Medical Dermatology

Skin Infection

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Human skin is susceptible to infection by a multitude of different organisms:

 

  • Bacteria: Cellulitis occurs when a break in the skin allows bacteria to enter the body.  This may occur after injury or a medical procedure.  Bacterial infections are typically diagnosed with a simple culture, and they may be treated with topical or oral antibiotics.  While not usually serious, it is possible for bacterial skin infections to progress deeper into the tissues or into the blood stream.
  • Viruses:  Viral infections are common in childhood, though vaccines may help some children avoid chicken pox, measles, and mumps.  Herpes simplex virus (HSV) may cause repeated flares of cold sores or genital herpes.  Wart viruses cause benign, proliferating bumps in the skin.  Shingles is caused by a recurrence of the chicken pox virus later in life.  Occasionally, short-lived viral infections may cause a widespread skin rash.  Viral cultures and skin biopsies are useful in diagnosing the above conditions while treatment includes oral antiviral medications, oral corticosteroids, or supportive care.
  • Fungus and Yeast:  Most fungal infections take the form of athlete’s foot, “jock itch,” or ringworm, which are all caused by the same fungus living in the outer layers of the skin.  It is usually easily treated with topical creams, but more widespread infections are cleared with oral antifungals.  Yeast infections occur in warm, moist areas that include the mucosal skin of the mouth or vagina, as well as skin folds in the groin and under the breasts.
  • Parasites:  Scabies are microscopic mites that live in the outer layers of the skin.  They cause itching and irritation and they may be difficult to correctly identify without microscopic examination of skin scrapings.  Scabies are highly contagious and many individuals experience a delay in diagnosis.  They are readily treated with oral and topical medications, though all of a person’s close contacts need to be treated to achieve lasting resolution. Body lice, while not microscopic, cause similar itching and skin irritation in hair-bearing areas.

 

Early identification of skin infections can lead to more rapid relief of symptoms, lessen the risk of serious complications, and ensure that the infection does not spread to others.

Skin Surgery

Surgical excision of skin growths under local anesthesia is provided at the Center for Dermatology and Laser Surgery. Growths requiring surgical removal would include moles, skin cancers, cysts and fatty tumors.  Our surgical providers provide a calm, compassionate environment where skin surgeries can be performed safely, with maximal comfort, and always with a concern for the cosmetic outcome.

If you have a growth that needs to be surgically removed, please schedule an appointment with a medical provider for evaluation and treatment recommendations. In some cases, due to the particular diagnosis, location, or cosmetic considerations, our patients will be referred to a plastic surgeon, surgical oncologist, ear/nose/throat specialist or Mohs surgeon for their surgical procedure.
Cosmetic surgery is not performed at the Center for Dermatology and Laser Surgery, but we do offer a number of non-invasive alternatives to surgery.  Please schedule with a cosmetic provider to further discuss these options.

UVB Light Treatments

Ultraviolet light B (UVB) therapy is a safe and effective treatment for a variety of skin conditions including psoriasis, eczema, vitiligo, and chronic itching.  UVB therapy is different from natural sunlight and tanning beds because it delivers a concentrated dose of UV light at a specific wavelength (311 nm), which minimizes the risk of sun damage and skin cancer.

UVB treatments are performed in-office, 2-3 times weekly on a regular schedule.  The affected skin is treated while standing in a light unit that uses swinging doors to completely encircle the body. Goggles are worn during this painless light exposure, which lasts less than five minutes. The goal, after at least 6-8 weeks of therapy, is to bring relief from rash and itch, and ideally, to induce remission of the underlying condition. It is not uncommon for patients to repeat a UVB series in the future on an as-needed basis.

Vitiligo

 

Vitiligo is an autoimmune disorder in which an individual’s immune system begins to recognize and attack the melanocytes, the pigment-producing cells in the skin.  This produces light colored or completely white patches of skin in the affected areas, the most common of which would be the face, arms, hands, feet and genitals. It may be difficult to recognize this depigmentation in a light-skinned individual, but in those with darker skin, the contrast can be quite noticeable. Vitiligo is not life threatening or contagious, but it is often a source of distress for those who are afflicted by the condition.

There is no cure for vitiligo, and while it may be difficult to restore pigment to affected skin, there are several ways in which the condition may be treated. Topical and oral anti-inflammatory medications can target the immune cells responsible for the depigmentation. UVB light therapy and Excimer laser can be effective in re-pigmenting skin over time as well. Often a combination approach has the greatest chance of success.  In rare cases, when there is a very large affected area of the body, and especially in light-skinned individuals, complete depigmentation with a topical lightening agent may be the treatment of choice. At any stage of the disease, it is vital to practice strict sun protection as areas of skin without pigment are extremely sensitive to sunburn, sun damage, and the development of skin cancer later in life.

To learn more about vitiligo, or to connect with others who have vitiligo, visit the American Vitiligo Foundation website.

Warts

Warts are benign skin growths that occur when the human papillomavirus (HPV) infects the upper layers of skin.  A person contracts HPV through skin-to-skin contact, or with an object that recently touched a wart.  While warts most commonly occur on the hands and feet, they can appear anywhere on the body including the face and genitals.  They may appear as thickened bumps on the hands and feet, flat pink bumps on the face and lower legs, or sometimes they are cauliflower-like.
Children are more likely to have warts because their immune systems have not learned to recognize and suppress HPV.  Warts may spontaneously disappear at any time, though many do not.  Warts are often unsightly, embarrassing or uncomfortable depending on their size and location.  Liquid nitrogen is the most common treatment for warts, however there are many options for treatment including canthacur, laser, cautery, immunotherapy and surgical removal.  Even very young children can be treated effectively with little discomfort.

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