Medical Dermatology

Skin Exams

Full-body skin exams are an important tool in screening patients for benign or cancerous lesions that they may not have been able to see or recognize on their own. From head to toe and back to front, we are trained and experienced professionals to inspect the skin for any suspicious growths. This quick and painless preventive measure is an invaluable tool in the early detection of skin cancer as well as many other dermatological conditions. In the case of a suspicious lesion, we will discuss performing a biopsy (sample) of the lesion and often take pictures of lesions that we recommend to be monitored for changes.

What is a biopsy?

A biopsy is a diagnostic test that involves removing a tissue sample and examining it under a microscope. This test is used to identify suspicious lesions and the abnormal cells within them, and to diagnose associated conditions such as cancer, psoriasis, or an infection. A biopsy can be performed in several different ways, including shaving off skin cells with a scalpel, removing a deep circular skin sample, or surgical excision of the entire lesion. Depending on the technique used, stitches may be required to restore the area. The sample is then thoroughly examined before an accurate diagnosis is made.

Tell me about Skin Cancer…

Skin cancer is the most common form of cancer in the United States and involves abnormal growths of skin cells that can form anywhere on the body, but most frequently appear on skin that is exposed to the sun. There are more than a million new cases of skin cancer in the US each year. Although most cases of skin cancer can be successfully treated, it is still important to keep skin safe and healthy and try to prevent this disease.

There are three major types of skin cancer that affect associated layers of the skin. These major types are:

Squamous cell carcinoma affects the squamous cells, which are just below the outer surface of the skin and serve as the inner lining.
Basal cell carcinoma affects the basal cells, which lay under the squamous cells and produce new skin cells.
Melanoma is the most serious form of skin cancer and affects the melanocytes, which produce melanin.
Everyday, skin cells die and new ones form to replace them in a process controlled by DNA. Skin cancer can form when this process does not work properly because of damage to DNA. New cells may form when they are not needed or older cells may not die. This can cause a growth of tissue known as a tumor. DNA damage is often a result of ultraviolet (UV) radiation from sunlight or tanning lamps. Since skin cancer can sometimes affect areas not exposed to the sun, heredity may also be a factor.

Certain factors such as fair skin, moles, weakened immune system and age, can also increase risk of skin cancer.

Skin cancer can often be identified as a new or changed growth on the skin that may often occur on the scalp, face, lips, ears, neck, chest, arms, hands or legs.

The appearance of the growth depends on the type of cancer, but can appear as:

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Pearly or waxy bump
Flesh-colored or brown scar-like lesion
Firm, red nodule
Crusted, flat lesion
Large brown spot with darker speckles
Mole that changes shape or color
Shiny, firm bumps
It is important to see your doctor if you notice any skin changes. Early detection is valuable in successfully treating skin cancer. Regular full body screening is recommended as well. A biopsy is performed to properly diagnose suspected cancerous growths.

Treatment for skin cancer depends on the type, size and location of the tumor. Most options remove the entire growth and are usually effective. Removal procedures are usually simple and require only a local anesthetic in an outpatient setting. Some of the treatment options for skin cancer include:

Freezing – also known as cryosurgery, kills tissue by freezing them with liquid nitrogen (LN2)
Excision – the abnormal tissue, as well as some surrounding healthy tissue, is cut out of the skin
Laser therapy – destroys cancerous growths with little damage to surrounding tissue and few side effects
Mohs surgery – removes larger skin growths layer by layer until no abnormal cells remain to prevent damage to healthy skin
Chemotherapy – uses drugs to kill cancer, may be applied through creams or lotions for top layer tumors
Other treatment options are also available, including new methods that are currently being studied.

Although most treatment for skin cancer is successful, new tumors can still form. It is important to practice preventive measures and see your doctor on a regular basis. You can also perform self skin checks to spot any changes as soon as possible.

Full-body skin exams are an important tool in screening patients for benign or cancerous lesions that they may not have been able to see or recognize on their own.

Check out this link to the American Academay of Dermatology regarding checking for moles.http://www.aad.org/spot-skin-cancer/understanding-skin-cancer/how-do-i-check-my-skin/what-to-look-for

What to look for: The ABCDEs of Melanoma

Download the AAD’s body mole map to note the results of your self-examination. Consult your dermatologist immediately if any of your moles or pigmented spots exhibit:

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A = Asymmetry
One half is unlike the other half.

