Although the face of Canadian dermatology shows a productive specialty committed to patient care, teaching, and research, the demographics of the Canadian baby boom generation will have a major negative impact on the effectiveness of Canadian dermatology in the service of the Canadian population. The attrition rate predicted in the 2001 survey and validated by the 2006 survey spotlights the critical imperative for the specialty to adapt to the future of a shrinking workforce in the face of expanding demand for its services.

Condyloma acuminata, also known as anogenital warts, represent a cutaneous infection caused by sexual transmission of the human papilloma virus. We present a case of overwhelming condyloma acuminata that was treated successfully without surgery using only topical imiquimod 3.75% cream. The patient, a 66-year-old female, was referred to Dermatology for large protruding verrucous plaques that covered the entire surface of her external vulva, perineum and perianal area. These lesions developed after being treated for genital warts with cantharidin. Four other cases treated with imiquimod were identified in the literature but either required surgery, higher doses or longer duration of treatment or involved pediatric populations. In patients who are not amenable to surgery, topical imiquimod may be a novel standalone or an adjunctive therapy for giant condyloma acuminata.

Background A growing interest exists in the relationship between diet and skin disease, with many recent studies identifying a role for omega-3 fatty acids (O3FAs) in various dermatological conditions. Objective Our objective was to identify the spectrum of uses for O3FA supplementation reported in literature and to evaluate the current level of evidence for its clinical application in skin disease prevention and management. Methods A search was conducted using Ovid MEDLINE for primary literature that examined O3FA intake and skin health. A manual search of reference lists was performed to identify additional articles for inclusion. Results A total of 38 studies met eligibility for review, reporting benefits for O3FA supplementation in the treatment of psoriasis, atopic dermatitis, acne, and skin ulcers. Additionally, a reduced incidence of skin cancer and a decrease in the severity of drug-associated mucocutaneous side effects were reported with O3FA supplementation. Conclusion This review yielded many well-studied benefits of O3FA uses in dermatology. Given its high safety profile, low cost, and ease of supplementation, O3FA is a reasonable supplement that may benefit patients wishing to improve inflammatory skin conditions through diet. Areas of particular clinical interest where supplementation may be valuable include O3FAs for systemic UV photoprotection, as well as adjuvant treatment for acne to reduce both inflammatory lesion count and the severity of mucocutaneous side effects associated with isotretinoin use.

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