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Medical Dermatology

Acne

Acne is a chronic disorder caused by occlusion of the pilosebaceous unit. It most commonly presents during adolescent years with many types of lesions: open and closed comedones (blackheads and whiteheads), inflammatory papules, pustules, and nodules. When untreated, it can lead to low self-esteem and psychological distress due to permanent scarring. There are a variety of treatments ranging commonly from topical antibiotics and retinoids to oral pills, including isotretinoin. At our practice, we aim to treat your acne early and adequately with a personalized approach to your regimen.

Actinic Keratosis (AK)

Actinic keratosis (AK) is a precancerous lesion caused by excessive sun exposure. Often seen in older patients, AKs may appear as rough, crusting, scaly patches. AKs are most commonly located in areas that have had abundant sun exposure, including the scalp, face, and upper lip. It is imperative to evaluate AKs as soon as possible to prevent their progression to squamous cell carcinoma (skin cancer), which can be fatal without appropriate intervention. Upon thorough assessment in our clinic, treatment plans range from cryotherapy to topical chemotherapeutic creams to advanced surgical removal. At our practice, we always aim for a medically sound, cosmetically exceptional experience for our patients.

Alopecia Areata

Alopecia areata is an acquired autoimmune condition that generally causes non-permanent hair loss of the scalp; it can also be associated with other autoimmune conditions. The onset can be sudden with the appearance of round bald patches. It tends to start in childhood but can affect those in early adulthood as well. Common treatment modalities include topicals steroids, intralesional steroid injections, and oral pills such as tofacitinib, among many others. We encourage our patients to visit us to see how we can treat your condition.

Atopic dermatitis is a chronic disorder within the eczema category. It generally tends to affect children but can present at any age. It is mainly characterized by itching and a red scaly rash that can become infected with scratching. It is commonly seen in families and along with other conditions such as asthma and seasonal allergies. There is generally a defect in the skin barrier function, which leads to the rash. Treatment includes a dry skin care regimen with liberal moisturizing, and topical steroids to decrease the inflammatory component of the rash. We encourage our patients to visit us to see how we can treat your condition.

Basal Cell Carcinoma (BCC)

Basal cell carcinoma (BCC) is the most common type of skin cancer caused by excessive sun and UV damage. BCC may appear as pink, pearly, smooth papules/nodules in areas previously affected by heavy sun exposure, including the scalp, face, neck, and arms. It normally affects the older patient populations, and if left untreated, BCC can be disfiguring and potentially fatal. We encourage our patients to visit us annually for a complete, thorough skin check to allow us to identify skin cancer at their earliest stages. Our specialized treatment plan may include electrodessication and curettage to surgical removal with our board-certified skin surgeons. At our practice, we take pride in our meticulously performed procedures, helping our patients achieve a cosmetically extraordinary result.

Contact Dermatitis

Contact dermatitis refers to a group of skin disorders where an itchy rash can occur due to direct contact of the skin with a causative agent. The appearance of the rash can range from redness and scaling with blisters acutely, to thickened lichenified skin chronically. This can occur as a single episode, or repeatedly.  Avoidance of the contactant is generally necessary, but other common treatment modalities include topical steroids, systemic steroids, and patch testing, among others. We encourage our patients to visit us to see how we can treat your condition.

Cysts

Cysts are pocket-like sacs that may contain dead skin cells (keratin), air, fluid, or other substances. Cysts are capable of presenting anywhere on the body and can affect any age group. Though most cysts are non-cancerous and benign, there are many etiologies and sub-classifications of cysts, and their presentation can be debilitating due to immense discomfort, pain, or cosmetic distress experienced by those affected. We encourage our patients to visit us to undergo a comprehensive, detailed assessment and treatment plan. Our treatment plans are personalized in approach and may range from simple cyst incision and drainage to more in-depth procedures including enucleation, marsupialization, or complete surgical resection.

