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July, 1953 THERAPEUTIC DERMATITIS—JAMES 277 counters some member of the family, neighbor, or other benevolent soul who insists that he try the ointment which did so much for them. For some reason the laity seems to think that all skin disorders are the same and therefore will respond to the same type treatment. We, as physicians and teachers, must strive to convey to the public that it is unwise to apply to the skin topical agents that have been prescribed for other patients, particularly if they contain sensitizers or other potentially harmful constituents. The druggist Those who escape self-prescribed medication as well as that prescribed by their neighbors have only to visit the local druggist who dispenses "over the counter." His prescriptions often produce untoward reactions of varying degrees. It is encouraging that there are many druggists who keep themselves busy carrying out the duties for which they are trained and do not attempt the pseudo-practice of medicine over the counter. We feel that the medical profession should 'establish better liaison with the pharmacists and explain the complications and dangers of over-the-counter precriptions for topical therapeutic agents. In a recent discussion with members of the Winston-Salem Drug Club, the need for a better understanding of the problems which are of mutual interest to the physician and druggist was evident. Especially is this need evident to the physician who has the opportunity to evaluate the many problems confronting the pharmacist. There is also a need for more rigid control of topical agents which we hope in the not too distant future will receive at least the attention that oral and parenteral agents are receiving today. We are fully aware of the pressure brought to bear on the druggist by the patient who wants "something for my itch"; however, pressure is no justification for the attempt to treat a disease process by one who is not trained in this field. Cure-Alls The newspaper and radio—and to some extent television—are contributing to the incidence of therapeutic dermatitis. It is becoming increasingly difficult to turn on the radio for a weather or news report without hearing also some testimonial or other undocumented claims for various topical agents to "ditch the itch" or cure all cutaneous ills. So gullible is our population that seldom a day passes that we do not see patients who obtain some of these agents for their skin and thereby produce a therapeutic dermatitis. To be sure, we could save our skins both economically and physiologically if we could educate our patients to be aware of the many false claims made by the "cure-alls" and "money back guarantees" advocated by the patent medicine manufacturers. Iatrogenic Factors Any discussion of therapeutic dermatitis must include iatrogenic factors. It is my feeling that the pharmaceutical salesman may be playing a role by inducing the physician to prescribe multiple topical agents which often have not been properly evaluated. They advertise at a high pitch with samples, literature, dogmatic statements, and reprints. We should not allow the unproven claims of the detail man to influence us too greatly in choosing topical agents for der-matologic disorders. Most physicians appreciate the need for pharmacologic information about oral and parenteral medicaments, especially in regard to the indications, dosage, contraindications, and toxicity. However, many of these same physicians are not as critical in evaluating topical agents. We do not subscribe to "holding on to the old." However, the patient will be spared much therapeutic dermatitis if we add new topical agents to our therapeutic armamentarium with a more critical appraisal. Particularly should we have some information about the sensitizing potential and the other untoward reactions which the medicaments may produce. Physicians, and to a large extent, the public, have learned not to prescribe a purgative for abdominal pain until at least a tentative diagnosis has been established. We may soon see the day when physicians, druggists, as well as the public will appreciate the need for an accurate diagnosis of skin disorders before purging the skin. Not infrequently physicians allow the patient to talk them into prescribing over the telephone for various cutaneous disorders. Not only do they accept the patient's diagnosis, which is usually incorrect, but they also rob themselves of an opportunity to observe the skin and determine the stage of the dermatitis—a prerequisite to proper treatment
Object Description
Rating | |
Fixed Title * | NCHH-17: North Carolina Medical Journal [1940-2001] |
Document Title | North Carolina Medical Journal [1940-2001] |
Subject Topical Other | Public Health -- Periodicals.; Physicians -- North Carolina -- Directory.; Societies, Medical -- North Carolina -- Periodicals. |
