David Leffell

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David J. Leffell, MD, was born in 1956 in Montreal, Canada and educated at Yale. Leffell is an internationally recognized expert in skin cancer and the Mohs technique, plastic reconstruction, and new technologies in dermatology. He specializes in the diagnosis, treatment, and prevention of melanoma and nonmelanoma skin cancer. [1] He is the David Paige Smith Professor of Dermatology and Surgery, [2] chief of Dermatologic Surgery and Cutaneous Oncology, [3] and former Deputy Dean for Clinical Affairs at Yale University School of Medicine . In January 2012, Dr. Leffell stepped down as chief executive officer of the Yale Medical Group , after 15 years of leadership of the organization. He serves on the board of Validus Pharmaceuticals and is a trustee of The Hopkins School, one of America's oldest independent schools.

Contents

Research

While still in medical training, Leffell developed and patented a laser method for measuring the aging of skin. [4] With Douglas Brash and others he has also published work that clarifies the genetic basis of the cancer-causing ultraviolet rays of the sun. [5] This work represented proof that an environmental agent could directly be linked to a genetic injury that causes cancer . Leffell was a member of the international team that discovered PTC1, a tumor suppressor gene that plays a critical role in the development of hereditary and sporadic basal cell cancer. [6] He shares patents for the PTC gene [7] and PTCH protein. [8] In 2012, GenentechRoche introduced an oral medication based on the related hedgehog pathway [9] Leffell also invented a simple office-based method for the treatment of vitiligo, a depigmenting disorder for which treatment is otherwise limited. [10] In collaboration with Susan Mayne, PhD at the Yale School of Public Health, Leffell has researched the role of tanning parlors in the development of skin cancer in young women. [11]

Publications

Dr. Leffell is the author or co-author of more than 130 publications, book chapters, and other media. He is an editor of the world's leading textbook of dermatology, Fitzpatrick’s Dermatology in General Medicine. He is also author of Manual of Skin Surgery (English and Chinese editions), a highly illustrated textbook of fundamental skin surgery for medical students, residents, and all specialties involved in skin surgery. A second English edition was published in 2012 Manual of Skin Surgery. Leffell also wrote Total Skin: The Definitive Guide to Whole Skin Care for Life, a "user-friendly" book intended to educate the general public about skin health. The book, originally published by Hyperion in 2000 has become a standard reference for the lay public on all aspects of skin health and disease and is now available as an ebook Totalskinandhealth. He has held editorial positions with many dermatology journals, including the Archives of Dermatology, The Journal of Dermatologic Surgery and Oncology, and Medical & Surgical Dermatology and is on the editorial board of Faculty of 1000. Leffell also appears extensively in print, on television, on the radio and on the web. In addition to medical publications, Leffell has appeared in The Enlightened Bracketologist with a chapter on Longevity and the Final Four of Everything writing on ways to enhance and preserve a youthful appearance. In 2011 Leffell published Connecticut Pastoral, a collection of photographs of the Connecticut Berkshires (Gaoh Press). In 2012, with colleagues Sumaira Aasi, MD of Stanford and Rossitza Lazova, MD of Yale, Leffell published Atlas of Practical Mohs Histopathology.

Yale Medical Group

Leffell has held successive leadership positions in the clinical practice at Yale since 1996. The group practice currently includes more than 900 full-time Yale School of Medicine faculty physicians who practice in more than 60 locations throughout the state of Connecticut. Leading a team of operations and strategic executives he focused on developing a patient-centered approach in a large, complex specialty organization. [12] In addition to overseeing a major branding initiative (converting the Yale faculty practice to the Yale Medical Group) and professionalizing the business operations of the organization, he spearheaded initiatives focused on enhanced patient service and integration of clinical research and clinical trials with the clinical practice. Leffell also oversaw the development of the medical billing compliance program and initiated the first program for faculty on the "Business of Medicine". Stephen Rimar, MD, who helped develop the program published one of the first textbooks of its kind based on the multidisciplinary lectures intended to provide practicing clinicians with fundamental knowledge of business. In 2010, with colleagues at Yale New Haven Hospital, he led the selection of Epic as the electronic medical record for Yale School of Medicine and the Yale New Haven Health System. Leffell reported on the effort in the CEO Newsletter of the Yale Medical Group. Leffell also believes that the cost/value paradox of academic medical centers is sustainable but requires thoughtful change. The centers, which represent huge capital investment, will always be the high cost providers of healthcare but will also be the source of cost-reducing innovation in medical care. The essay The Ostrich and the Wolf appeared in a communication to the faculty and staff of the Yale Medical Group.

