Randy Dotinga
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Indie scribbler, "incorrigible," & "some know nothing hack." Board member, @ahcj. Former prez, @asja_hq. Book agent: @annasproul. 🏳️🌈 randydotinga@gmail.com
Articles by Randy Dotinga
Atopic Dermatitis: Many Treatment Options, More in the Pipeline
CARLSBAD, Calif. — Dermatologists treating moderate-to-severe atopic dermatitis (AD) now have multiple options for their patients, a dermatologist told colleagues here, with three promising drugs in the works.
‘Elephant in the Room’: Antifungal Resistance Is On the Rise
CARLSBAD, Calif. — New challenges are arising in the world of tinea, a dermatologist warned colleagues at the fall symposium of the California Society of Dermatology and Dermatologic Surgery. “The elephant in the room is that we are actually in the midst of an antifungal resistance crisis,” said Iris Ahronowitz, MD, associate professor of dermatology at the University of California, Los Angeles, who spoke in a presentation at the meeting and a follow-up interview.
Military Service Linked to Worse ALS Survival, New Study Finds
Military service is linked to higher risk of a myotrophic lateral sclerosis (ALS), and a recent study found that veterans have worse survival times than nonveterans for reasons that are unclear. In an adjusted analysis of outcomes in 6908 nonveterans and 1735 veterans with ALS, military service was associated with a 25% higher mortality risk (hazard ratio, 1.25; P <.0001).
Daily Business Report: October 22, 2026
One of San Diego’s largest landlords settles security deposit lawsuit for $19.25 million By Dorian Hargrove | Times of San Diego One of California’s largest apartment landlords has agreed to pay $19.25 million to settle a class-action lawsuit alleging it wrongly withheld security deposits.
‘Impact of Killing’ Psychotherapy Linked to Better Outcomes in Vets
A 10-session psychotherapy program designed to treat veterans distressed by killing in combat outperformed or equaled the impact another therapy strategy had on measures of psychosocial functioning, according to a recently published randomized clinical trial.
More Veterans With Depression Not Getting VA Treatment
Though a combination of antidepressants and psychotherapy is often recommended to treat depression, a new retrospective cohort study found that more veterans are either receiving one treatment alone or neither treatment altogether, at least among those enrolled in US Department of Veterans Affairs (VA) health care.
Judge Says Rady Children’s Can Partially Limit Gender-Transition Care
A Superior Court judge on Monday agreed to allow Rady Children’s Hospital San Diego to temporarily limit the gender-transition services it provides to new patients. Judge Matthew Braner ruled that Rady and its sister hospital in Orange County only have to provide puberty blockers to new patients, and then only if they’re on the cusp of puberty. New patients will no longer have access to hormone therapy or to puberty blockers at other stages of puberty.
Stakes Are High When Pediatric Hypertension Is Missed
SAN DIEGO — Hypertension gets less attention in kids than in adults, but according to a nephrologist, it’s vitally important to treat because it can set children on a path to poor health for their lifetime.
Eating Disorders in Kids: Watch for These Red Flags
SAN DIEGO — A 13-year-old girl loses 30 lb in 9 months, but her weight is still in the 90th percentile for her age. A teen athlete has a slow heart rate accompanied by weight loss. These scenarios may seem unlikely to trigger a physician to suspect an eating disorder and investigate further. But they’re both potential warning signs, a pair of pediatricians told colleagues in a presentation at the American Academy of Pediatrics (AAP) 2026 National Conference.
Acne: New Research Offers Fresh Insights Into Isotretinoin
CARLSBAD, Calif. — There’s still more to learn about isotretinoin, a mainstay of acne therapy since the 1980s, a dermatologist told colleagues at the symposium. Recent research is offering insight into its potential effects on height, its compatibility with common laser treatments, and a strategy to prevent relapse, said Carol Cheng, MD, associate clinical professor of dermatology and director of the Acne & Rosacea Clinic at the University of California, Los Angeles.
