General Dermatology

Moles & Birthmarks

Moles (also called nevi) are flat or raised collections of pigmented skin cells. They are common and almost every adult has a few. Adults with lighter skin typically have more moles and this is normal. Moles are usually a uniform brown color and round or oval in shape.

Congenital moles are present at birth. These are frequently larger and darker than other moles. Most common moles appear during childhood and young adulthood. They grow naturally with the growth of a child and sometimes darken or lighten in color. New moles or changes to existing moles can be a sign of melanoma in adults.

Moles exhibiting any of the following warning signs should be examined by your dermatologist:

• Larger than six millimeters
• Itching or bleeding
• Rapid change in color, size or shape
• Multiple colors or very dark brown/black color
• Asymmetry or notched borders

Psoriasis

Psoriasis is an immune-mediated skin condition most commonly consisting of dry, raised, scaly patches of skin on the scalp, elbows, and knees. However, there are several types of psoriasis that can appear differently and affect any body area.

Over eight million Americans have some form of psoriasis. Some people who have psoriasis, especially severe psoriasis, may develop arthritis (called psoriatic arthritis).

Treatment of psoriasis depends on the type, severity and location. The patient’s age, medical history and the effect the disease on physical and mental health are also used to determine the appropriate treatment.

Topical treatments consist of prescription cortricosteroid creams and medications derived from vitamin D. Over the counter topical treatments containing salicylic acid and coal tar may be recommended to be used in combination. For more severe cases, oral and injectable medications are prescribed. These include methotrexate, Otezla, Cosentyx, Enbrel, Humira, Illumya, Skyrizi, Stelara, Tremfya, Taltz and others.

Skin Infections

Warts:

Warts are contagious skin growths caused by the human papilloma virus. Many treatments are available for warts, the simplest being over-the-counter salicylic acid solutions and patches. In-office treatments include freezing the warts with liquid nitrogen, application of Cantharidin or even injectable medications. Medication may also be prescribed by your physician for at-home use. Warts usually need multiple treatments for total resolution. Sometimes surgical removal is required.

Molluscum:

Molluscum contagiosum is a skin infection caused by a pox virus. It’s quite common among children and is usually spread by skin-to-skin contact. It can also spread by touching something that someone with molluscum has used (such as unwashed towels, clothes or sports equipment). Molluscum are painless, raised bumps on the skin that look like pink pearls. The growths often have a slight indentation in the center filled with a waxy core. They may develop nearly anywhere on the body. Scratching can spread the infection, leading to lines or clusters of them on the skin. They can be successfully treated with topical medications, liquid nitrogen or surgical removal.

Impetigo:

Impetigo is a bacterial skin infection. It is especially common in children and highly contagious through skin-to-skin contact or contact with towels, clothing, or sports equipment used by someone with the infection. Staph and strep cause most cases of impetigo and it usually enters broken skin. Once inside, the bacteria cause an infection in the top layers of the skin. It may appear as a sore or red, raw skin that can have honey-colored crust. Treatment is important to limit the spread of the infection and prevent a deeper, more serious infection. Your dermatologist may prescribe topical or oral antibiotics and recommend skin care to help clear the infection quickly.

Fungal infections:

Dermatologists can help diagnose and treat fungal infections of the skin and nails. These include ringworm (tinea corporis), athlete’s foot (tinea pedis), jock itch (tinea cruris) and nail fungus (onychomycosis). Your dermatologist may send a sample of infected skin, hair or nail to a laboratory to confirm the diagnosis. Over-the-counter topical creams or powders may be recommended or prescription antifungal creams, shampoos or pills may be needed. Treatment is important to prevent spreading the infection to new body areas and to other people.

Rosacea

Rosacea is a common skin condition. It may start with a tendency to flush or blush more easily than other people. The redness usually starts on the nose and cheeks but can spread to the forehead and chin or other body areas. Rosacea has different subtypes that can involve redness, flushing, and visible blood vessels (erythematotelangiectatic rosacea), redness, swelling, and acne-like breakouts (papulopustular rosacea), skin thickening with a bumpy texture (phymatous rosacea), or red and irritated eyes with eyelid swelling (ocular rosacea).

Rosacea tends to appear between age 30 to 50 in fair-skinned people from Celtic or Scandinavian ancestry and those who have a family history of rosacea or severe acne. However, it is also seen in other age groups as well as skin of color. Both men and women are affected. The cause of rosacea is not completely understood at this time.

Rosacea symptoms flare up periodically. Triggers can include stress, sunlight, alcohol (especially red wine), wind, heat, spicy foods, hot beverages, strenuous exercise, and chemicals in skin or hair care products. Treatment may consist of a variety of topical creams, low-dose oral antibiotics as well as recommendations for rosacea-friendly skin care and avoidance of triggers.