B = Border
An irregular, scalloped or poorly defined border.

C = Color
Is varied from one area to another; has shades of tan, brown or black, or is sometimes white, red, or blue.

D = Diameter
Melanomas are usually greater than 6mm (the size of a pencil eraser) when diagnosed, but they can be smaller.

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E = Evolving
A mole or skin lesion that looks different from the rest or is changing in size, shape or color.

Acne

Acne is the term for the blocked pores (blackheads and whiteheads), pimples, and deeper lumps (cysts or nodules) that can appear typically on the face, neck, chest, back, shoulders and upper arms. Seventeen million Americans currently have acne, making it the most common skin disease in the country. While it affects mostly teenagers, and almost all teenagers have some form of acne, adults of any age can have it. Adult females often suffer from hormonal acne that is primarily presents on the jawline, chin and influenced by hormonal changes. Acne is not life-threatening, but it can cause physical disfigurement (scarring) and emotional distress.

Treatment for acne varies depending on the type and severity of lesions, as well as the skin type, age and life.

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Options include:

Topical Medications
Antibiotics
Accutane
Blackhead Extraction
Microdermabrasion
Chemical Peels
Skin Care
Acne scarring can be treated in a variety of ways as well. These include:

Chemical Peels
Dermabrasion/Microdermabrasion
Soft Tissue Fillers
Laser/Pulsed Light Treatments
Tips:

To prevent scars, do not pop, squeeze, or pick at acne; seek treatment early for acne that does not respond to over-the-counter medications.
Use noncomedogenic (does not clog pores) cosmetics and toiletries.
Use oil-free cosmetics and sunscreens.
Use medication as directed and allow enough time for acne products to take effect, which might be six to eight weeks.
Dry Skin

Dry skin is a common condition that can develop as a result of certain skin diseases like psoriasis or environmental factors such as cold weather, hot showers, harsh soaps and sun exposure. Patients with this condition often experience skin that feels rough, tight and may be itchy or red. For most, this is only a temporary problem and can be managed through simple home and life measures, including using moisturizers and special creams or avoiding hot showers and baths. For severe cases, prescription creams and ointments may be recommended to calm skin.

Eczema

Eczema is a group of inflamed skin conditions that result in chronic itchy rashes. About 15 million people in the U.S. suffer from some form of eczema, including 10-20 percent of all infants. Symptoms vary from person to person but often include dry, red, itchy patches on the skin which break out in rashes when scratched.

Objects and conditions that trigger itchy eczema outbreaks may include rough or coarse materials touching the skin, excessive heat or sweating, soaps, detergents, disinfectants, fruit and meat juices, dust mites, animal saliva and danders, upper respiratory infections and stress.

Treatment involves the restriction of scratching, use of moisturizing lotions or creams, cold compresses and nonprescription anti-inflammatory corticosteroid creams and ointments. If this proves insufficient, physicians may prescribe corticosteroid medication, antibiotics to combat infection, or sedative antihistamines. Phototherapy is a common procedure that uses light to reduce rashes. For severe cases, drugs such as cyclosporine A may be recommended for treatment.

Fungal Infections

Fungal infections are common skin conditions that may cause redness, itching, burning and scaling. They can also cause blisters or peeling. Fungus can grow anywhere on the body, but tends to develop in warm, moist areas such as the feet, groin and armpit area. Common types of fungal infections include athlete’s foot, jock itch, ringworm and yeast infections.

Fungal infections can usually be successfully treated with antifungal oral or topical medications. They are not usually serious, but may be contagious, so treatment is important. Keeping the body clean and changing socks and underwear everyday can help prevent fungal infections.

Hair Loss

Hair loss can occur as a result of aging, heredity, medications or an underlying medical condition, and can affect men and women of all ages. It may leave you with pattern baldness, patchy spots or thinned hair. Most people are troubled by this undesired change to their appearance and may be frustrated that there is no cure available for the condition of hair loss.