US To Crack Down On Mail-Order Canadian Drug Imports: What You Need To Know
The Canadian prescription drug lifeline for thousands of Americans may be in jeopardy. New US Customs and Border Protection regulations starting October 22 will disrupt or even halt mail-order prescription deliveries from Canada and elsewhere to US patients, patient advocates say. “This is an emergency,” warned Lucia Mueller, president of PharmacyChecker.com, which verifies international pharmacies and compares drug prices, in an interview.
Chronic Cough in a Child? Don’t Make Assumptions About Causes
SAN DIEGO — Pediatricians should check their assumptions when a child comes down with a chronic cough, a pulmonologist cautioned colleagues at the American Academy of Pediatrics (AAP) 2026 National Conference. Kids never get bronchitis? Not true. Asthma likely explains isolated chronic cough? No. Cough suppression and over-the-counter cold drugs can be helpful? Maybe not. What should pediatricians do? Rely on established guidance.
Contact Dermatitis: Helping Patients Navigate Potential Allergens
CARLSBAD, Calif. — If a patient turns out to be sensitive to an allergen, should their dermatologist just say, “Here’s what you tested positive to. Stay away from it”? Absolutely not, dermatologist Brandon Adler, MD, told colleagues here at the fall symposium of the California Society of Dermatology and Dermatologic Surgery.
e-Bikes Linked to More Pediatric Injuries Than e-Scooters
SAN DIEGO — A new study is shedding more light on the danger of e-bikes, which have skyrocketed in popularity over the past 5 years. At Children’s Hospital Los Angeles, Los Angeles, California, from 2019 to 2025, e-bikes accounted for higher rates of concussions, fractures, surgeries, and inpatient admissions than e-scooters, reported orthopedic surgeon Bianca Edison, MD, MS, and colleagues at the American Academy of Pediatrics (AAP) 2026 National Conference.
GLP-1RAs Show Promise in Opioid Overdose in Veterans, More Research Needed
A recent study of veterans with type 2 diabetes mellitus (T2DM) and opioid use disorder (OUD) hints that glucagon-like peptide-1 receptor agonists (GLP-1RAs) could offer the added benefit of lowering the risk of overdose, although the findings are conflicting.
Tips on Navigating Long COVID, Breathing Problems in Teen Athletes
SAN DIEGO — In the era of long COVID, it’s not enough to automatically assume a teenage athlete has asthma when they say “I can’t breathe,” a pediatrician advised colleagues at the American Academy of Pediatrics (AAP) 2026 National Conference. Instead, “when an athlete presents with dyspnea, I’m going to always ask what physiology is producing that symptom,” said Suzanne McNulty, MD, of Aliso Viejo, California, in a presentation about breathing problems in the context of post-COVID effects.
In Youngest Patients, Colorectal Cancer Is More Severe and Fatal
SAN DIEGO — Colorectal cancer (CRC) is becoming more common in young people. A new multicenter study finds those aged up to 21 years are often diagnosed with advanced disease at 3 or more months after the development of symptoms. In addition, the mortality rate is high.
‘Think Beyond SPF’: Sunscreen Isn’t the Only UV Protection Strategy
SAN DIEGO — A viral TikTok video posted by a dermatology practice in Austin, Texas, doesn’t address the usual popular skin topics such as acne or cosmetic surgery. Instead, it has racked up nearly 10 million views by exposing the reality behind a seemingly simple and cheap sun protection strategy: the T-shirt. “A normal white T-shirt has a UPF [ultraviolet (UV) protection factor] of 5, which means that 20% of UVA/B passes to the skin.
Hair-Loss Treatments: From Minoxidil to Transplant Surgery
SAN DIEGO — There’s good news about hair loss, Marc Avram, MD, dermatologist, told colleagues here at the Masters of Aesthetics Symposium: “We’re in an era where we have really good treatments that not only prevent it from getting worse” but also can result in hair regrowth, he said.
Federal Bill Takes Aim at Private Equity’s Role in Healthcare
As Oregon goes, so goes the nation. That’s the hope of a Democratic US senator who wants to limit private equity’s role in healthcare via legislation modeled on the Beaver State’s strict policies. The Stop Corporate Takeovers of Physicians Act, introduced this month by Senator Elizabeth Warren (D-Mass.) and congressional colleagues, aims to tightly control who can own a medical practice or contract for medical services.
