deliberately baking the skin.

Truett, a dermatologist for 15 years, said even a light tan is evidence that sun damage has already taken place. There is no such thing, he said, "as a safe tan." He said it amazes him when young patients tell him, "I've got to get a tan so I won't burn in Florida." That, he said, "doesn't make a bit of sense."

He and other doctors with Henderson Dermatology and Owensboro Dermatology are seeing more and more young adults with early skin cancers and visible signs of aging caused by sun damage. "It used to be rare to see a 20-year-old with melanoma," Truett said, referring to the deadliest form of skin cancer. Now, he said, it sadly isn't a rarity,” and there are a number of 20-year-olds with basal cell and squamous cell carcinomas."

He's also seeing people in their early 20s "with wrinkles, brown spots" and other signs of premature skin aging. The damage, he said, is from both unprotected sunning and the use of tanning beds.

What about that recent much-publicized study that indicated some UV radiation is beneficial because it stimulates Vitamin D production in the body and strengthens the immune system?

Truett said he believes data was misrepresented to the public. "You don't have to have a significant amount of sun to get Vitamin D," he said, adding the vitamin can also be provided via supplements or medication. "Most people get all the Vitamin D they need through a normal diet and a small amount of ambient light on a daily basis."

The National Skin Cancer Foundation predicts there likely will be about 1.3 million newly diagnosed cases of skin cancer this year. It can strike most anyone, it's noted, including first Lady Laura Bush, who had a skin cancer tumor removed from her right shin last November.

Truett reminds the public that the sun's damaging effects can take place on a ski slope or in the Midwest or most anywhere else. He and his wife are planning a skiing trip to Canada, he said, and will be taking plenty of strong sunscreen with them.

The American Society for Dermatologic Surgery, the American Academy of Dermatology and the Skin Cancer Foundation offer tips that include the following:

 Generously apply sunscreen to all exposed skin using a product that will protect against both ultraviolet A and ultraviolet B rays. Reapply every two hours, even on cloudy days, and after swimming or sweating.

 Remember the sun's rays are strongest between 10 a.m. and 4 p.m.

 Protect children from sun exposure by applying sunscreen.

 Be aware of sores that aren't healing. Somethimes what appears to be an annoying pimple that won't go away is an early form of skin cancer.

 Monitor your moles. Melanoma usually develops in a pre-existing mole. It is important to closely monitor the size, shape, color and number of moles on the skin. Changes should be reported to a doctor. Moles that become asymmetrical, have uneven borders, become larger or change colors should be investigated. In its earliest stages, melanoma is nearly 100 percent curable. If it advances and spreads to other parts of the body, where it becomes harder to treat, it can be fatal.

 Know your genes. If there is a history of skin cancer in your family and you have light hair and light eyes, you are at a greater risk for skin cancer and should always protect yourself with sunscreen.

"I'm not encouraging people to stay inside with covered windows," Truett said. "Just try to avoid cooking your skin."

By: Judy Jenkins
The Gleaner