By Michael Kaufman

With healthcare reform on more people’s lips these days than Botox is in them, it seems fitting to share a few observations based on my experience as a medical writer and reporter. This thought was triggered by the recent report that Arnold Klein, a dermatologist in Beverly Hills, is the biological father of two of Michael Jackson’s children.

Dr. Klein is known within his specialty as an expert in performing aesthetic procedures (including those involving Botox) and his seminars and workshops are always jam-packed with clinicians eager to learn his latest techniques. I witnessed this phenomenon a few years ago while covering a meeting of the Hawaii Dermatology Seminar in Maui.  I know, it was a tough job but someone had to do it.

I’ve been connected with dermatology since the late 1970s, when I began a nine-year stint as editor of the Dermatology News. As such I was on hand for the first presentation on the cosmetic use of botulinim toxin (Botox), the first on topical minoxidil (Rogaine) to regrow hair, and the first in the United State on liposuction, given by Pierre Fournier—the French inventor of the procedure. The latter was memorable for a mind-numbing series of slides featuring before-and-after photos of numerous bare buttocks of female patients. “Here are zee saddlebags,” Dr. Fournier would say, aiming a laser pointer at the offending derriere. “And here are zee buttocks after zee procedure.”

In March I covered the 67th annual meeting of the American Academy of Dermatology as a freelancer. My assignment was to comb through the voluminous material presented at the five-day meeting in San Francisco and gather information on promising new drugs and products in development. Much of what I needed could be found among the several thousand scientific posters displayed. But the poster that grabbed my attention most was one on gentian violet, an old standby that has been around since the late 1800s and was used worldwide for decades to treat a wide range of infections.

It is rarely used for that purpose today in the US. At first it was nostalgia that drew me to the poster. Seeing the words “gentian violet” for the first time in decades brought back warm memories of my mother applying the purple stuff to a myriad of childhood cuts and scrapes. I liked that it didn’t burn like iodine and I thought the purple color was kind of cool. Who cared if it was greasy and stained the bed sheets?

As I read the abstract and the rest of the poster it became clear there was a lot more than nostalgia that made it worthwhile. Researchers from the Department of Dermatology at the Downstate Medical Center in Brooklyn had evaluated the ability of gentian violet to kill seven strains of methicillin resistant Staphylococcus aureus (MRSA) bacteria obtained from skin wounds of patients at the medical center.

You remember MRSA. Before the swine flu stole the headlines, it was one of the biggest public health scourges since AIDS. In 2005, 19,000 documented deaths were attributed to MRSA, even more than the number of deaths caused by HIV/AIDS. “School closings from fears of infection are now commonplace across the country,” says Michael Berry, MD, a dermatology resident at Downstate and lead author of the poster.

Moreover, the rise in the number of cases of MRSA has been accompanied by its resistance to commonly used antibiotics. “MRSA is becoming an ever-increasing problem to treat,” says Dr. Berry. “Resistant strains are commonly encountered in post-surgical sites, superficial skin wounds, and leg ulcers.” And, he explains, resistance to mupirocin, the most commonly used topical antibiotic, is rising, as is resistance to other often-used topical antimicrobials. The Downstate study confirmed earlier findings of several small studies carried out in Japan. Gentian violet is 100% effective in killing five of the seven strains evaluated, and nearly 100% effective against the other two. What’s more, it is inexpensive and readily available without a prescription.

“Mupirocin costs approximately $40 for a 30-gm tube,” says Dr. Berry. “A 2-ounce bottle of gentian violet can be purchased on line for $1.99.” He and his colleagues concluded that gentian violet may be “one of the more useful drugs for the treatment of skin lesions infected with MRSA.” Its effectiveness and low cost compared to other agents, Dr. Berry says, “might make people willing to accept a little purple discoloration on the bed sheets.”

Of course people would have to know about it first and despite the best efforts of Dr. Berry and his colleagues, few do. Only three people were on hand for his oral presentation—and I was one of them. The other two were his parents. A few weeks later I had an appointment with my dermatologist. He had not heard anything about the Downstate study and was grateful for the information, saying, “I will use it in my practice.” But he was not surprised the word has not gotten out. “There is no money in it,” he explained.

Michael can be reached at michael@zestoforange.com.

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