VA Study Offers Insight into RSV Vaccine Longevity
The newness of the respiratory syncytial virus (RSV) vaccine is causing clinicians to focus their attention on getting single shots into the arms of patients as opposed to worrying about what comes next. But a gap in knowledge persists: Should patients come back for a second dose, as they do with the influenza vaccine? Or is a single dose enough?
Recommendations on Eye Protection During Aesthetic Treatments
SAN DIEGO — Dermatologists and their staff members must take special precautions to protect the eyes when using lasers for facial procedures, a Boston dermatologist cautioned colleagues. Catherine M.
Cosmetic Dermatology: Know When to Say No and Avoid Assumptions
SAN DIEGO — When faced with a difficult patient, Los Angeles dermatologist H. Ray Jalian, MD, urged aesthetic specialist colleagues to remember that they’re not required to treat everyone who comes in the door. Saying “no” is a treatment decision, Jalian said in a presentation on “when not to treat” at the 2026 Masters of Aesthetics Symposium.
Rural vs Urban Veteran Residence Impacts Unplanned Readmission, Death Rates Postdischarge
Older veterans living in rural communities who were discharged home from US Department of Veterans Affairs (VA) hospitals were less likely to be readmitted within 30 days than their urban counterparts but faced a higher risk of death, a new observational cohort study finds. The July 2026 Journal of Rural Health study tracked 99,557 veterans aged ≥ 65 years who were discharged home from 120 VA medical or neurology wards in fiscal year 2023.
VA Study: Vaccine Linked to Fewer COVID-Related Cardiovascular Events
Veterans aged > 75 years who received both COVID-19 and influenza vaccinations in late 2024 were about 50% less likely to develop COVID-related major adverse cardiovascular events (MACE) than individuals only vaccinated against influenza, a recent target-trial emulation cohort study finds. The results also indicate that vaccination provided significant protection against MACE linked to all causes, not just COVID-19.
Doc Sues Malpractice Insurer for Refusing to Settle $4.7 Million Lawsuit
In a case that sheds light on disputes that can divide malpractice insurers and physician clients, a South Carolina ob/gyn has accused his insurance company of refusing to settle a doomed malpractice case — ultimately costing him millions of dollars beyond his policy’s limit. In a federal lawsuit filed on August 24, Gregory A.
Should optometry play a bigger role in wet AMD monitoring?
As U.S. optometrists push to expand their scope of practice, a recent British randomized trial suggested that community optometrists could safely play a large role in the monitoring of neovascular (wet) age-related macular degeneration (AMD).
Shock wave therapy for erectile dysfunction is on the rise
Some men in the United States seeking relief for erectile dysfunction aren’t getting prescriptions for Viagra. Instead, they’re flocking to health clinics to subject their private parts to low-energy sound waves touted as a painless path to penile healing. The treatment, called shock wave therapy, is controversial. But if it delivers on its promise to improve erections by boosting blood flow in the penis, then it could help the millions of people whose ED is caused by vascular problems.
Nearly Half of US Internal Medicine Docs Are Foreign-Born: Study
As the Trump Administration continues to support a crackdown on legal immigration, a new study reported that physicians born in other countries account for nearly half of a sample of almost all internal medicine physicians in the US.
Ex-Mayo Exec Sues, Says She Was Fired for Whistleblowing on AI Security, Privacy
A former director who oversaw research at the Mayo Clinic accuses the healthcare system of retaliation after she raised the alarm about “fundamental lapses” in evaluating AI tools for patient care and research. In a July 6 lawsuit filed in federal court, Traci Tamiko Eto, MA, claims that her insistence on “adhering to federal and institutional standards regarding AI governance and the IRB [internal review board] process” led to her firing.