Drug Eruptions

Drug eruptions can range from very mild, only involving the skin, to very severe, with fever and involving other organs. The rash can also come in many forms from red patches and bumps, to pustules, to almost complete redness of the affected person with skin peeling. Treatment options are generally aimed at stopping the offending medication, and treating symptoms with topicals, systemic steroids, or other possible immunosuppressant depending on the severity. If you have a reaction to a medication, it is important to have it diagnosed as you may have to avoid it, and similar classes of medications in the future. We encourage our patients to visit us to see how we can treat your condition.

Dyshidrosis

Dyshidrosis is a disorder falling within the hand and foot eczema category. It presents with deep-seated blisters usually on the palms, soles, and sides of fingers and feet, which can dry and cause cracks in the skin. There is also usually intense itching associated. This condition tends to have many causes, but it is commonly aggravated with sweating, hot weather, humid conditions, and chronic contact with irritants (water, detergents, solvents). Treatment includes avoidance of exacerbating triggers and symptomatic treatment with topical steroids. We encourage our patients to visit us to see how we can treat your condition.

Dysplastic Nevi

Dysplastic nevi are moles that have an abnormal appearance. They can be found anywhere on the body, but are most often seen on the trunks of male patients and calves on female patients. It is important to identify dysplastic moles as soon as possible because it could be a sign of impending skin cancer. At our practice, our board-certified dermatologists assiduously perform a thorough physical exam, assessing for asymmetry, irregular borders, abnormalities in color, substantial diameters, and evolution of the nevi throughout time. It is estimated that in the United States, patients with dysplastic nevi have a lifetime risk of greater than 10% for developing melanoma. Thus, we consistently encourage our patients to visit us for their annual skin check to ensure there are no signs of imminent skin cancer.

Genital Warts

Genital warts (aka condyloma acuminata) can be uncomfortable, concerning, and painful. They are most commonly caused by two specific strains of a sexually transmitted infection called human papillomavirus (HPV, types 6 and 11). Normally appearing pink or mauve in color, genital warts characteristically project outwards from the surface of the skin and can be located anywhere on the genitourinary systems due to skin-to-skin transmission of those affected. Some may experience redness, itching, and susceptibility to bleeding, and we encourage our patients to visit us for a thorough assessment to develop a personalized treatment plan. Common therapies can include topical medications, cryotherapy, or surgery, and debilitating symptoms are expected to resolve within 6 months after treatment is initiated. We encourage our patients to visit us to see how we can treat your condition.

Malignant Melanoma

Malignant melanoma is the third most common type of skin cancer seen in the United States. It can happen at any age but tends to affect the older population due to its relation to excessive sun and UV damage. It is caused by uncontrolled growth of the pigment-producing cells in the skin, and can arise without a pre-existing lesion, or can come from the transformation of a mole or lentigo. These skin cancers can metastasize, or spread to other organs in the body and cause death if left untreated. Because of this, it is important to recognize these skin cancers early. Look for changes in moles or lentigines following the ABCDE’s: Asymmetry, Border irregularity, Color variation, Diameter over 6 mm, Evolving (enlarging, changing). Our specialized treatment plan may include surgical removal with our board-certified skin surgeons if the lesions are early. At the advanced stages, referral for excision, Mohs surgery, and/or sentinel lymph node biopsies may be necessary with the addition of chemotherapy treatments by a medical oncologist. At our practice, we aim to catch all skin cancers early, leading to a medically sound, cosmetically exceptional experience for our patients.

Molluscum Contagiosum

Molluscum contagiosum is a virus that causes painless, flesh-colored, dimpled lesions to appear generally on the face, trunk, and extremities. These lesions are characterized by their quintessential, central umbilication. Molluscum contagiosum normally affects school-aged children, and because lesions can be itchy, it is easily transmitted by touching contaminated surfaces and between individuals. Should you suspect your child is at risk, visit our practice for a thorough evaluation from our board-certified dermatologists. A treatment plan for your child can be achieved seamlessly and stress-free with our providers.

