Caller: Thin Sun-Damaged Skin That Bleeds Easily

Broadcast from KSQD, Santa Cruz on 10-30-2025:

• Dr. Dawn opens with Halloween-themed scary medical stories, beginning with food toxins lurking in refrigerators and pantries. She explains how molds on grains and nuts, particularly Aspergillus species, produce aflatoxins that bind to DNA and cause liver cancer, making peanuts especially risky. Fusarium on wheat produces trichothecenes and fumonisins damaging cell membranes. Penicillium molds on fruits like apples produce patulin creating reactive oxygen species that harm organs. She advises discarding soft moldy foods entirely since fungal hyphae penetrate deeply, while hard cheeses can have moldy portions cut away. Meat spoilage involves bacteria producing cadaverine and putrescine, with E. coli, Campylobacter, Salmonella, and Clostridium causing severe illness through heat-stable toxins.
• A caller asks about yogurt-covered peanuts tasting rancid and confirms Botox contains botulinum toxin A in different salt forms, used medically for migraines, hyperhidrosis, and strabismus. The caller also describes paper-thin skin on sun-exposed forearms that bleeds easily. Dr. Dawn explains UV radiation damages collagen and elastin, making blood vessels vulnerable to shear forces. She recommends topical vitamin K products like Dermal K and protective lycra sleeves or gardening gauntlets to prevent injuries, emphasizing the need for annual dermatologic exams after extensive sun exposure.
• An emailer asks about RSV vaccine recommendations before overseas travel. Dr. Dawn disagreed with the couple's physician, citing US Preventive Services Task Force guidelines recommending RSV vaccination for all adults 60 and older, plus those 50+ with chronic conditions. She discusses FDA-approved home testing options including the PIXEL by LabCorp test for COVID, flu, and RSV, and iHealth rapid tests. She notes RSV point-of-care tests are available to medical practitioners and recommends thorough vaccination before international trips.
• Dr. Dawn presents a frightening investigation into private equity hospital bankruptcies, focusing on Steward Healthcare's 31 hospitals and Prospect's 16 facilities. Private equity firm Cerberus earned $700 million while Steward 650 documented incidents of deficient care including deaths. One woman died from hemorrhage after vendors repossessed equipment due to unpaid bills. She explains the shell game where companies sell hospital land to Medical Properties Trust, forcing new operators to pay rent while private equity extracts profits. The Brookings Institution study reveals systematic prioritization of investor returns over patient care, with courts failing to prevent these practices despite some states passing protective legislation.
• She discusses stillbirth rates being significantly underreported, with Harvard research showing actual rates of 1 in 147 pregnancies versus CDC's 1 in 175, worsening to 1 in 95 for black families. Over 70% involved known risks like obesity or diabetes, but 30% had no identifiable factors. Dr. Dawn emphasizes unconscious bias in medicine where women's complaints are dismissed, particularly affecting women of color and non-English speakers, noting both patient and provider biases require training to address.
• Dr. Dawn warns about HPV-related oral squamous cell carcinoma in young men, explaining that changing sexual practices over 30 years have created new transmission routes from genitals to mouth. Major risk factors include smokeless tobacco and hard alcohol which damage DNA. She mentions newly available saliva tests for persistent HPV detection, recommending risk factor reduction for positive cases.
• She concludes optimistically with a breakthrough Huntington's disease treatment using microRNA molecule AMT-130 delivered via virus to brain striatum. The treatment mirrors toxic Huntington protein's RNA, creating double-stranded structures cells destroy, preventing toxic protein accumulation. The three-year trial of 29 patients showed 75% slowing of disease progression with few side effects, offering hope for 100,000 Americans carrying the mutation, including 40,000 with current symptoms.