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Am Fam Physician. 2002;66(1):14

The article on page 119, by Daniel L. Stulberg, M.D., Marc A. Penrod, M.D., and Richard A. Blatny, M.D., is the first in a new series on the management of common skin problems, contributed by the Utah Valley Family Practice Residency, Provo, Utah. Dr. Stulberg, who is director of the dermatology curriculum at the residency and serves as coordinator of the series, says the series will tackle a spectrum of skin conditions that family physicians are likely to encounter. Articles will provide clues to distinguishing benign from malignant skin conditions and determining which may be signs of systemic diseases that may require further evaluation and treatment.

The series, “Caring for Common Skin Conditions,” will include articles on infestations and bites, benign skin tumors, cutaneous manifestations of internal disease, hyperpigmented lesions, hair loss, and molluscum contagiosum and warts. The lead article, in this issue—“Common Bacterial Skin Infections”—includes discussion of cellulitis, erysipelas, impetigo, folliculitis, furuncles, and carbuncles, with a photo guide of these conditions.

According to Dr. Stulberg, the idea for the series originated with one of AFP's assistant medical editors, Dr. Sumi Sexton, who had participated in an Internet quiz that the Utah residency has been producing since 1998. Looking for ways of using Internet technology in the residency to enhance teaching in family medicine, Dr. Stulberg developed an Internet quiz that focused on skin problems. Using digital photographs taken by family physicians, Dr. Stulberg put together clinical scenarios and photographs, with related questions. Originally designed as a way to make learning fun for residents, the quiz was eventually adopted into the program's curriculum on skin conditions. The quiz is now distributed across the country and even internationally, and a few other family practice residencies have adopted the quiz into their curriculum.

Participants receive a new clinical scenario every two weeks, along with two to three JPEG images showing skin conditions and related microscopy, if indicated. Participants are given a chance to diagnose the condition, and the answer and discussion are included with the next clinical scenario. So far, a total of 84 cases have been developed and distributed. Residency programs that are interested in trying the quiz may contact Dr. Stulberg at uvdstulb@ihc.com.

Photographs included in the “Caring for Common Skin Conditions” series in AFP have also been drawn from family physicians'practices. Most of the articles will come from the Utah residency. Faculty and residents there identified topics they thought were most relevant to practicing family physicians. The Utah Valley Family Practice Residency is a community-based program sponsored by Intermountain Health Care (IHC), an integrated health system serving Utah and Idaho. IHC operates 22 hospitals and 400 physician group practices, and is ranked as the number one integrated healthcare system by Modern Healthcare.

The residency program is located at Utah Valley Regional Medical Center, one of the largest facilities in the system, with over 22,000 inpatient admissions each year. Residents there gain clinical experience working in the family practice clinic. The three-year program is fully accredited and accommodates six residents at each level. The program seeks to train family physicians for a balanced lifetime of personal growth and community service—and with educators such as Dr. Stulberg helping out—we're betting on its success.

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