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Editorial, JCMS Vol. 4(2)

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Chronic urticaria is a common but frustrating problem to both patients and physicians. The article by Sharma, Miller, and Murray discusses the results of a questionnaire distributed to allergists, der-matologists, and physicians interested in urticaria. The results of the questionnaire highlight the dif-ferences and similarities in approaches to the investigation and management of patients with urticaria. This is followed by an insightful guest editorial by Dr. Gordon Sussman, an allergist with extensive expe-rience with this disorder.

A revolution in telecommunications is clearly shaping our lives in the 21st century. The Internet is p roviding extensive information to both physicians and patients and it has considerably advanced med-ical care. Another avenue where telecommunications is playing a significant role is in the area of telemedicine. Telemedicine allows access to care to underserviced areas where tertiary services are not normally available. The article by Phillips and colleagues discusses the role of teledermatology and the potential for this modality in future dermatologic care.

In addition to advances in telecommuncations, one of the major advances that medicine has faced is in the area of biotechnology. Our therapeutic choices have increased exponentially with the advent of newer agents, many as a result of biotechnologic advances. This has been particularly true in the area of immune modulation. The recently approved topical immune response modulator imiquimod is one such agent which has been shown to be effective in the treatment of genital warts. Liota and col-leagues have now expanded the use of imiquimod to the treatment of molluscum contagiosum. In addi-tion to telecommunications and biotechnology, our specialty has seen significant changes in laser t reatment of skin disorders.

One of the growing trends in laser therapy is the use of lasers for hair removal. Laughlin et al. examine the use of alexandrite laser, and have demonstrated the long term effectiveness of this laser in hair removal. One of the most devastating conditions seen by dermatologists is toxic epidermal necrolysis. Eisen and Shear review advances and delineate the optimal approach to care of patients with this potentially life threatening disease.

In our continuing Genetics series, Bale and Toro describe the advances in the genetic and molecu-lar approaches in identifying Darier-White disease.

A further trend in medicine in the 21st century is the empowerment of patients to become more actively involved in their clinical care. The article by Jackson recounts the personal observation of John Updike, the prolific, erudite American author who was diagnosed at an early age with psoriasis. His thoughts about his disease and treatment are important reading for all physicians.

Daniel N. Sauder
Division of Dermatology
University of Toronto

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