Download 1.)Each individual biopsy must be

•Information sheets:
These are given to the patient to begin reading while you are
getting scripts, samples together. This is so they have a chance to
read over the information and ask questions before they leave.
If there is a topic for which you’d like to prepare a patient
information handout, speak with Dr. Kalb
When you give a patient a sheet, take another for yourself to
become acquainted with the information
Take sheets from the back of the folder, so Audrey will know when
more copies are needed
•New Patients
Make sure you ask for who referred and for primary MD
In addition to information contained on the body sheet, the
following should be listed on the first page:
FmHx (Psoriasis, Eczema, Skin Cancer)
Previous Dermatologic Treatment
Pertinent Medical Hx and current medications
****Update at each visit********
Some simple survival rules…
No yawning is allowed when Beth is tired
Food is always welcome
Very Important: No specimen should ever be left unlabelled.
•If a patient does not have a referral, they must sign a waiver before their
visit
Documentation:
•All doctors in the Buffalo Medical group use the same chart, so there may
be multiple visits for non-dermatologic problems. Previous derm visits
will be marked with a yellow flag.
CC:
#1
#2
#3
PmHx:
FmHx:
• The first entry for every visit should be the date of the last visit and the
patient’s age and sex.
-Psoriasis
-Eczema
-Skin Ca
Previous Derm History:
-any biopsies
-skin Ca
-eczema
-psoriasis
Medications
Allergies:
•Extra pages can be found under paperclip on left of chart.
•Patients with a history of skin cancer should have a purple ‘Skin Cancer
History” record. If there is not already one started, ask Audrey for the
form.
•One try for blood draws (get Beth or Mark if not successful on the first
try).
•Before removing skin tags, make sure the patient has completed a skin tag
removal waiver. Have them stop at the desk for the charge ticket before
leaving.
Imp/Plan:
#1
#2
#3
Pt. Info Given
Example biopsy:
Biopsy A –R leg
Area anesthetized with
local/ biopsy / Al Cl /
aquaphor/ bandaid.
Biopsies:
1.)Each individual biopsy must be documented separately in chart.
Make sure to document location of biopsy in chart.
If there are multiple biopsies label them A,B, C, ect
If there is possibility of Ca write a plan (excised at visit, RTO, Dr Wirth)
2.)Label the specimen
3.)Next fill out the pathology request form to be sent with the specimen.
(This will be shown to you)
Accutane (ten pack)
10, 20, 40mg
Aclovate (0.05%)
15,45,60gm
4.)Make sure to log the biopsy in the log bookAquaphore
**** (OTC)
15, 52.5gm
QD
Amlactin
140gm
QD
Loprox T/S, Gel, Cream
15, 30, 90gm
QD
Apexicon E
60 gm
QD
Lotrimin cream,solution
15, 30, 45gm
QD
Avita (tretinoin)
cream/gel 0.025%
20, 45Gm
QD
Luxiq Foam
50,100,150gm
QD
Lustra 4% cream
3.5, 28.4gm
QHS
Metro Gel 1.0%
30, 45gm
Daily
Bactrim DS
QD/BID
Bactroban (2%
muciprocin)
Cream 15, 30 gm
Ointment 22gm
TID
Metrolotion/Cream
60 ml
Qd
Benzamycin
23.3, 46.6gm
QD/QOD
Minocin
50, 100mg
Daily
Brevoxyl cleanser
(4% or 8%)
6 oz.
