E Komo Mai

Turtle Bay Resort
Kahuku, Oahu, Hawaii
August 17 - 19, 2018

We are in the early planning stages for our 2018 program.  Turtle Bay has been a wonderful venue and is convenient for our Hawaii registrants. In order to keep Hot Spots an Ohana (family) we plan to limit the number of registrants to 50.  Please join us in 2018!

When the surgeon-poet George Bascom attended a CME conference in Colorado some years ago, he wrote the following poem:

Seminar at Breckenridge
The peaks are frozen gold
above the gritty streets. Boots
grate briskly on the way
to lectures about lungs.
The holy heights
cry down to use, but inside under tinted glass
we file like mourners
to the conference room.
 Our goal is that at Hot Spots you don't feel that way! 

Hot Spots 2017 Invitation

Hot Spots Ohana 2018
August 17 – 19, 2018
Turtle Bay Resort
Kahuku, Oahu, Hawaii

Please save the dates for our 2018 Hot Spots program.  This annual conference was begun in 1987, has been evolving ever since and presently it has become an ohana.

We will have talks that stretch the attendees minds rather than the predictable academic or promotional lectures given by paid professional circuit riders that one can hear elsewhere.

We will continue to have the case presentation part of the program that has been memorable and successful in the past. We also will encourage younger people, students and trainees, to present material.

So, save the dates for a outstanding and congenial program.


Dave Elpern
Doug Johnson
George Reizner


Waimea State Park (near Turtle Bay)

Turtle Bay Resort, Oahu, Hawaii
Friday - Sunday

August 17 - 19, 2017

Our 2017 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 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!

Program Overview and Credit Statement

'A'ohe pau ka'ike i ka halau ho'okahi
One can learn from many sources

HOT SPOTS HAWAII is a unique continuing medical education program that blends clinical and therapeutic updates while allowing time for reflection and introspection. The program will be held at the Turtle Bay Resort on Oahu's North Shore. Doug Johnson has negotiated a favorable rate. Hot Spots is designed to allow attendees to consider aspects of our personal and professional lives not typically included in traditional continuing education. Leave your cell phones, pagers and problems behind and use your time at Turtle Bay to think about your own needs without the pressing demands of caring for others. We hope you can join us and promise you will have a rewarding and memorable experience. Doug Johnson has organized memorable social functions for you and your guests.

C.M.I. Credit Statement
This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Hot Spots Foundation for Dermatological Education (HSFDE) through the joint providership of Hot Spots in Dermatology. The HSFDE program is accredited for 9 Hours of Category I CME Credit.
Credit designation:  The HSFDE designates this program for a maximum of 9 hours of Category 1 CMI Credit™. Participants should claim only the credit commensurate with the extent of their participation in the activity.

Tax Deductible Status:
For an educational course to be deductible the course only needs some form of certification, which The Hot Spots Foundation will supply. The general requirements that qualify for tax deductible status are that the educational course:
1. Is required by an employer or the law to keep a present salary, status, or job; or
2. Maintains or improves skills required for present work.
3. All registrants will receive a certificate of attendance.

will find that Hot Spots 2018 meets your CMI needs perfectly and your expenses can be claimed as a business expense.

CMI - Continuous Medical Inspiration

At Hot Spots, we provide valuable CMI!

Toward Continuous Medical Education (Free Online Full Text)
Roni F Zeiger, MD. J Gen Intern Med. 2005 Jan; 20(1): 91–94.
While traditional continuing medical education (CME) courses increase participants' knowledge, they have minimal impact on the more relevant end points of physician behavior and patient outcomes. The interactive potential of online CME and its flexibility in time and place offer potential improvements over traditional CME. However, more emphasis should be placed on continuing education that occurs when clinicians search for answers to questions that arise in clinical practice, instead of that which occurs at an arbitrary time designated for CME. The use of learning portfolios and informationists can be integrated with self-directed CME to help foster a culture of lifelong learning.