Pemphigoid/Pemphigus

Pemphigoid/pemphigus fall under the class of chronic blistering skin rashes. These both are autoimmune diseases caused by the destruction of proteins that hold the skin cells together. Pemphigus vulgaris tends to affect the younger population and presents with flaccid soft blisters involving the scalp, trunk, extremities, and even the oral cavity. Bullous pemphigoid tends to affect the older population and presents with tense blisters involving the scalp, trunk, extremities, and less so the oral cavity. Both conditions can be severely debilitating, leaving open wounds, discoloration of the skin, and potential scarring. The blisters can be quite painful as well. Treatments can range from wound care along with topical steroids, systemic steroids, or other systemic immunosuppressants. At our practice, we aim to diagnose your rash early and accurately, so adequate treatment can be provided.

Pityriasis Rosea

Pityriasis rosea is a viral rash that spontaneously resolves in about 6 to 8 weeks from the time of onset. The cause is currently unknown but thought to be related to HHV-6 or HHV-7, as well as certain medications. It characteristically starts off with a single larger “herald patch” that appears first. This is commonly followed by the development of smaller, scaly, oval patches, usually on the trunk. Because it is self-resolving, treatment is usually aimed at symptomatic relief and can include topical steroids or sometimes antibiotics. At our practice, we aim to diagnose your rash early and accurately, so no unnecessary testing or treatments are performed.

Pityriasis (Tinea) Versicolor

Pityriasis (Tinea) versicolor is a fungal infection that is caused by Malassezia globosa or Malassezia furfur – a yeast. Most commonly appearing during the summer and in hot, humid climates, adolescents and young adults are the primary demographic for this infection. Tinea versicolor presents as multiple light, hypopigmented macules and patches with sharp borders in affected areas. At our practice, we encourage our patients to visit us as soon as these symptoms appear. We provide a full work-up that includes microscopic evaluation and formulate a treatment plan that can include topical or oral antifungals to ensure complete alleviation.

Psoriasis

Psoriasis is a chronic inflammatory skin condition characterized by symmetrical red, scaly, plaques with sharp border and usually overlying silvery scale. It also tends to involve extensor surfaces such as elbows and knees but can appear anywhere, including the scalp and nails. Its cause is multifactorial, but there is a big hereditary and genetic component. Along with psoriasis, patients can also get psoriatic arthritis, which can lead to long-term destruction of joints if untreated. The flaking from psoriasis can be embarrassing to deal with, and the lesions themselves can be painful if fissuring occurs. Treatment includes topical steroids, intralesional steroids, and systemic immunosuppressants and biologics. We encourage our patients to visit us so we can treat your condition with a personalized approach, allowing you to get the clear skin results you desire.

Rosacea

Rosacea is a chronic vascular/inflammatory rash that tends to affect patients with fairer skin types. There are 4 major subtypes: 1) Erythematotelangiectatic – central facial recurrent blushing and dilated or broken blood vessels that can become permanent; 2) Papulopustular – acneiform like inflammatory lesions, with background of redness; 3) Phymatous – sebaceous overgrowth most commonly on the nose, leading to a bumpy and boggy deformed appearance; 4) Ocular – affecting the eyes, leading to dry gritty sensation and other possible visual impairment long term. Treatment includes avoidance of exacerbating triggers, topical antibiotics, and/or oral antibiotics. At our practice, we aim to treat your skin condition properly to get you the skin results you want.

Seborrheic Dermatitis

Seborrheic Dermatitis is a common chronic skin disorder falling within the eczema category. It tends to affect newborns and the elderly most commonly. It presents with a red scaly rash, which affects the seborrheic regions (areas that are rich in sebum/oil-producing sebaceous glands); this includes the scalp, face, and trunk. The rash can be quite itchy if it is inflamed and left untreated. Common treatments include washing with an anti-dandruff shampoo, applying topical steroids and topical antifungal agents, and avoiding excessive moisturizers. At our practice, we aim to treat your skin condition properly to get you the skin results you want.

