Please Save These Dates

Please Plan To Join Us

The Art and Science of Cutaneous Medicine
AUGUST 16 - 18, 2019

Course Directors
David Elpern, MD, Douglas Johnson MD,
George Reizner MD

Credit Information:
The program is accredited for 9 to 12 hours of Category I Credit.

For More Information contact:
Doug Johnson: or

Dave Elpern:



Waimea State Park (near Turtle Bay)

Turtle Bay Resort, Oahu, Hawaii
Friday - Sunday

August 16 - 18, 2019

Our 2019 program will be held at Turtle Bay on Oahu's North Shore.  We have organized Hot Spots in Dermatology since 1987. It is an intimate meeting at which the faculty and registrants have time to interact as colleagues rather than in a strictly didactic manner. We provide 9 - 12 hours of  Category I CME credits.  Hot Spots is not a business; but a gathering of people that, like Chaucer's student, "would gladly lerne and gladly teche." Please join us!

Registration Page.
     Turtle Bay Resort
     Condos within walking distance to Turtle Bay Resort  Air BnB or VRBO
2019 Faculty  and Syllabus (not ready yet)
If you want to give a case report, here is the Protocol.


2019 Faculty

2019 Hot Spots in Dermatology
Tentative Faculty
David Elpern, Williamstown, Massachusetts 
Doug Johnson, Honolulu Hawaii 
George Reizner,  Madison, Wisconsin

Madeline Duvic, Houtson, Texas
Roman Glamb, Honolulu Hawaii
Roy Grekin, San Francisco, California
Julia Lehman, Rochester, Minnesota
Vail Reese, San Francisco, California
Jorge Roman, Dermatology Resident, New York University
Margit Sande-Kerback, Hospital Chaplain, Honolulu, Hawaii
Michael Webster, Melbourne, Australia

Attendees are invited to give short case presentation of interesting or difficult cases.  The protocol will be sent to you on request and posted on the Hot Spots web site.




AUGUST 16 - 18, 2019
Physicians: $400 or $175 per day
After June 1, $500
On-Site Registration: $600
Nurses, Residents PAs and NPs: $200.
After June 1, $250
Students: Free

Cancellation Policy: A $50 non-refundable fee is charged for cancellations before July 1. Thereafter one half of the fee will be returned for cancellations received before July 30. No refunds can be accepted after that date. All cancellations must be in writing.

To Enroll, please scroll down for a form you can cut and paste or access: Printable Registration Form

To contact us:
Marie KramerPhone: 808-531-7541

If you don't want to use the printable form above, you can copy the form below.
Copy, Paste, Fill in and fax or mail the following form to us with registration check. You can also email us for this Registration Form at DJE.

HOT SPOTS HAWAII -- AUGUST 16 - 18, 2019

Physicians: $400 After June 1, 500
Nurses, Residents, PAs and NPs: $200. After May 1, $250
Students: Free

Cancellation Policy: A $50 non-refundable fee is charged for cancellations before July 1. Thereafter one half of the fee will be returned for cancellations received before July 30. No refunds can be accepted after that date. All cancellations must be in writing.

Please copy, fill out form and make check payable to:
"Hot Spots in Dermatology"
c/o Marie Kramer
1380 Lusitana Street, Suite 401
Honolulu, HI 96813


Tuition fee enclosed: $_________

Total: $_________

Full Name: Last________________ First____________ Middle Initial____


Daytime Phone ( )______________Fax Number ( )________________

Email Address _______________________________

Street Address_______________________________________________

City_________________________ State__________ Zip Code_________

Specialty ______________________________________

Specialty (if non-MD)_____________________________________



Diplopia and Pterygium Surgery

Malcolm R. Ing, MD
Clinical Professor and Chair Ophthalmology
John A. Burns School of Medicine, University of Hawaii

In the past years, most of the patients referred to me for treatment of double vision and restrictive strabismus were those who had previous scleral bucking retinal procedures.  Recently, the most common cause of these problems  in my practice has been previous pterygium surgery.

All patients who had the diagnosis of restrictive strabismus following pterygium surgery were studied for common findings. The author reviewed the technique utilized during the previous surgery.  The surgical corrective surgery was reviewed and the results compared.

 All patients had previous pterygium surgery with the utilization of an amniotic graft during the initial surgery. All patients complained of diplopia greater in the field opposite the initial operative site.  Esotropia was measured with prisms. All patients had a positive forced duction test. Dense scar tissue was invariably found covering the medial rectus and adjacent sclera.  Careful dissection of this scar tissue was performed utilizing the operating microscope and a muscle hook under the medial rectus during the dissection. After the scar tissue was completely removed, the forced duction test was negative in all cases. A medial rectus  recession was also performed if there was esotropia in the primary position.  An autograft was utilized to cover the defect. The preoperative esotropia and diplopia was relieved in all cases, including for one patient who could not abduct the eye beyond the mid line prior to the corrective surgery.

Corrective surgery can be very useful in relieving diplopia and esotropia  following  pterygium surgery.

Ela-Dalman N, Velez FG, Rosenbaum  AL   Incomitant esotropia following pterygium excision surgery. Arch Ophthalmol 2007; 125:36973.

Health Anxiety - DJ Elpern

Health Anxiety Talk:  Hot Spots 2016


Health Anxiety is a common affliction of patients seeking medical attention, yet many physicians are usually unaware of it.  We surveyed 222 consecutive patients from a dermatology practice in Western Massachusetts and found that upwards of 49% were cognizant of some level of health anxiety.  This is the first report of health anxiety from a general dermatology clinic.

1. Tyrer P, Eilenberg T, Fink P, Hedman E, Tyrer H.
Health anxiety: the silent, disabling epidemic. BMJ. 2016 Apr 25;353:i2250.

2. Cyberchondria. Wikipedia.

3. Tyrer P, et. al  Prevalence of health anxiety problems in medical clinics. J Psychosom Res. 2011 Dec;71(6):392-4. Abstract


Case Report Protocol

Suggestions for Case Presentation

We encourage all attendees to present one or two interesting cases.  These presentations should be no longer than 5 - 7 minutes.

Since before Hippocrates, case reports have provided a rich resource for teaching and research in medicine. Case reports are published by many prominent journals—more than 140,000 case reports are indexed in MEDLINE from 1996 to 2000—and a number of narrative guidelines for the preparation of case reports have appeared in the medical literature. To facilitate the preparation of case reports, we suggest the following protocol.  This template can be used by perdons in any practice setting and any discipline to collect and report interesting and unusual cases.
Adapted from: How to write a case report.  McCarthy LH, Reilly KE.  Fam Med 2000;32:190-5.)

I.  Abstract – on one line
         Presented by Your Name(s)

II.  History of Present Illness

III. Physical Exam

IV.  Clinical Photos

V. Tentative Diagnosis and Plan

VI. Work-up
         Tests with results
         Biopsy – photomicrographs if available

VII.   Final Diagnosis if applicable

VIII. Questions you have for your colleagues

IX. References