Francesca Cheung, MD CCFP, is a family physician with a special interest in dermatology. She received the Diploma in Practical Dermatology from the Department of Dermatology at Cardiff University in Wales, UK. She is practising at the Lynde Centre for Dermatology in Markham, Ontario and works closely with Dr. Charles Lynde, MD FRCPC, an experienced dermatologist. In addition to providing direct patient care, she acts as a sub-investigator in multiple clinical studies involving psoriasis, onychomycosis, and acne.

Abstract
Granuloma annulare (GA) is a benign and usually self-limited cutaneous condition that classically presents as arciform to annular plaques in a symmetrical and acral distribution. The exact etiology of GA is unknown. Two-thirds of patients with GA are less than 30 years old. GA is recognized based on its characteristic appearance and no specific investigation is necessary. Reassurance and clinical observation may be the treatment of choice for localized and asymptomatic disease. Spontaneous resolution occurs within 2 years in 50% of cases. Persistent lesions may be treated with very potent topical corticosteroids, intralesional corticosteroid injections, or cryotherapy. Use of more toxic treatments are controversial in recalcitrant cases.
Keywords: Granuloma annulare, Overview, Paraneoplastic, Self-limiting, Treatment.

Dr. Robert Madan is currently the Acting Psychiatrist-in-Chief, Executive Medical Director for the Centre for Mental Health and the Medical Program Director for the Psychiatric Day Hospital at Baycrest.

Learning Objectives
By the end of the session, participants will be able to:
- Describe the problems with pharmacological treatment of behavioral symptoms of dementia;
- Describe a non-pharmacological approach to treating behavioral symptoms of dementia.

Keywords: dementia, behaviour, agitation
 

Abstract
From time-to-time we select a topic and present the information and facts in an exciting and visually informative format. Today our choice of condition to present as an infographic is Ulcerative Colitis, an important topic for which we are also developing a CME program that is scheduled for release later this year.

Keybowrds: ulcerative colitis, gastrointestinal, IBD

Michael Gordon, MD, MSc, FRCPC, Medical Program Director, Baycrest Geriatric Health Care System; Professor of Medicine, University of Toronto, Toronto, ON.
 

Learning Objectives

When it comes to dementia much of the focus is related to diagnosis and treatment(s). A terminal phase is not always considered with conditions that cause dementia-but must be to properly plan care.

To address clinical and ethical challenges that face health care providers and families for this population and to provide health care providers with processes by which to address such ethical dilemmas.

Keywords: dementia, caregiving, end-of-life planning

I
have the pleasure of introducing the latest edition of the Journal Of Current Clinical Care. As always there are a multitude of noteworthy developments to report and
a variety of interesting and clinically relevant topics that are covered in this issue.

As hinted in my last editorial, I am pleased to welcome Dr. Charles Lynde as Editor-in-Chief for the Dermatology Educational Resource @HealthPlexus and the Journal of Current Clinical Care. Dr. Lynde with the help of his fellow editors Drs. Anne
Goodfellow, John Kraft and Francesca Cheung, will spearhead a Dermatology
section on www.healthplexus.net and the Journal of Current Clinical Care. For this edition, Shahana Nathwani and Dr. Joseph Lam from the University of British Columbia provide an approach to ‘lumps and bumps’ in the pediatric population. There are
a number of conditions that present clinically as ‘lumps and bumps’ in this age group.
Some of these follow a benign course and can be safely observed, and others are more
concerning and require definitive therapy and may even result in serious complications.
A helpful feature of the article is a practice helper tool: A menu of cutaneous lesions in
the pediatric population categorized according to colour.

I am also happy to introduce our new department called Infographics. Going
forward we will select a topic and present the information and facts in an exciting and
visually informative format. In this issue our choice of condition to present as an infographic is Ulcerative Colitis, an important topic for which we are also developing a
CME program that is scheduled for release later this year.

Another first that we are introducing in this issue is a Lecture Series department.
Dr. Michael Gordon, the Medical Program Director at Baycrest Geriatric Health
Care System at the University of Toronto, is one our regular contributors, and is the
Editor-in-Chief of our Dementia Educational Resource, gives an engaging talk on Later
Stage Dementia and focusing on Promotion of Comfort, Compassion and Care, complete with video and slides.

Also in this issue, Dr. Michael Gordon in his article When to Have the Critical
Conversation? Issues in Planning for Persons with Dementia and their Caregivers,
uses a poignant family vignette to remind us that as health care providers we should
encourage families and our patients to initiate conversations early regarding treatment
at the end of life.

Drs. Lovingly Quitania Park and Sarah Tomaszewski Farias from the
Department of Neurology at the University of California at Davis review the concept of
Functional Limitations Predict Future Decline in Mild Cognitive Impairment (MCI).
MCI is a term used to describe a transitional stage between normal aging and dementia.
In MCI there are subtle changes in everyday activities that may indicate the presence
of an under lying neurodegenerative condition, however patient independence is maintained. The authors review how to assess for cognitive impairment in this population
and the prognostic implications of on subsequent conversion to dementia and the rate
of progression of dementia.

The effects of caregiver burden are often expressed as a decline in psychological and
physical health, as well as an increase in physician visits. In the article, Identifying and
Managing Caregiver Burden Among Spouses of Individuals with Parkinson’s Disease Dr. Andrew Johnson et al., examines some of the predictors of caregiver burden,
with a specific emphasis on the burden experienced by caregivers of individuals with
Parkinson’s disease. Helpful strategies for relieving caregiver burden are also reviewed.

I hope you enjoy this edition of the journal. As always, your comments and questions are welcomed.