Common Dermatological Diagnoses A-C

• Acne

  What is acne?

  (Acne Informational Video)

  Acne is a disorder of the hair follicles and sebaceous glands. With acne, the sebaceous glands are clogged, which leads to pimples and cysts.
  
  Acne is very common - nearly 17 million people in the US are affected by this condition. Acne most often begins in puberty. During puberty, the male sex hormones (androgens) increase in both boys and girls, causing the sebaceous glands to become more active - resulting in increased production of sebum.

  How does acne develop?

  The sebaceous glands produce oil (sebum) which normally travels via hair follicles to the skin surface. However, skin cells can plug the follicles, blocking the oil coming from the sebaceous glands. When follicles become plugged, skin bacteria (called Propionibacterium acnes, or P. acnes) begin to grow inside the follicles, causing inflammation. Acne progresses in the following manner:

  • Incomplete blockage of the hair follicle results in blackheads (a semisolid, black plug).
  • Complete blockage of the hair follicle results in whiteheads (a semisolid, white plug).
  • Infection and irritation cause whiteheads to form.

  Eventually, the plugged follicle bursts, spilling oil, skin cells, and the bacteria onto the skin surface. In turn, the skin becomes irritated and pimples or lesions begin to develop. The basic acne lesion is called a comedo.
  Acne can be superficial (pimples without abscesses) or deep (when the inflamed pimples push down into the skin, causing pus-filled cysts that rupture and result in larger abscesses).

  What causes acne?

  Rising hormone levels during puberty may cause acne. In addition, acne is often inherited. Other causes of acne may include the following:

  • Hormone level changes during the menstrual cycle in women
  • Certain drugs (such as corticosteroids, lithium, and barbiturates)
  • Oil and grease from the scalp, mineral or cooking oil, and certain cosmetics may worsen acne
  • Bacteria inside pimples
  • Acne can be aggravated by squeezing the pimples or by scrubbing the skin too hard.

  What are the symptoms of acne?

  Acne can occur anywhere on the body. However, acne most often appears in areas where there is a high concentration of sebaceous glands, including the following:

  • Face
  • Chest
  • Upper back
  • Shoulders
  • Neck

  The following are the most common symptoms of acne. However, each child may experience symptoms differently. Symptoms may include:

  • Blackheads
  • Whiteheads
  • Pus-filled lesions that may be painful
  • Nodules (solid, raised bumps)

  The symptoms of acne may resemble other skin conditions. Always consult your child's physician for a diagnosis.

  Treatment of acne:

  • Specific treatment will be determined by your child's physician based on:
  • Your child's age, overall health, and medical history
  • Severity of the acne
  • Your child's tolerance for specific medications, procedures, or therapies
  • Expectations for the course of the condition
  • Your opinion or preference

  The goal of acne treatment is to minimize scarring and improve appearance. Treatment for acne will include topical or systemic drug therapy. Depending upon the severity of acne, topical medications (medications applied to the skin) or systemic medications (medications taken orally) may be prescribed by your child's physician. In some cases, a combination of both topical and systemic medications may be recommended.

  Topical medications to treat acne:

  Topical medications are often prescribed to treat acne. Topical medication can be in the form of a cream, gel, lotion, or solution. Examples include:

  Benzoyl Peroxide	Kills the bacteria (P. acnes)
  Antibiotics	Helps stop or slow down the growth of P. acnes and reduces inflammation
  Tretinoin	Stops the development of new acne lesions (comedones) and encourages cell turnover, unplugging pimples
  Adapalene	Decreases comedo formation

  Systemic medications to treat acne:

  Systemic antibiotics are often prescribed to treat moderate to severe acne, and may include the following:

  • Doxycycline
  • Erythromycin
  • Tetracycline

  Treatment for severe, cystic, or inflammatory acne:

  Isotretinoin (Accutane®), an oral drug, may be prescribed for individuals with severe, cystic, or inflammatory acne to prevent extensive scarring. Isotretinoin reduces the size of the sebaceous glands that produce the skin oil, increases skin cell shedding, and affects the hair follicles, thereby reducing the development of acne lesions. Isotretinoin can clear acne in 90 percent of patients. However, the drug has major unwanted side effects, including psychiatric side effects. It is very important to discuss this prescription medication with your child's physician.

