Mohs micrographic surgery
Mohs surgery involves the systematic removal and analysis of thin layers of skin at the tumor site until the last traces of cancerous tissue have been eliminated. The immediate and complete microscopic examination and evaluation of excised tissue is what differentiates Mohs surgery from other cancer removal procedures. Only cancerous tissue is removed, minimizing both post-operative wound size and the chance of regrowth.
Mohs surgery is most commonly used for basal and squamous cell carcinomas, although it can be recommended for the eradication of other cancers such as melanoma. High precision makes Mohs surgery ideal for the elimination of cancers in cosmetically important areas such as the face (nose, eyelids, lips, hairline), hands, feet and genitals.
Moles and birthmarks
Known as nevi (singular “nevus”), moles and other birthmarks are benign pigmented spots or patches of skin that range in color from tan, brown and black (moles) to red, pink or purple (vascular nevi, such as strawberry hemangiomas or port wine stains). Though most birthmarks are harmless, they may develop into cancer. Moles exhibiting any of the following warning signs should be examined by a professional immediately:
Larger than six millimeters.
Itches or bleeds.
Rapidly changes in color, size or shape.
Has multiple colors.
Is located where it can't be easily monitored, such as on the scalp.
Depending on their depth, location and color, as well as the patient’s skin type, age and other factors, treatment for benign but unattractive birthmarks may take the form of laser or pulsed light therapy, microdermabrasion or surgical excision.
Rosacea is a chronic skin disease affecting about 14 million Americans that causes redness and swelling on the face and also occasionally the scalp, neck, ears, chest, back and/or eyes. Although it can affect anyone, rosacea typically appears in light-skinned, light-haired adults aged 30-50. Symptoms range from red pimples, lines and visible blood vessels to dry or burning skin and a tendency to flush easily, but many people find that the emotional effects of rosacea – i.e. low self-confidence and avoidance of social situations – are more difficult to handle than the physical ones. It is not yet known what causes rosacea and the disease is not curable, although it can be treated in many ways, including topical and oral medications, laser therapy and laser surgery. Early detection and intervention are essential to achieve the most effective results, or to reduce the severity of symptoms if rosacea has already progressed.
Psoriasis encompasses a group of chronic skin disorders that cause an itching and/or burning sensation, 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 lifestyle; and the effect the disease has on the patient’s general mental health. The most common treatments are topical medications, phototherapy, photochemotherapy (PUVA), and oral or injectable medication (for severe symptoms).
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, adults of any age can have it. Acne is not life-threatening, but it can cause physical disfigurement (scarring) and emotional distress. Treatment varies depending on the type and severity of lesions, skin type and the patient’s age and lifestyle, but on average results are visible in six to eight weeks. Options include:
Punch excisional surgery for deep "ice-pick" pitted scarring
Dermabrasion and microdermabrasion
Patients with mild acne can supplement treatment at home by washing with warm water and a mild soap twice a day and/or using a topical over-the-counter acne medication.
Warts are normally noncontagious skin growths caused by viruses. Different warts respond to different treatments. Some go away on their own. Salicylic acid products (in the form of drops, gels, pads and bandages) can help self-treatment of many warts by dissolving the keratin protein that makes up the wart and the dead skin above it. Others can be removed via liquid nitrogen freezing or electrical stimulation. Surgery may be recommended for painful or large warts that do not respond to these treatments.
Ringworm is a contagious skin infection that manifests as itchy, scaly, ring-shaped red patches on the skin, bald spots in the hair or beard, or discolored, thickened nails. The most commonly infected areas of skin are on the scalp, body, groin or foot. When we refer to “jock itch” and “athlete’s foot,” we’re really talking about ringworm.
Ringworm is caused by a fungus, not a worm. It tends to occur in warm, moist areas of the body, and can be passed from person to person by touching the skin or an item that has been in contact with the infected area (clothing, hair brushes, towels, or pool or shower surfaces). Pets – especially cats – can also transmit the fungus. Many cases occur in children, although people of any age can be affected.
Use of antifungal powders or creams, keeping the skin dry, and washing sheets and nightclothes daily are often sufficient to treat the infection. If rashes persist for more than four weeks, however, or if symptoms are severe or a bacterial infection occurs, the patient should see a physician for more aggressive treatment. Antifungal pills, prescription antifungal medications or antibiotics may be prescribed.
Eczema is a term used to describe 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.