Seborrheic Keratosis (SK)

Seborrheic keratosis (SK) is a benign, non-cancerous skin lesion. These are well-demarcated, raised lesions that range from tan to dark brown in color. SKs possess a characteristic “stuck on” appearance, and can present in populations of all ages. These lesions become more prevalent and numerous as patients age. At our practice, we take tremendous priority in thoroughly evaluating all seborrheic keratoses as they can appear similarly to melanoma, or in association with other non-melanoma skin cancers.

Shingles

Shingles is a common painful, blistering rash that tends to affect the elderly population. It occurs from reactivation of the varicella-zoster virus (VZV), which also causes chickenpox – thus, anyone that has had chickenpox in the past can develop this rash. It presents with symptoms of pain, itching, or tingling before the onset of the rash, which more commonly has painful localized blisters along a dermatomal distribution of a sensory nerve. If not treated early, patients can have chronic debilitating sensory pain once the rash itself has resolved. Treatments include antiviral therapy. At our practice, we aim to treat your skin condition early and properly to prevent any complications.

Squamous Cell Carcinoma (SCC)

Squamous cell carcinoma (SCC) is the second most common type of skin cancer seen in the United States. It affects patients with prior excessive sun or UV exposure, and usually presents as raised, rough and crusting lesions or a non-healing ulcer with raised borders. Squamous cell carcinoma can easily bleed and are found on the face, neck, ears, and arms. Early detection of SCC is significant because these lesions carry a high risk of metastasis to other parts of the body compared to basal cell carcinoma. SCC represents 90% of all head and neck cancers on initial presentation; because of its high occurrence, we encourage our patients to visit us for a detailed, comprehensive physical examination and immediate therapy.

Tinea

Tinea is a fungal rash that can affect all parts of the body from the scalp, to trunk and extremities, to the groin, to finger- and toenails. It is commonly known as “ringworm.” It is ubiquitous in the environment, but can also be picked up from pets. It presents with an annular scaly red patch and sometimes pustules on the body and scalp. Patients with the scalp form can also experience non-permanent hair loss. In the nails, it can present with thickening and discoloration of the nail plate and debris underneath the nail. Treatments include topical and oral antifungal medications, as well as preventative measures against recurrence. We encourage our patients to visit us and see how we can treat your condition.

Urticaria (Hives)

Urticaria (hives) are red, itchy, slightly raised welts that can appear anywhere on the body during an allergic reaction. There are many reasons why hives appear, and the etiologies are broad – affecting patients of all ages in multiple circumstances. Patients with urticaria can present due to allergies toward food, medications, arthropod bites, and even as sequelae to viral infections. In rarer instances, hives may also present secondary to cold temperatures and psychological stress. Urticaria does not leave permanent, long-lasting skin changes, but can recur and severely affect the quality of life. At our practice, we offer a complete, thorough evaluation with a wide range of therapies to resolve this common pathology.

Viral Warts

Viral warts are growths on the skin caused by human papillomavirus (HPV). They can be painful, uncomfortable, and unsightly. Many times, patients will notice the “seeds,” which are dark black pinpoint discolorations from the thrombosed blood vessels of the lesions. Lesions can be caused by skin-to-skin transmission, and thus are seen more in school-age children or those with immunosuppressive conditions of medications. Some may experience redness, itching, and susceptibility to bleeding, and we encourage our patients to visit us for a thorough assessment to develop a personalized treatment plan. Our therapy can include but is not limited to topical medications, cryotherapy, or surgery.

Vitiligo

Vitiligo is an acquired autoimmune condition causing loss of skin pigmentation. It is thought that the immune system attacks and destroys the pigment-producing cells in the skin. It tends to affect younger populations with onset in the 2nd to 3rd decade of life. It presents with white patches of skin, which can rapidly progress to involve large body surface areas. This can be very distressing and cosmetically disabling for our patients. In addition, there can be other autoimmune diseases in close association with this condition. Treatments include topical steroids, topical calcineurin inhibitors, light treatments, and other systemic medications. Here at our practice, we aim to treat your skin condition properly to get you the skin results you want.