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• Acne Scar Removal
  
  

  Treatment for acne scars

  Specific dermatological procedures to minimize acne scars will be determined by your physician based on:

  • Your age, overall health, and medical history
  • Severity of the scar
  • Type of scar
  • Your tolerance for specific medications, procedures, or therapies

  • Your opinion or preference

  Although acne often is a chronic condition, even if it lasts only during adolescence, acne can leave life-long scars. Acne scars typically look like "ice pick" pit scars or craterlike scars. Although proper treatment for acne may help minimize scarring, several dermatological procedures may help to further minimize any acne scars, including the following:

  • Dermabrasion
    Dermabrasion may be used to minimize small scars, minor skin surface irregularities, surgical scars, and acne scars. As the name implies, dermabrasion involves removing the top layers of skin with an electrical machine that abrades the skin. As the skin heals from the procedure, the surface appears smoother and fresher.
  • Chemical Peels
    Chemical peels are often used to minimize sun-damaged skin, irregular pigment, and superficial scars. The top layer of skin is removed with a chemical application to the skin. By removing the top layer, the skin regenerates, often improving its appearance.
  • Collagen Injections
    A type of collagen that is derived from purified bovine (cow) collagen is injected beneath the skin to replace the body's natural collagen that has been lost. Injectable collagen is generally used to treat wrinkles, scars, and facial lines.
  • Laser Resurfacing
    Laser resurfacing uses high-energy light to burn away damaged skin. Laser resurfacing may be used to minimize wrinkles and fine scars.
  • Punch Grafts
    Punch grafts are small skin grafts used to replace scarred skin. A hole is punched in the skin to remove the scar, which is then replaced with unscarred skin (often from the back of the earlobe). Punch grafts can help treat deep acne scars.
  • Autologous Fat Transfer
    An autologous fat transfer uses fat taken from another site on your own body and it is injected into your skin. The fat is placed beneath the surface of the skin to elevate depressed scars. This method is used to correct deep contour defects caused by scarring from nodulocystic acne. Because the fat may be reabsorbed into the skin over a period of months, there may be a need for the procedure to be repeated.
• Actinic Keratosis
  
  

  What is actinic keratosis?

  Actinic keratosis, also known as a solar keratosis, is a scaly or crusty bump that arises on the skin surface. The base may be light or dark, tan, pink, red, a combination of these, or the same color as the skin. The scale or crust is horny, dry, and rough, and is often recognized by touch rather than sight. Occasionally, it itches or produces a pricking or tender sensation.

  Actinic keratosis can be the first step in the development of skin cancer, and, therefore, is considered a precancerous skin condition. The presence of actinic keratoses indicates that sun damage has occurred and that any kind of skin cancer can develop.

  How does an actinic keratosis develop?

  An actinic keratosis develops slowly and most likely appears on the face, ears, bald scalp, neck, backs of hands and forearms, and lips. It tends to lie flat against the skin of the head and neck, but appear elevated on arms and hands. Often, a person will have more than one actinic keratosis lesion.

  The lesions are usually not life threatening, provided they are detected and treated in the early stages. However, if this is not done, they can grow large and invade the surrounding tissues and, on rare occasions, metastasize, or spread, to the internal organs.
  The most aggressive form of keratosis, actinic cheilitis, appears on the lips and can evolve into squamous cell carcinoma. When this happens, about 20 percent of these carcinomas metastasize to other parts of the body.

  It is estimated that up to 10 percent of active lesions, which are more red in color and more tender than the rest, will take the next step and progress to squamous cell carcinomas.

  What causes actinic keratosis?

  Sun exposure causes almost all actinic keratoses. Sun damage to the skin accumulates over time, so that even a brief exposure adds to the lifetime total. Certain groups of people are more at risk than others, including the following:

  People who have fair skin, blonde or red hair, and blue, green, or gray eyes are at the greatest risk, but darker-skinned people can develop keratoses if they expose themselves to the sun without protection.

  African-Americans rarely have these lesions.

  Individuals who are immunosuppressed as a result of cancer chemotherapy, acquired immune deficiency syndrome (AIDS), or organ transplantation are also at higher risk.

  One in six people will develop an actinic keratosis in the course of a lifetime, according to some estimates. Older people are more likely than younger people to develop actinic keratoses, because cumulative sun exposure increases with age.

  Treatment for actinic keratosis:

  Specific treatment for actinic keratosis will be determined by your physician based on:

  • Your age, overall health, and medical history
  • Extent of the disease
  • Your tolerance for specific medications, procedures, or therapies
  • Expectations for the course of the disease
  • Your opinion or preference

  When diagnosed early, treatment for actinic keratosis may include cryotherapy (freezing the lesion), topical chemotherapy (anticancer drugs), or other treatments.