For San Diego’s LGBTQ Community and Cops, an Ever-Evolving Relationship
It had been more than half a century since her eventful visit to a San Diego lesbian bar, but Jill McCall still remembered what happened when the cops came calling. She went out with pals one day in 1966 to celebrate her new job at the headquarters of Pacific Southwest Airlines, and they landed at a joint called The Club (now The Casbah) near the airport. “We’re there probably about an hour,” McCall recalled in a 2018 KPBS documentary. “All of a sudden, the lights went on.
For San Diego’s LGBTQ Community and Cops, an Ever-Evolving Relationship
It had been more than half a century since her eventful visit to a San Diego lesbian bar, but Jill McCall still remembered what happened when the cops came calling. She went out with pals one day in 1966 to celebrate her new job at the headquarters of Pacific Southwest Airlines, and they landed at a joint called The Club (now The Casbah) near the airport. “We’re there probably about an hour,” McCall recalled in a 2018 KPBS documentary. “All of a sudden, the lights went on.
Urologist Wins $6.8 Million in Damages in Retaliation Case
A federal jury in St. Louis has awarded more than $6.8 million in damages to a urologist who claimed a local health system retaliated against her for complaining about the workplace. In a 2024 lawsuit against SSM Health — a nonprofit, Catholic healthcare network — and the affiliated Saint Louis University in St. Louis, Deborah La Scola, MD, claimed she was fired after complaining about gender-based discrimination and harassment.
JAK and IL-23 inhibitors for ulcerative colitis: Making decisions about dosage
While JAK and interleukin (IL)-23 inhibitors have rapidly entered routine care for ulcerative colitis (UC), the ideal maintenance doses remain unclear. "The unresolved question is: Which patient actually needs the higher maintenance dose?" said Rahul Dalal, MD, MPH, a gastroenterologist at Brigham and Women's Hospital and Harvard Medical School in Boston.
Anesthesiologist MDs Beat CRNAs in Trademark Fight
Under fire from MD or DO anesthesiologists who claim their job title is being misappropriated, the American Association of Nurse Anesthesiology (AANA) has withdrawn applications to register trademarks for two variations on its name. The AANA will keep using its revised name, however, keeping alive the battle over whether the clinicians long known as “nurse anesthetists” can rebrand themselves as “nurse anesthesiologists.” Here’s what you need to know about this ongoing dispute.
Blinatumomab Outperforms Chemotherapy in High-Risk B-ALL
Replacing two blocks of chemotherapy with two blocks of the bispecific antibody blinatumomab significantly improved event-free survival in children with high-risk B-cell acute lymphoblastic leukemia (B-ALL), according to findings from the randomized, phase 3 AIEOP-BFM ALL 2017 trial. At 4 years, event-free survival was 12.7 percentage points higher with blinatumomab than with chemotherapy, and relapses were about half as likely.
Talquetamab Combinations Show Survival Benefit in r/r Myeloma
Combinations of the bispecific antibody talquetamab and daratumumab — with or without pomalidomide — outperformed standard therapy in patients with relapsed or refractory (r/r) multiple myeloma, according to an interim analysis of the randomized phase 3 trial MonumenTAL-3.
Immigrant Physicians, Medical Students at Center of Storm as US Court Battles Intensify
Last winter, the Trump administration made a series of moves to limit immigration, immediately throwing into doubt the plans of physicians and medical students around the world planning to come to the US or continue working here. The White House paused the processing of visa applications for immigrants from 39 countries, leaving physicians from countries such as Iran, Somalia, and Nigeria in limbo, then added more countries to the list of targeted countries.
Skin Disorders in Transgender Patients: Treatment Recommendations
An estimated in the US aged 13 years or older identify as transgender, according to a recent report — and many take hormonal medications that can boost the risk for skin disorders. Here are some recommendations from three dermatologists about managing acne and other skin-related issues when caring for transgender patients. Transgender males, who were born as biological females, often take testosterone — a major driver of acne — as part of gender-affirming hormone therapy.
Blood Test Flags Mantle Cell Lymphoma Relapse Before PET-CT
A blood test following CAR T-cell therapy for relapsed/refractory mantle cell lymphoma (MCL) appears to do a better job than PET-CT scans at predicting which patients have poor prognoses, a small, retrospective, real-world study finds. In 15 of 18 patients who relapsed, the blood test identified relapse a median of 6.5 months before PET/CT did.