Education

Dr. Leffell received his undergraduate degree in biology from Yale College where he was on the editorial board of the Yale Daily News and a resident of Pierson College. He returned to Montreal to attend McGill University Faculty of Medicine where he received his MD, CM degree in 1981. He completed residencies in internal medicine at Cornell Cooperating Hospitals and in dermatology at Yale New Haven Hospital. At Yale, he also completed a post-doctoral research year as a National Institutes of Health research fellow. Following his residencies, he completed a fellowship in advanced dermatologic surgery at the University of Michigan. Dr. Leffell founded the Dermatologic Surgery and Cutaneous Oncology program at Yale in 1988.

Related Research Articles

Dermatology is the branch of medicine dealing with the skin. It is a speciality with both medical and surgical aspects. A dermatologist is a specialist medical doctor who manages diseases related to skin, hair, nails, and some cosmetic problems.

Squamous cell skin cancer Medical condition

Squamous-cell skin cancer, also known as cutaneous squamous-cell carcinoma (cSCC), is one of the main types of skin cancer along with basal cell cancer and melanoma. It usually presents as a hard lump with a scaly top but can also form an ulcer. Onset is often over months. Squamous-cell skin cancer is more likely to spread to distant areas than basal cell cancer. When confined to the outermost layer of the skin, a precancerous or in situ form of cSCC is known as Bowen's disease.

Kidney cancer Medical condition

Kidney cancer, also known as renal cancer, is a group of cancers that starts in the kidney. Symptoms may include blood in the urine, lump in the abdomen, or back pain. Fever, weight loss, and tiredness may also occur. Complications can include spread to the lungs or brain.

Basal-cell carcinoma Most common type of skin cancer

Basal-cell carcinoma (BCC), also known as basal-cell cancer, is the most common type of skin cancer. It often appears as a painless raised area of skin, which may be shiny with small blood vessels running over it. It may also present as a raised area with ulceration. Basal-cell cancer grows slowly and can damage the tissue around it, but it is unlikely to spread to distant areas or result in death.

Head and neck cancer Cancer arises in the head or neck region

Head and neck cancer develops from tissues in the lip and oral cavity (mouth), larynx (throat), salivary glands, nose, sinuses or the skin of the face. The most common types of head and neck cancers occur in the lip, mouth, and larynx. Symptoms predominantly include a sore that does not heal or a change in the voice. Some may experience a sore throat that does not go away. In those with advanced disease, there may be unusual bleeding, facial pain, numbness or swelling, and visible lumps on the outside of the neck or oral cavity. Given the location of these cancers, trouble breathing may also be present.

Proton therapy Medical Procedure

In medicine, proton therapy, or proton radiotherapy, is a type of particle therapy that uses a beam of protons to irradiate diseased tissue, most often to treat cancer. The chief advantage of proton therapy over other types of external beam radiotherapy is that the dose of protons is deposited over a narrow range of depth; hence in minimal entry, exit, or scattered radiation dose to healthy nearby tissues.

Actinic keratosis Medical condition

Actinic keratosis (AK), sometimes called solar keratosis or senile keratosis, is a pre-cancerous area of thick, scaly, or crusty skin. Actinic keratosis is a disorder of epidermal keratinocytes that is induced by ultraviolet (UV) light exposure. These growths are more common in fair-skinned people and those who are frequently in the sun. They are believed to form when skin gets damaged by UV radiation from the sun or indoor tanning beds, usually over the course of decades. Given their pre-cancerous nature, if left untreated, they may turn into a type of skin cancer called squamous cell carcinoma. Untreated lesions have up to a 20% risk of progression to squamous cell carcinoma, so treatment by a dermatologist is recommended.