Hot Spots Syllabus

Hot Spots in Dermatology -Tentative Syllabus
August  17 - 19, 2018

Thursday, August 16:
6:00 pm.  Get together at The Johnson’s Cabana 6:00

Friday, August 17
8:00 am Registration and Breakfast
8:30 a.m. - 12:30 p.m.  Plenary Sessions
8:30 - 9:30 a.m.
Drs. Crowell, Elpern, Glamb, Kumar, Johnson, Rademaker and others
9:30 - 10:00: Marius Rademaker.  “How I use isotretinoin”
10:00 - 10:30 Bhushan Kumar. “Non-venereal genital dermatoses”
10:30 - 10:45 Refreshment Break
10:45 - 11:15  Malcolm Ing. “Let Us Now Praise Famous Men”
11:15 - 11:45
11:45 - 12:30 Frank Dann.  “As I’ve Seen it over Four Decades.”

Saturday, August 18
8:00 am Registration and Breakfast
8:30 - 9:00 am  Michael Schoenfield: My 20 Year History with Skin Cancer
9:00 - 9:30  Bhushan Kumar. D/D of Dermatological diseases in relation to leprosy
9:30 - 10:00 Marius Rademaker. MTX for atopic eczema in the era of dupilumab
10:00 - 10:15 Paul Esaki. TBD
10:15 - 10:30 Refreshment Break
10:30 - 11:00 Julie Crowley,  Fake Skin Disease: Coming to your clinic soon
11:00 - 11:30 Vail Reese. Countering Creeping Confusion:
                                       A Proposal to Re-Name Herpes Virus Taxonomy
11:30 - 12:00 Dave Elpern.  Medically Unexplained Dermatological Symptoms

Sunday, August 19
7:30 am Registration and Breakfast
8:00 - 8:30.  Julie Crowley
8:30 - 9:00 am  Michael Schoenfield: Close Encounters with Overmedicalizatiopn
9:00 - 9:30  Bhushan Kumar. D/D of Dermatological diseases in relation to leprosy
9:30 - 10:00 Marius Rademaker. MTX for atopic eczema in the era of dupilumab
10:00 - 10:15
10:15 - 10:30 Refreshment Break
10:30 - 11:00 Doug Johnson.  TBD
11:00 - 11:30 Dave Elpern.  Medically Unexplained Dermatological Symptoms

11:30 – 12:00 George Reizner: Aloha Oe




AUGUST 17 - 19, 2018
Physicians: $400 or $175 per day
After June 1, $500
On-Site Registration:To Be Decided
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:

Doug Johnson
Phone: 808-342-6002
Email: dwj808@gmail.com

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 17 - 19, 2018

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 Douglas Johnson, M.D.
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)_____________________________________


2017 Faculty

Hot Spots Faculty 2010

2014 Hot Spots in Dermatology
Tentative Faculty

Terrilea Burnett, Ph.D. Cancer Center of Hawaii, Honolulu, Hawaii
David Elpern, M.D.  Williamstown, Massachusetts
Larry Eron, M.D.  Kailua, Hawaii
Henry Foong MBBS, Ipoh, Malaysia
Roman Glamb, M.D. Honolulu Hawaii
Roy Grekin, M.D. San Francisco, California
Malcolm Ing, M.D.  Honolulu, Hawaii
Doug Johnson, M.D.  Honolulu Hawaii
Marian Melish, M.D. Honolulu, Hawaii
George Reizner, M.D.  Madison, Wisconsin
Michael Webster, Dermatologist, Pascoe Vale, N.S.W. 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.


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. https://en.wikipedia.org/wiki/Cyberchondria

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


50 Years in the Curl, by Malcolm Ing

50 Years in the Curl
                                Malcolm R. Ing, MD, FACS

Abstract: the author will describe his surfing experience in a half century quest for the perfect wave ride. 
History:  Great changes in equipment and style have taken place over the past 50 years. The author’s first equipment-- a redwood hollow board of 14 feet contrasts greatly to his present 8 foot foam and fiber glass board. The author will describe his encounters with several “Surfing Legends.”
Discussion: The risk of injury in surfing has been reduced and, though his own personal experience, he will describe ways to prevent these injuries.
Question for the Audience: How many in the audience would like to experience surfing?
1. Rick Grigg. Big Surf Deep Dives and the Islands. Editions Limited. 1998.
 2. Fred Hemmings. The Soul of Surfing. Sports  Enterprises .1997.
3. Ben Marcus. The Surfboard. Voyager Press. 2007