Medical Dermatology

Basal Cell Carcinoma is an abnormal, uncontrolled growth or lesion that arises in the skin’s basal cells, which line the deepest layer of the epidermis (the outermost layer of the skin). They often look like open sores, red patches, pink growths, shiny bumps, or scars and are usually caused by a combination of cumulative and intense sun exposure.

Squamous cell carcinoma is the cancer that develops in the outermost portion of the skin called the epidermis. Squamous cell carcinoma is the second most common type of skin cancer. Anyone with a substantial history of sun exposure can develop squamous cell carcinoma. Older people with fair skin and light eyes are at the highest risk. Squamous cell carcinoma may arise from a precancerous lesion known as an actinic keratosis. Squamous cell carcinoma first appears as a pink or red flat spot with a fine scale or scab that grows to form a firm, red bump that may develop an ulcer.

Melanoma is a skin cancer that originates from melanocyte cells which produce pigment, brown or black color. Melanoma is life threatening if it spreads beyond the skin to other organs or metastasize. Melanoma occurs in individuals with 1) a history of a lot of sun exposure including sunburns, regular tanning practices and tanning bed use, 2) fair skin, light hair, and blue eyes, 3) many moles and freckles, and 4) a family history of melanoma. The first visible sign of melanoma is change in appearance of an existing mole. The mole may become: 1) larger, 2) change color, either lighter or darker, 3) develop an irregular shape or asymmetrical, and 4) become itchy, sore, scaly, or bleed. Melanomas also develop as a new mole or pigmented area of the skin or nail. Rarely melanomas have no pigment.

Atypical mole (Atypical Nevi) are unusual benign moles that may resemble melanoma. People who have them may be at an increased risk of developing melanoma especially if they have a high number of such moles. The higher the number of these moles someone has, the higher the risk. Heredity appears to play a part in developing atypical nevi. Those who have atypical nevi plus a family history of melanoma have a greatly increased risk of developing melanoma. Monthly skin self-examinations as well as regular professional skin exams with a dermatologist are crucial to identifying these moles and monitoring them for changes.

Actinic keratosis is a rough, dry, scaly patch or growth that forms on the skin. An actinic keratosis forms when the skin is chronically damaged by ultraviolet (UV) rays from the sun or indoor tanning. Anyone who has multiple actinic keratoses should be under a dermatologist’s care. Actinic keratoses are considered precancerous, which means there is a possibility they will progress into a squamous cell carcinoma/skin cancer.

Lentigines are freckles caused by sun exposure. They are usually harmless but may cause cosmetic concerns. Regular surveillance and monitoring for changes is important for lentigines as some can mimic the early stages of melanoma, which is a form of skin cancer. The best way to prevent lentigines is to stay out of the sun as much as possible and use sunscreen, UV protective clothing, and avoiding tanning/tanning beds.

Moles (Nevi) are brown or black growths, usually round or oval, that can appear anywhere on the skin. They can be rough or smooth, flat or raised, single or multiple. They occur when cells that are responsible for skin pigmentation, known as melanocytes, grow in clusters instead of being spread out across the skin. Most moles are less than one-quarter inch in size.

Seborrheic keratoses are common, non-cancerous growths of the outer layer of the skin which first appear during adult life. With age, more growths appear and existing growths will enlarge and become thicker. Seborrheic keratoses appear on both covered and uncovered parts of the body; they are not caused by sunlight. The tendency to develop seborrheic keratoses is inherited. Seborrheic keratoses are harmless and do not become malignant.

Cherry angiomas are small, bright red, raised or flat benign growths of the skin. They are not dangerous and usually start developing after the age of 30. Bleeding can occur if angiomas gets scratched, rubbed or cut open. Cherry angiomas can be removed for cosmetic reasons. Common procedures for removing cherry angiomas include cauterization, excision, and laser treatments.

Skin tags (Acrochordons) are common growths on the skin. They are not dangerous, but can be annoying or aesthetically unpleasing. Skin tags can be easily removed and usually do not recur although there is not a way of preventing your body from producing new skin tags. Cosmetic procedures such as cauterization, cryosurgery, and excision may be used to remove skin tags.

Warts (Verrucae) are small, harmless growths that appear most frequently on the hands and feet. Sometimes they look flat and smooth, other times they have a dome-shaped or cauliflower-like appearance. Warts are caused by different forms of human papilloma virus (HPV). They occur in people of all ages and can spread from person-to-person and from one part of the body to another.

Acne is the most frequent skin condition seen by dermatologists. It consists of pimples that appear on the face, back and chest. About 80% of adolescents have some form of acne and about 5% of adults experience acne. In normal skin, oil glands under the skin, known as sebaceous glands, produce an oily substance called sebum.

Rosacea is a chronic skin condition in adults that causes facial redness, acne-like pimples, visible small blood vessels on the face, swelling and/or watery, irritated eyes. This inflammation of the face can affect the cheeks, nose, chin, forehead or eyelids. More than 14 million Americans suffer from rosacea. Prompt and effective treatment can prevent progression to debilitating condition.

“Rash” and “eczema” are general terms for a wide variety of skin conditions. A rash refers to a change that affects the skin and usually appears as a red patch or small bumps or blisters on the skin. The majority of rashes and eczema can be treated effectively with the right diagnosis and treatment.

Atopic dermatitis often occurs in individuals with allergies and asthma. There is a tendency toward excess inflammation in the skin. This presents as itchy, scaly and thickened skin and is very irritating. Atopic dermatitis can affect all age groups but is more common in children. Treatment plans combine therapies and protective methods to help heal the skin.

Psoriasis is a skin condition that creates red patches of skin with white, flaky scales. It most commonly occurs on the elbows, knees and trunk, but can appear anywhere on the body. The first episode usually strikes between the ages of 15 and 35. It is a chronic condition that may cycle through flare-ups and remissions throughout the patient’s life. Psoriasis affects as many as 7.5 million people in the United States. About 20,000 children under age 10 have been diagnosed with psoriasis.

Dry skin is a common problem that can occur at any age. Dry skin may be rough, scaly, flaky, and it may itch. Skin is the largest organ in the body and creates the first line of defense against harmful microorganisms and toxins. Dry skin compromises this barrier and can lead to exacerbations of chronic skin conditions. There are many causes of dry skin. With age, the skin produces less of the natural oils that help the skin retain its moisture. There are also environmental factors such as indoor heating or air conditioning that can affect the skin.

Hair loss can stem from a variety of underlying causes. It is important to have hair loss evaluated to determine the best treatment. Nails also can suffer from a variety of conditions including infections, inflammatory disease, and growths.