Benign tumor Mass of cells which cannot spread throughout the body

A benign tumor is a mass of cells (tumor) that lacks the ability either to invade neighboring tissue or metastasize. When removed, benign tumors usually do not grow back, whereas malignant tumors are cancerous and sometimes do. Unlike most benign tumors elsewhere in the body, benign brain tumors can be life-threatening. Benign tumors generally have a slower growth rate than malignant tumors and the tumor cells are usually more differentiated. They are typically surrounded by an outer surface or stay contained within the epithelium. Common examples of benign tumors include moles and uterine fibroids.

Merkel-cell carcinoma Rare and highly aggressive skin cancer

Merkel cell carcinoma (MCC) is a rare and aggressive skin cancer occurring in about 3 people per 1,000,000 members of the population. It is also known as cutaneous APUDoma, primary neuroendocrine carcinoma of the skin, primary small cell carcinoma of the skin, and trabecular carcinoma of the skin. Factors involved in the development of MCC include the Merkel cell polyomavirus, a weakened immune system, and exposure to ultraviolet radiation. Merkel-cell carcinoma usually arises on the head, neck, and extremities, as well as in the perianal region and on the eyelid. It is more common in people over 60 years old, Caucasian people, and males. MCC is less common in children.

Mohs surgery Microscopically controlled surgery used to treat common types of skin cancer

Mohs surgery, developed in 1938 by a general surgeon, Frederic E. Mohs, is microscopically controlled surgery used to treat both common and rare types of skin cancer. During the surgery, after each removal of tissue and while the patient waits, the tissue is examined for cancer cells. That examination dictates the decision for additional tissue removal. Mohs surgery is the gold standard method for obtaining complete margin control during removal of a skin cancer using frozen section histology. CCPDMA or Mohs surgery allows for the removal of a skin cancer with very narrow surgical margin and a high cure rate.

Vulvar cancer Cancer involving the vulva

Vulvar cancer is a cancer of the vulva, the outer portion of the female genitals. It most commonly affects the labia majora. Less often, the labia minora, clitoris, or vaginal glands are affected. Symptoms include a lump, itchiness, changes in the skin, or bleeding from the vulva.

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References

  1. ↑ "Archived copy" (PDF). Archived from the original (PDF) on 2010-12-02. Retrieved 2011-10-26.{{cite web}}: CS1 maint: archived copy as title (link)
  2. ↑ "David J. Leffell, M.D., Dermatology: Yale School of Medicine". Archived from the original on 2009-01-30. Retrieved 2009-04-05.
  3. ↑ "Home , Dermatologic Surgery: Yale School of Medicine". Dermatology.yale.edu. Retrieved 2010-10-07.
  4. ↑ "Optical method and apparatus for detecting and measuring aging, photoaging, dermal disease and pigmentation in skin".
  5. ↑ "Working Knowledge". Sciamdigital.com. Retrieved 2010-10-07.
  6. ↑ Gailani, Mae R.; Ståhle-Bäckdahl, Mona; Leffell, David J.; Glyn, Michael; Zaphiropoulos, Peter G.; Undén, Anne Birgitte; Dean, Michael; Brash, Douglas E.; Bale, Allen E.; Toftgård, Rune; Toftgård, R. (1996-09-01). "The role of the human homologue of Drosophila patched in sporadic basal cell carcinomas". Nature Genetics. 14 (1): 78–81. doi:10.1038/ng0996-78. PMID   8782823. S2CID   5221628.
  7. ↑ "Basal cell carcinoma tumor suppressor gene".
  8. ↑ "Basal cell carcinoma tumor suppressor protein".
  9. ↑ "Erivedge® (Vismodegib) | Advanced Basal Cell Carcinoma (ABCC) Treatment".
  10. ↑ McGovern, Thomas W.; Leffell, David J. (2001-12-20). "Surgical therapies, part II: flip-top transplants in vitiligo". Dermatologic Therapy. 14: 15–19. doi:10.1046/j.1529-8019.2001.014001015.x. S2CID   73408130.
  11. ↑ Ferrucci, L. M., Cartmel, B., Molinaro, A. M., Leffell, D. J., Bale, A. E., and Mayne, S. T. Indoor tanning and risk of early-onset basal cell carcinoma. J. Am. Acad. Dermatol. 8 December 2011, doi: 10.1016/j.jaad.2011.11.940. NIHMS339428.
  12. ↑ "Making practice perfect: Medicine@Yale, May / June 2008". Archived from the original on 2011-08-26. Retrieved 2010-10-07.
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