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by Joseph B. Schneider DO   June 26, 2023

You may have heard about the new class of medication called the Jak-inhibitors, or simply Jak’s (pronounced Jack or Jax).

They are a fairly new class of medication that inhibits the Janus Kinase proteins. These proteins are involved in regulating the process in which cells grow, survive, develop and differentiate. When there is too much activation of these proteins inflammation can occur, causing a variety of skin diseases such as psoriasis, eczema, some forms of alopecia (hair loss), and vitiligo (loss of pigment in the skin). They can also be involved in rheumatoid arthritis and other inflammatory diseases. The first generation of this medication class were all injected into the body. There were some serious potential side effects such as heart attack and stroke. With the newer formulations, they are available now in a pill, or topical creams that are applied directly to the skin, with much less side effect potential.

A few I am particularly excited about:

  • Tofecitinib cream (Xeljanz) – approved for vitiligo, which currently has few good treatment options.
  • Ruxolitinib cream (Opzelura) – appears to be a very good non-steroid option for eczema.
  • Baricininib (Olumiant) – these pill have been approved for alopecia areata.
  • Abrocitinib (Cibinqo) – orally taken pills that have been approved for atopic dermatitis.
  • Deucravacitinib cream (Sotyktu) – this cream has been approved for psoriasis.

by Eric Christensen, MD    May 24, 2023

Allergic rhinitis, commonly known as hay fever, is a condition characterized by inflammation of the nasal passages caused by allergens such as dust mites, pollen, mold or pet dander. Sinusitis, on the other hand, is an inflammation of the sinuses, which are hollow spaces within the bones of the face connecting with the nasal passages. Both of these conditions share many common symptoms such as nasal congestion, runny nose and sneezing. In fact, there is a strong relationship between these two conditions.

Allergic rhinitis can often lead to the development of sinusitis. When a person with allergic rhinitis breathes in an allergen, such as pollen or dust mites, the nasal passages become inflamed, causing them to produce an excessive amount of mucus. The mucus collects in the sinuses, leading to blockages and trapping of bacteria. This, in turn, can lead to an infection in the sinuses, resulting in sinusitis.

by Colleen Reisz, MD   January 3, 2023

Most Covid-related hair loss falls under the category of telogen effluvium. This type of hair loss is reversible and is characterized by an increase in shedding. Before the pandemic, telogen effluvium was most associated with the post-partum period. Pregnancy confers complex metabolic changes on the mother that alter fluid volume, insulin sensitivity, thyroid function and ectopic fat deposition. Shedding starts 3-4 months after delivery and corrects with time over 6 months to a year. Other recognized triggers for telogen effluvium include new medications, a prolonged medical illness, surgery and rapid weight loss associated with ketogenic diets, to name a few. Telogen causes the hair to shed from all over the scalp, distinguishing telogen from androgenetic alopecia, which targets the frontal scalp and crown. Telogen effluvium should be temporary, as the loss of the hair shaft initiates the renewal process. Hair grows approximately a centimeter a month, so the first signs of regrowth are often seen at the junction of the forehead and frontal hair line.

by Leila Miller, PA-C, DMSc    April 8, 2023

Tinnitus is the perception of sound – only heard by the patient – in the absence of an external source. They may hear ringing, ocean waves, roaring, crickets, a dial tone, sirens, hissing, buzzing, their heartbeat, and even music. It may be heard in one or both ears, or throughout the head, and is intermittent or constant. One out of six Americans complain of having tinnitus; of these, one out of three suffer from tinnitus distress.

Tinnitus distress is when tinnitus starts to elicit a constant negative emotional response, such as depression, anxiety, irritability or shame. This usually comes on abruptly and is traumatic.

There is a misconception that as there is no cure for tinnitus, there are no effective management options available to patients suffering from tinnitus distress. Many approaches exist. The most common include education, counseling, masking devices, sound therapy, dietary supplements, acupuncture, transcranial magnetic stimulation, and cognitive behavioral therapy. Cognitive behavioral therapy is the most researched, clinically proven program for tinnitus today!

by Brian M. Hendricks, DO    September 27, 2022

There are many causes of dizziness, and the word “dizziness” can mean different things. Conventionally, we think of dizziness as an inner ear problem, but this is not always the case. Typically, inner ear problems manifest as vertigo. “Vertigo” is a distinct symptom that is characterized by “spinning.” The patient may feel like they are spinning or the environment is spinning. Other symptoms, such as “lightheadedness” or “unsteadiness” are usually not inner ear related and can be caused by an number of other different problems, including blood pressure issues, cardiac conditions, peripheral nerve weakness or a problem with the central nervous system.

Understanding and defining the symptom you have can help better direct you to the appropriate provider you need to help you, and can cut down on unnecessary visits. If you are experiencing vertigo, we would be happy to evaluate and treat your condition.

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