San Diego shooting victims remembered for selfless dedication to their Muslim community
San Diego shooting victims remembered for selfless dedication to their Muslim community (washingtonpost.com) San Diego shooting victims remembered for selfless dedication to their Muslim community By Randy Dotinga; Daniel Wu 2026052009013400 SAN DIEGO — Amin Abdullah was so disturbed by the 2019 massacre at mosques in Christchurch, New Zealand, that he became a security guard and stood watch over the Islamic Center of San Diego, according to a chaplain who works with children there.
Study Questions Value of Management Consultants at US Nonprofit Hospitals
Nonprofit hospitals spend billions on management consultants, who have developed a reputation as job-killers. But a new study suggests they have negligible impact on how the institutions are run and how patients are treated.
Museum Artworks Offer Lessons in Clinical Vision to Dermatology Students and Residents
Every year, dermatology students and residents across the US visit local art museums. They have one main assignment: Look, describe, and discuss. A painting by Edvard Munch, the Norwegian artist who is most famous for “The Scream,” might be on the agenda at Harvard University’s Busch-Reisinger Museum. It shows a man and woman from the back, seemingly gazing at a body of water from a shore. They seem to be estranged — but maybe not.
Volume Matters in Ablative Radiotherapy for PDAC
For patients receiving ablative radiotherapy for inoperable pancreatic ductal adenocarcinoma (PDAC), an expanded treatment area may improve local disease control, a retrospective cohort study found. Among 121 consecutive patients, nearly all of whom received definitive MR-guided radiotherapy with a clinical target volume (CTV) design, only 14% experienced locoregional failure at a median follow-up of 14 months.
Skin-Picking and Hair-Pulling Disorders: Which Medications Work?
DENVER — Skin-picking and hair-pulling disorders are “underrecognized, understudied, and undertreated,” a dermatologist told colleagues, but medications — especially glutamatergic agents — are showing promise in trials.
Physician Accused of Using Imposter for Mandatory Class
A California anesthesiologist stands accused of blowing off a mandatory remediation program by enlisting a much younger man to pose as him in Zoom meetings, complete with hair and a mustache dyed white. The alleged imposter’s hair wasn’t fully dyed, however, and his eyebrows were black. California state medical board officials accuse Gary Lee Greenberg, MD, of gross negligence, dishonesty, and unprofessional conduct.
‘Frustratingly Vague’: Insurers Fail to Get Specific on Prior Authorization Reforms
Under pressure from politicians, American health insurers say they’ve voluntarily slashed prior authorization (PA) requirements for medical services by 11% this year. But they’re refusing to provide specifics, and they’re not being greeted as liberators. “The information is frustratingly vague,” said Sabin Dang, MD, retinal specialist in St. Louis and critic of PA requirements.
Oral JAK1 Inhibitor Povorcitinib Shows Promise in Hidradenitis Suppurativa
DENVER — An experimental oral JAK1 inhibitor showed durable benefit in patients with moderate-to-severe hidradenitis suppurativa (HS) through more than a year of treatment, a pair of identical placebo-controlled phase 3 trials found. At 54 weeks in the STOP-HS1 and STOP-HS2 trials, up to 71.4% of patients taking povorcitinib achieved at least a 50% reduction from baseline in the total abscess and inflammatory nodule (AN) count, reported Martina L.
Male Vets Less Likely to Undergo Intimate Partner Violence Screening
Male veterans are less likely than their female counterparts to be referred for follow-up questions when initial screening suggests they may be at risk of intimate partner violence (IPV), a recent large cross-sectional study finds.
Melasma: nueva era de opciones de tratamiento tópico
DENVER. El panorama de las terapias tópicas para el melasma evoluciona con rapidez, a medida que se dispone de un flujo constante de nuevos agentes, los cuales ofrecen alternativas a los tratamientos tradicionales de primera línea, según explicó la Dra. Nada Elbuluk a sus colegas en el Congreso Anual de la American Academy of Dermatology (AAD) de 2026. Dra.
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