Description | Includes Transactions of the Society, -1960; 1961- , Transactions issued separately, bound in.; Includes Transactions of the auxiliary to the Medical Society of the State of North Carolina and Proceedings of the North Carolina Public Health Association. Official organ of the Medical Society of the State of North Carolina, 1940-May 1972; of the North Carolina Medical Society, June 1972-. Vols. for 1940-May 1972 published by the Medical Society of the State of North Carolina; June 1972- by the North Carolina Medical Society. |
Contributor | Medical Society of the State of North Carolina. Transactions.; Medical Society of the State of North Carolina.; North Carolina Medical Society.; North Carolina Medical Society. Transactions.; North Carolina Public Health Association. Proceedings. |
Publisher | [Winston-Salem] : North Carolina Medical Society [etc.], 1940- |
Repository | University of North Carolina at Chapel Hill. Health Sciences Library. |
Host | University of North Carolina at Chapel Hill |
Date | 1953 |
Identifier | NCHH-17-014 |
Form General | Periodicals |
Language | English |
Rights | This item is part of the North Carolina History of Health Digital Collection. Some materials in the Collection are protected by U.S. copyright law. This item is presented by the Health Sciences Library of the University of North Carolina at Chapel Hill for research and educational purposes. It may not be republished or distributed without permission of the Health Sciences Library. |
Digital Collection | North Carolina History of Health Digital Collection |
Sponsor | The North Carolina History of Health Digital Collection is an open access publishing initiative of the Health Sciences Library of the University of North Carolina at Chapel Hill. Financial support for the initiative was provided in part by a multi-year NC ECHO (Exploring Cultural Heritage Online) digitization grant, awarded by the State Library of North Carolina, and funded through the Library Services and Technology Act (LSTA). |
Volume Number | 14 |
Health Discipline | Medicine |
Digital Format | JPEG 2000 |
Print / Download PDF Version | http://archives.hsl.unc.edu/nchh/nchh-17/nchh-17-014.pdf |
Document Sort | all; nchh-17 |
Volume Link | http://dc.lib.unc.edu/cdm/search/collection/nchh/field/identi/searchterm/NCHH-17-014 |
Title Link | http://dc.lib.unc.edu/cdm/search/collection/nchh/field/documa/searchterm/NCHH-17 |
Catalog Record link | http://search.lib.unc.edu/search?R=UNCb1306322 |
Revision History | done |
Description
Fixed Title * | Page 277 |
Document Title | North Carolina Medical Journal [1940-2001] |
Subject Topical Other | Public Health -- Periodicals.; Physicians -- North Carolina -- Directory.; Societies, Medical -- North Carolina -- Periodicals. |
Description | Includes Transactions of the Society, -1960; 1961- , Transactions issued separately, bound in.; Includes Transactions of the auxiliary to the Medical Society of the State of North Carolina and Proceedings of the North Carolina Public Health Association. Official organ of the Medical Society of the State of North Carolina, 1940-May 1972; of the North Carolina Medical Society, June 1972-. Vols. for 1940-May 1972 published by the Medical Society of the State of North Carolina; June 1972- by the North Carolina Medical Society. |
Contributor | Medical Society of the State of North Carolina. Transactions.; Medical Society of the State of North Carolina.; North Carolina Medical Society.; North Carolina Medical Society. Transactions.; North Carolina Public Health Association. Proceedings. |
Publisher | [Winston-Salem] : North Carolina Medical Society [etc.], 1940- |
Repository | University of North Carolina at Chapel Hill. Health Sciences Library. |
Host | University of North Carolina at Chapel Hill |
Date | 1953 |
Identifier | NCHH-17-014-0535 |
Form General | Periodicals |
Page Type | all; article |
Language | English |
Rights | This item is part of the North Carolina History of Health Digital Collection. Some materials in the Collection are protected by U.S. copyright law. This item is presented by the Health Sciences Library of the University of North Carolina at Chapel Hill for research and educational purposes. It may not be republished or distributed without permission of the Health Sciences Library. |
Filename | northcarolina141953medi_0535.jp2 |
Digital Collection | North Carolina History of Health Digital Collection |
Sponsor | The North Carolina History of Health Digital Collection is an open access publishing initiative of the Health Sciences Library of the University of North Carolina at Chapel Hill. Financial support for the initiative was provided in part by a multi-year NC ECHO (Exploring Cultural Heritage Online) digitization grant, awarded by the State Library of North Carolina, and funded through the Library Services and Technology Act (LSTA). |
Volume Number | 14 |
Issue Number | 7 |
Page Number | 277 |
Health Discipline | Medicine |
