More information, please
In the article, diclofenac gel (Solaraze) is re- You left us hanging! After reading the article by ferred to as a “newer topical chemotherapy” Mark E. Meijer, MD, “An unusual approach to when it is actually considered by most to be a glycemic control” (March 2005), I felt that the nonsteroidal anti-inflammatory drug. In the actual approach was not outlined. His article current Solaraze prescribing information, the marked his successes and his “study” results but mechanism of action in the treatment of actinic never actually told us what his approach was.
keratoses (AK) is unknown. And while the au- The example of Dr. Meijer’s patient handout on thors state that Solaraze is “gaining widespread page 34 was a teaser.What else does he teach the acceptance,” it is currently the third most com- patient? There was no address except his city to monly prescribed topical product for AK in both Likewise, the article recommends treating AK with imiquimod (Aldara) three times per weekfor eight weeks. However, in the drug’s prescrib- Dr. Meijer responds:
ing information, the recommended dosage is If simple problems have simple solutions, then complex two times per week for 16 weeks. Additionally, problems do not. The fact that the well-funded no safety information associated with Aldara is United Kingdom Prospective Diabetes Study could presented (i.e., application-site reactions/disor- not achieve weight control while achieving intensive ders, including treatment-site infections), yet in- glycemic control suggests that treating “diabesity”(both flammation as an effect with 5-fluorouracil is diabetes and obesity) is not as simple as writing a prominently noted in the article. The Aldara prescription. Nevertheless, noted psychologist, B.F. prescribing information notes: “Most patients Skinner, MD, showed that simple behavior modifica- using Aldara Cream for the treatment of AK tion could achieve very complex behavior changes ( but experience erythema, flaking/scaling/dryness only at one small step at a time ).Complex changes can and scabbing/crusting at the application site require many steps, and unfortunately, there was just not enough room in the article to provide these details. However, I do have a DVD, “The Prevention and Treatment of Diabetes,” that better explains my results and how they were achieved. ( Editor’s note: For a free copy of Dr.Meijer’s DVD,e-mail a request to A complete copy of my patient information handouts has been published in my book, Ten Stepsto Control Diabetes, which can be purchased A detailed tutorial is avail-able at no additional charge to health-care providers. Ifyou would like personal assistance, you may also con-tact me through my Web site. Ultimately, my success in treating patients with di- abesity is the result of my ability to simplify theproblems (diet, diabetes, obesity, etc.) and their corre-sponding solutions. Diclofenac for actinic keratoses
I would like to comment on a few statements in
“A quick guide to five common skin diseases”
by Robert Norman, DO, MPH, and Kenneth
Wallace,MD (March 2005).


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