General & Consultative Dermatology
Acne and Acne Scars
Seventeen million Americans currently have acne, making it the most common skin disease in the country. Acne is not life-threatening, but it can cause physical disfigurement (scarring) and emotional distress. Treatment can include topical and oral medications, chemical peels, or surgical procedures, depending on the type and severity of lesions, skin type, and the patient's age and lifestyle. For most treatments, results are visible in six to eight weeks. Options include:
- Oral Medication
- Topical medication
- Chemical Peels
- Cyst removal
- Punch excisional surgery for deep "ice-pick" pitted scarring
Preventative Dermatological Care
A few precautions on your part and regular examinations by a dermatologist can prevent you from getting some skin conditions and ensure that any developing problems are detected and treated early. Good skin care includes wearing sunscreen of at least SPF 15 when outdoors, keeping the skin clean, avoiding tanning booths and other sources of intense ultraviolet light, not scratching or picking at rashes or pimples, and seeing a medical professional for evaluation if you suspect a problem, or about once a year for older patients.
Bacterial and Fungal Infections
Bacterial infection of the skin, also called cellulitis, occurs when a break in the skin allows bacteria that normally live on the surface to enter the body, causing inflammation, redness, pain, warmth, fever/chills, fatigue, and muscle aches. The break itself may arise from trauma, an animal or insect bite or sting, after some surgeries, with the use of certain drugs, or from skin wounds due to medical conditions such as diabetes or peripheral vascular disease. Left untreated, bacterial infection can lead to tissue death (gangrene), sepsis, generalized infection, shock, meningitis (if cellulitis is on the face) and lymphangitis (inflammation of the lymph vessels). Treatment may require hospitalization, oral antibiotics, or analgesics to control pain.
Fungal infections of the skin are caused by microscopic organisms that live on the hair, nails (onychomycosis), mouth (angular cheilitis/oral thrush), and outer skin layers. They are quite common. The fungal infection cutaneous candidiasis, for example, which occurs in warm, moist crevices of the body, is the usual cause of diaper rash and vaginal yeast infections. Fungal infections are most likely to occur in people with diabetes, who are obese, or who take antibiotics or oral contraceptives. They are treatable (sometimes with difficulty) but often recur. Treatments include topical and systemic antifungal medications.
Eczema and Atopic Dermatitis
Eczema is the name of a group of skin conditions involving red rashes that become irritated, moist, oozing or bumpy when scratched. Atopic dermatitis, also called infantile eczema, is a common form that affects about 10 percent of children.
Atopic dermatitis is inherited and so cannot be prevented, but it is treatable. Since rashes are caused by exposure to allergens in the environment (as opposed to contact dermatitis, which worsens when the skin physically touches an irritant), known triggers such as heat, wool, hot water, certain foods or skin products, soaps and detergents should be avoided or removed from the home. A child or teen who has been diagnosed with Atopic dermatitis may be given steroid creams, antihistamines to relieve itching, and/or antibiotics to treat any infections caused by scratching. Trying not to scratch the area is also important and can reduce the likelihood of developing skin scales or lichenification (thickening).
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Actinic keratoses appear on the sun exposed areas of the skin and are the result of chronic sun exposure. They are considered pre-cancerous and should be treated as early as possible. Seborrheic keratoses, often called age spots, can appear anywhere on the body. These growths are always benign, but can mimic pre-cancers and skin cancer. Evaluation and treatment of these growths is essential in the early detection of skin cancer.
Pediatric / Adolescence Dermatology
Dermatologists are trained to treat patients of all ages, from newborns to the elderly. This includes the diagnosis, treatment and prevention of problems of the skin, hair and nails. Conditions common among children are moles and birthmarks, dermatitis, acne, warts, vitiligo, insect bites and birth defects. In adults we treat a range of conditions such as cancers and pre-cancers, rosacea, psoriasis and shingles. We also treat eczema, allergies and other disorders that occur in all age groups, and carefully examine moles or other growths to determine whether they are or may become cancerous.
Problems with the skin may occur as a symptom of a systemic disease or as a side-effect of some drugs, medications, and other treatments. Diseases that frequently present in the skin include diabetes, Crohn's disease, lupus erythematosus, Lyme disease, pruritis, sarcoidosis, scleroderma, thyroid disease, vasculitis and some cancers. Treatment is geared toward both the skin symptoms and the underlying condition.
Dr. McKinley-Grant specializes in Cutaneous T-cell Lymphoma and Sarcoidosis diagnosis and treatment.
Skin Cancer Diagnosis, Treatment and Surgery
Skin cancer is a disease in which malignant (cancer) cells form in the tissues of the skin.
The skin is the body's largest organ. It protects against heat, sunlight, injury, and infection. Skin also helps control body temperature and stores water, fat, and vitamin D. The skin has several layers, but the two main layers are the epidermis (upper or outer layer) and the dermis (lower or inner layer). Skin cancer begins in the epidermis, which is made up of 3 kinds of cells:
- Squamous cells: Thin, flat cells that form the top layer of the epidermis.
- Basal cells: Round cells under the squamous cells.
- Melanocytes: Found in the lower part of the epidermis, these cells make melanin, the pigment that gives skin its natural color. When skin is exposed to the sun, melanocytes make more pigment, causing the skin to darken.
Skin cancer can occur anywhere on the body, but it is most common in skin that has been exposed to sunlight, such as the face, neck, hands, and arms. There are several types of cancer that start in the skin. The most common types are basal cell carcinoma and squamous cell carcinoma, which are nonmelanoma skin cancers. Actinic keratosis is a skin condition that sometimes develops into squamous cell carcinoma.
Bullous diseases are characterized by large (>1 cm) blisters, or bullae, on the skin. These fluid-filled lesions are usually caused by inflammation in or under the surface layer of skin, called the epidermis. Other symptoms may include rashes, itchy or red patches, sores, pain or swelling. Treatment varies depending on the specific condition but is generally geared toward relieving symptoms, reducing inflammation with the use of topical steroids or immunosuppressants, and preventing or treating any infections that occur.
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).
Rashes, Allergies and Irritations
Rashes are changes in the skin's color or texture. Simple rashes are called dermatitis, which means the skin is inflamed or swollen. Some rashes are independent symptoms, but many cause itching, burning or other discomfort. Rashes occur for a variety of reasons, some relatively benign, some extremely serious. Many rashes look similar to one another so their causes may be difficult to diagnose.
Cutaneous T-Cell Lymphoma
Cutaneous T-cell lymphomas, known as CTCLs, are serious but rare disorders. Lymphomas are cancers of the lymphatic system, a part of the immune system that produces white blood cells and helps fight infections and diseases.
Sarcoidosis is an inflammatory disease where abnormal lumps or nodules, known as granulomas, develop in one or more organs throughout the body. While the exact cause remains unknown, doctors theorize that sarcoidosis stems from the immune system's exposure to substances in the environment.
Hair loss, or alopecia, is a common condition which may be a consequence of natural aging, a side effect of medication, or a manifestation of a health disorder. It can result in total baldness, thinning of the hair, or patchy bald spots and may be confined to the scalp or affect other areas of the body. Hair loss may be temporary or permanent, depending on its cause.