Daily
MTX
15 mg/week 2.5mg
tablets
Once per
week
Brevoxyl gel (4 or 8%)
42.5, 90 gm
QD
Noritate Cream
30gm
Daily
Benzaclin Gel
25, 50gm
QD/QOD
Neoral (cyclosporin)
100mg
Carac Cream 0.5%
30 gm
Daily
Nizoral
15, 30, 60gm/200mg
Carmol 40 cream/lotion
(40% urea)
7 oz / 8 oz
Daily
Nizoral Shampoo
1% OTC 2% Rx
15, 30, 60gm
Daily
Carmol HC 1.0
30gm
Daily
Oxistat 1%
Cream/Lotion
Clenia Cream
(sulfacetaminde10%/sul
fur 5%)
28 gm
QD/QOD
Olux Foam 0.05%
50,100gm
QD
Pandel HC 0.1%
15, 45, 80gm
QD
Clindamycin (Cleocin)
1% gel or soln 30,
60gm, 1% lotion 60
ml, pledgets 60/box
Daily
Plexion
Cream/Cleanser
30 gm / 6 oz
QD
Plaquenil
200mg
Daily
Clobetasol cream
0.05%
15,30,60 gm
QD
Pramasone 2.5% lotion
60, 120, 240ml
QD prn
Pramasone 2.5% cream
30, 60gm
QD prn
Clobetasol scalp soln
0.05% 60 ml
QHS prn
Propecia
1mg
Daily
Clobex lotion 0.05%
60 ml
QD prn
Protopic 0.01%
QD
Cordran tape
Lg roll
QD prn
Ointment
30,60,100gm
Cutivate (0.05%) cream
15, 30, 60gm
QD prn
Psorcon 0.05% Cream
15, 30, 60gm
QD prn
Cyclocort 0.1 cream
15, 30, 60gm
QD prn
15, 30, 60gm
QD prn
Dapsone
25, 100mg
QD, BID
Psorcon 0.05%
Ointment
Dermasmooth FS
120 ml
QHS
Retin A (0.025%,
0.05%, 0.1%) cream
20, 45gm
QHS
Desowen lotion, cream
or ointment
15, 60, 120ml
QD prn
Retin A Micro (0.1 % or
0.04%)
20, 45gm
QHS
Differin 0.1% cream/gel
15, 45 gm
qhs
60ml
BID
Diflucan
50, 120, 150, 200mg
Daily
Rogaine solution (2% or
5%)
Diprolene (0.05%)
15, 50gm
QD prn
15, 50gm
QD prn
30 gm cream, 6 oz
cleanser
Daily
Diprosone (0.05%)
Sodium sulfacetamide
10%/ Sulfur 5%
Solaraze gel
50, 100 Gm
QD
Dovonex cream 0.005%
30, 60, 100gm
QD
Soriatane
25mg
QOD-QD
Dovonex ointment
0.005
30, 60, 100 gm
QD
Spectazole
15, 30, 60gm
Daily
Dovonex scalp solution
60ml
QD
Sulfacet-R (10%)
25ml
Daily
Doxepin
10 – 25 mg
1-2 qhs
Synalar (0.025% )
15, 60gm
QD
Doxycycline
100mg
QD-BID
Taclonex Ointment
60gm
QD
Drysol
37.5 ml
qhs
30, 100 gm
QOD-QD
Duac Gel
45 gm
QD-QOD
Tazorac Cream, Gel
(0.1%, 0.05%)
QD
25, 100gm
Daily
Topicort (0.25%) Cream
Ointment/Gel
15, 30gm
Efudex cream (5%)
Elocon (0.1%) cream
15, 45gm
QD prn
30,60,100 gm
QD
TAC (Triamcinolone)
0.1% cream/ointment
15, 60, 240gm, 1
pound jar
QD prn
Elidel cream
Exelderm solution
30 ml
Daily
Exelderm cream 1%
60 gm
Daily
QD
125, 250, 500mg
Tri-luma cream
(fluocinolone/hydroquin
one/tretinoin)
0.01%/4%/0.05%
30gm
Famvir
Folic acid
1mg
Daily
Ultravate
15, 50gm
QD
Finacea azelaic acid
15% gel
50gm
QD
Vanos 0.1% cream
60 gm
QD
Vytone Cream (1%)
30gm
QD
Hydrocortisone 2.5%
15, 30, 60 gm
QD
Vaniqa (13.9%) cream
Hydroxyzine (Atarax)
10-25 mg
QHS-TID
Westcort 0.2%
15, 45, 60gm
Keflex
250, 500mg
TID/QID
Zithromax (#6 Zpack)
250mg
Klaron Lotion 10%
120 ml
QHS
Zovirax
400, 800mg
Lamisil (tabs)
250mg
Daily
Zyrtec
10mg
QHS
Lamisil spray, cream
30ml, 30 gm
qd
Lidex 0.05% cream/soln
15, 30, 60, 120gm
QD prn
Zyrtec Syrup
5mg/5ml
QD
Locoid 0.1% cream/oint
15, 45gm
QD prn
Lamisil spray, cream
30ml, 30 gm
QD
Locoid scalp solution
60ml
qhs
Triaz Gel (6% or 10%)
BID
BID
Dermatology
Dr. Robert Kalb
295 Essjay Road
Williamsville, NY 14221
(716) 630-1102
[email protected]
This is a Monday-Friday ambulatory care experience. Students participate in the
office on Essjay road. This is a very busy dermatology office. On Wednesday
afternoons students attend lecture and clinic with dermatology residents at Buffalo
General Hospital. During this rotation the student will:
•Learn to describe skin lesions by morphology and distribution
•Learn to diagnose and treat common skin disorders
•Understand the role of the dermatologist, dermatopathologist and
dermatologic surgeon in the care of skin disorders.
•The medical student is given considerable autonomy and responsibility.
Responsibilities of the student may include:
•Taking a relevant history from each patient
•Performing skin exams both independently and with Dr. Kalb
•Giving local anesthesia and IM injections
•Assisting in skin biopsies and removal of lesions
•Formulating a treatment plan
•Providing patient information regarding their conditions
•Recording the patient’s visit in the their chart
•Calling patients with the results of their biopsies