While many people are forced to deal with hair loss and let the condition progress naturally, there are several treatments available to help promote hair growth or hide hair loss. depends on the location and extent of the hair. Our approach to hairloss includes a detailed medical history, exam of your scalp, possibly blood work order to rule out and systemic causes and occasionally biopsy of the scalp.

Psoriasis

Psoriasis is a group of chronic skin disorders that cause itching and/or burning, scaling and crusting of the skin. Over seven million men and women in the U.S. of all ages have some form of psoriasis, which may be mild, moderate or severe. The most commonly affected areas are the scalp, elbows, knees, hands, feet and genitals.

Psoriasis cannot be cured but it can be treated successfully, sometimes for months or years at a time and occasionally even permanently. Treatment depends on the type, severity and location of psoriasis. The patient’s age, medical history and life may also have a significant impact on the methods utilized. The most common treatments are topical medications, phototherapy, photochemotherapy (PUVA), and oral or injectable medication (for severe symptoms).

Rashes

A rash is a change in the skin’s color or texture. Simple rashes are called dermatitis, which means the skin is inflamed or swollen. Contact dermatitis is caused by touching an irritating substance such as clothing materials and dyes, latex, cosmetics, soaps or certain plants like poison ivy. Seborrheic dermatitis forms red patches and scaling, usually on the face and head, where it is more commonly known as dandruff or cradle cap. Other common rashes include eczema, psoriasis, impetigo, shingles, chicken pox, measles, scarlet fever, insect bites and those caused by medical conditions such as lupus or rheumatoid arthritis.

A dermatologist is usually able to identify the rash by looking at it and asking about accompanying symptoms. Mild rashes can often be treated with simple home care practices such as avoiding soaps and bathing in warm water. Others may require moisturizing creams, prescription medications or more extensive treatment.

Scar Revision

Scar revision is performed to reduce the appearance of scars caused by injury or previous surgery. While many scars fade over time and eventually transform to become barely noticeable, many patients experience disruptions to the healing process that cause scars to become red, raised, indented or otherwise deformed.

Many patients are unhappy and embarrassed by the appearance of these scars, especially when they are located in prominent areas, and seek treatment to improve them. We provide comprehensive scar revision services to help patients achieve smooth, clear skin that they no longer have to be ashamed of. Treatments to improve scars may include prescription medications, chemical peels, microdermabrasion, steroid injections or laser treatment.

Hyperhidrosis

Hyperhidrosis is a rare condition that causes excessive sweating on the hands, feet, armpits, face and genital area, or all over the entire body. The cause of this condition is unknown, although it often runs in families and begins during childhood.

Patients with hyperhidrosis may sweat all over their body or in certain areas. Their skin may become white and wrinkled or red and irritated as a result of the constant moisture, and may develop an odor as well. Hyperhidrosis often causes patients to feel embarrassed, awkward and self-conscious, especially during social situations.

Most cases of hyperhidrosis are caused by other factors (secondary hyperhidrosis), including:

Anxiety
Heart disease
Hormone changes
Blood sugar problems
Caffeine
Certain medications
In some cases, there may be no known cause for this condition, which is referred to as primary or focal hyperhidrosis. This condition tends to affect both sides of the body and can occur on the hands, feet, underarms, head and face.

Treatment for hyperhidrosis depends on the severity of the condition, but may include prescription-strength antiperspirant or medication to help control sweating or stop the stimulation of the sweat glands. Botox injections in the armpits block the nerves that cause sweating and can effectively treat hyperhidrosis for up to eight months for each injection.

In severe cases, surgery may be required to remove the nerves that control the sweat glands, or the actual glands themselves. This procedure is usually considered a last resort to be used only after conservative methods have failed. Patients who undergo surgery may develop new or even worse sweating, a condition known as compensatory sweating, later in life.

Vitiligo

Vitiligo is a common skin condition in which patches of the skin lose pigmentation and appear white. These patches develop when melanin is not produced properly, and tend to spread over time as the condition progresses. Patients may also experience premature whitening of the hair and a loss of color inside the mouth. Although not harmful, patients with vitiligo are often bothered by their appearance and may want to seek treatment to correct their skin tone.

Treatment for vitiligo depends on the severity of the condition, and may include oral or topical medications, UVB therapy, depigmentation or skin grafts. While there is no cure for this condition, treatment is often effective in improving the appearance of the skin.