Successful Resolution Of Very Difficult Cases In Rockville, MD
We take pride in resolving problems and diagnostic dilemmas, particularly when patients have had persisting conditions that seemed to defy solutions. It is with this background that we felt it would be of interest to present several such cases, written up by patients themselves at our request, but without identification of those individuals. In each of these cases, we were the sixth or later medical personnel to see the patient, and helped bring about a satisfactory answer when this had not previously been achieved.
Case #1 – Sixth Opinion
"I am very pleased with Dr. Shore's care and treatment. I had discussed an issue with five previous doctors (a small unexplained growth) and none were able to help. Dr. Shore took the time to listen to me, made a diagnosis (by performing a biopsy) and recommended follow-up treatment which no doubt saved me much pain and future suffering. He is very knowledgeable and has a friendly manner. Dr. Shore is a solid healthcare provider and I plan on seeing him on a regular basis."~Richard S.
This case illustrates that it is not always possible to diagnose an entity simply by looking at it, and that biopsying a lesion, where appropriate, can often reveal the answer. Being aware of the less common appearances of various benign and malignant entities is obviously of importance, and in this instance, performing a biopsy revealed a still curable cancer that was not suspected by five previous examiners.
Case #2 – Sixth Opinion
"Dr. Shore,I want to thank you again for your enormous help with my skin problem. Over 3 years had passed with constant itching, irritation, discomfort, pain, & just general misery. I had been to 5 doctors previously - none of them could give me an answer. We had run every test, tried multiple ideas to fix it, but nothing worked. I had just about given up hope of ever feeling "normal" when my GP suggested I look up a dermatologist. I randomly found you through my insurance website, & scheduled an appointment. You were able to see me quickly (always a shock these days), & to my amazement you offered me a diagnosis on my 1st visit: Seborrheic dermatitis. Who knew that so many years of misery could be wiped away with such a simple treatment plan? After 5 doctors can't help, you begin to lose hope. But I was led to you - my 6th opinion - and you gave me a solution. I'm happy to report that I am completely symptom-free today!" ~Thank you again, Ms. Whole-Lot-Happier
Our commentary: This case illustrates that some common conditions, such as this patient's seborrheic dermatitis, can occur and be most symptomatic at sites not usually seen. When this happens, the correct diagnosis may not be made. This can result in ineffective treatment, as in this patient's case before we saw her. By being aware of the diagnostic possibilities and taking a thorough history including inquiring about the symptoms of seborrheic dermatitis in the common sites (such as scalp and face, which were present), we were able to recognize that her ongoing problem was related to the same condition in much rarer sites (such as body creases including the groin). Establishing the correct diagnosis helped us immeasurably in prescribing an effective treatment.
Case #3 – Eighth Opinion
"I came to Dr. Shore after struggling with Alopecia Universalis- a rare autoimmune disease involving rapid loss of all hair, including eyebrows and eyelashes. Before seeing Dr. Shore I had been to seven other doctors in different specialties- dermatology, endocrinology, and academia, including major universities such as Johns Hopkins, Duke, University of Virginia, and Georgetown. I underwent many different treatment plans, but no practitioners were able to help my condition. I came to Dr. Shore a frustrated patient that had almost given up hope of ever having eyebrows, eyelashes, or any hair again. Dr. Shore was understanding and took time to explain his success with hair loss recovery and his proposed treatment plan. Confident in his regimen, after a few treatments, hair growth seemed promising with the emergence of fine baby hairs. With Dr. Shore's expertise and monitoring, my hair has continued to grow, and now I even have my eyebrows and eyelashes! I am so happy to have found Dr. Shore and would recommend him- whether it be your 3rd, 4th, 5th, or in my case 8th opinion." ~Sincerely,'Ms. 8th opinion'
This case illustrates that there are sometimes solutions to medical problems, even when numerous physicians and even specialized clinics have not come up with an answer previously. This patient had the most severe form of a type of hair loss called alopecia areata – she had lost almost every hair on her body (alopecia universalis). Unlike milder cases, these severe forms of hair loss tend to be extremely treatment resistant. Through experience and trials, we have learned how to bring back the hair successfully, as we have done with other patients with this condition.