Full Text | July, 1953 THERAPEUTIC DERMATITIS—JAMES 277 counters some member of the family, neighbor, or other benevolent soul who insists that he try the ointment which did so much for them. For some reason the laity seems to think that all skin disorders are the same and therefore will respond to the same type treatment. We, as physicians and teachers, must strive to convey to the public that it is unwise to apply to the skin topical agents that have been prescribed for other patients, particularly if they contain sensitizers or other potentially harmful constituents. The druggist Those who escape self-prescribed medication as well as that prescribed by their neighbors have only to visit the local druggist who dispenses "over the counter." His prescriptions often produce untoward reactions of varying degrees. It is encouraging that there are many druggists who keep themselves busy carrying out the duties for which they are trained and do not attempt the pseudo-practice of medicine over the counter. We feel that the medical profession should 'establish better liaison with the pharmacists and explain the complications and dangers of over-the-counter precriptions for topical therapeutic agents. In a recent discussion with members of the Winston-Salem Drug Club, the need for a better understanding of the problems which are of mutual interest to the physician and druggist was evident. Especially is this need evident to the physician who has the opportunity to evaluate the many problems confronting the pharmacist. There is also a need for more rigid control of topical agents which we hope in the not too distant future will receive at least the attention that oral and parenteral agents are receiving today. We are fully aware of the pressure brought to bear on the druggist by the patient who wants "something for my itch"; however, pressure is no justification for the attempt to treat a disease process by one who is not trained in this field. Cure-Alls The newspaper and radio—and to some extent television—are contributing to the incidence of therapeutic dermatitis. It is becoming increasingly difficult to turn on the radio for a weather or news report without hearing also some testimonial or other undocumented claims for various topical agents to "ditch the itch" or cure all cutaneous ills. So gullible is our population that seldom a day passes that we do not see patients who obtain some of these agents for their skin and thereby produce a therapeutic dermatitis. To be sure, we could save our skins both economically and physiologically if we could educate our patients to be aware of the many false claims made by the "cure-alls" and "money back guarantees" advocated by the patent medicine manufacturers. Iatrogenic Factors Any discussion of therapeutic dermatitis must include iatrogenic factors. It is my feeling that the pharmaceutical salesman may be playing a role by inducing the physician to prescribe multiple topical agents which often have not been properly evaluated. They advertise at a high pitch with samples, literature, dogmatic statements, and reprints. We should not allow the unproven claims of the detail man to influence us too greatly in choosing topical agents for der-matologic disorders. Most physicians appreciate the need for pharmacologic information about oral and parenteral medicaments, especially in regard to the indications, dosage, contraindications, and toxicity. However, many of these same physicians are not as critical in evaluating topical agents. We do not subscribe to "holding on to the old." However, the patient will be spared much therapeutic dermatitis if we add new topical agents to our therapeutic armamentarium with a more critical appraisal. Particularly should we have some information about the sensitizing potential and the other untoward reactions which the medicaments may produce. Physicians, and to a large extent, the public, have learned not to prescribe a purgative for abdominal pain until at least a tentative diagnosis has been established. We may soon see the day when physicians, druggists, as well as the public will appreciate the need for an accurate diagnosis of skin disorders before purging the skin. Not infrequently physicians allow the patient to talk them into prescribing over the telephone for various cutaneous disorders. Not only do they accept the patient's diagnosis, which is usually incorrect, but they also rob themselves of an opportunity to observe the skin and determine the stage of the dermatitis—a prerequisite to proper treatment |
Digital Format | JPEG 2000 |
Print / Download PDF Version | http://archives.hsl.unc.edu/nchh/nchh-17/nchh-17-014.pdf |
Document Sort | all; nchh-17 |
Article Title | Therapeutic Dermatitis |
Article Author | George W. James |
Volume Link | http://dc.lib.unc.edu/cdm/search/collection/nchh/field/identi/searchterm/NCHH-17-014 |
Title Link | http://dc.lib.unc.edu/cdm/search/collection/nchh/field/documa/searchterm/NCHH-17 |
Catalog Record link | http://search.lib.unc.edu/search?R=UNCb1306322 |
Revision History | done |
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