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• Allergens - Insect Stings
  
  

  Insect stings that most commonly cause allergic reactions:

  Insects that are members of the Hymenoptera family most commonly cause allergic reactions. These include:

  • Bees
  • Wasps
  • Hornets
  • Yellow Jackets
  • Fire Ants

  Allergic reactions to insect stings:

  Usually, the reaction is short-lived, with redness and swelling followed by pain and itching. Generally, the reaction lasts only a few hours, although some may last longer. For other people, however, allergic reactions to these insect stings can be life threatening.

  Immediate medical attention is required.

  This severe reaction is a medical emergency that can involve organ systems throughout the body. The reaction is called anaphylaxis and can include severe symptoms such as:

  • Itching and hives over most of the body
  • Swelling of the throat and tongue
  • Difficulty in breathing
  • Dizziness
  • Headache
  • Stomach cramps, nausea, or diarrhea
  • Rapid fall in blood pressure
  • Shock
  • Loss of consciousness

  Can insect stings be prevented?

  Avoidance of insects is the best preventive measure. Suggestions include:

  • When outdoors, be careful of eating or drinking uncovered foods or beverages, which can attract insects.
  • Avoid going barefoot, and wear closed-toe shoes when walking in grassy areas.
  • When gardening, watch for nests in trees, shrubs, and flower beds.
  • Other areas in which to use caution: swimming pools, woodpiles, under eaves of houses, trash containers.

  Treatment for insect stings:

  Specific treatment for insect stings will be determined by your physician based on:

  • Your age, overall health, and medical history
  • Extent of the reaction
  • Your tolerance for specific medications, procedures, or therapies
  • Expectations for the course of the reaction
  • Your opinion or preference

  Suggestions for immediate treatment for highly-allergic people, according to the American Academy of Allergy, Asthma and Immunology, include:

  • When possible, immediately remove stinger, and scrape over the area with a fingernail. However, do not squeeze the area, which may force the venom into the body.
  • An emergency treatment kit should be kept nearby at all times. Talk with your physician about what it should include.
  • Seek emergency care as soon as possible.
• Allergens: Poison Ivy/Poison Oak
  
  

  What is poison ivy/poison oak?

  There are three native American plants that collectively may be called poison ivy: poison ivy, poison oak, and poison sumac. These plants cause an allergic reaction in nearly 85 percent of the population. To be allergic to poison ivy, you must come in contact with the plant once for "sensitization" to the oils to occur. This means that next time contact with the plant occurs, a reaction may occur.

  What causes the allergic reaction?

  The resin in the plants contains an oily substance called urushiol. Urushiol is easily transferred from the plants to other objects, including tools and animals. This chemical can remain active for a year or longer. It is important to know that the oils can be transferred from clothing, pets, or smoke from a burning plant.

  What is the allergic reaction to poison ivy/poison oak?

  The reaction is usually contact dermatitis, which may occur several hours, days, or even weeks after exposure. The dermatitis is characterized by a rash followed by bumps and blisters that itch. Sometimes, swelling occurs in the area of contact. Eventually, the blisters break, ooze, and then crust over.

  Treatment for poison ivy/poison oak:

  There in no cure for poison ivy once the rash starts. Avoiding the poison plants is the best treatment. It is very important to teach your children what the plants look like and not to touch them.

  If contact with the plants has already occurred, you should remove the oils from the skin as soon as possible. Cleansing with an ordinary soap within 6 hours after the initial exposure has proven to be effective. Repeat the cleaning with the soap three times. There are also alcohol-based wipes that help remove the oils. Wash all clothes and shoes also because the oils can remain on these.

  For the itching, your physician may recommend over-the-counter creams, such as calamine lotion or bathing in Aveeno bath. Sometimes, your physician will prescribe a medication by mouth for the itching.

  If the blisters and rash are on the face, near the genitals, or all over the body, your physician should be notified. After a thorough history and physical, your physician may prescribe a steroid cream or injection to help with the swelling and itching.

  Is poison ivy/poison oak contagious?

  No. It can not be spread from person to person by touching the blisters or from the fluid inside the blisters. It can be spread, however, if the oils remain on the skin, clothes, or shoes. This is why washing your hands, clothes, and shoes as soon as possible is very important.

  Preventing poison ivy/poison oak:

  • Teach all family members what the plants look like.
  • Wear long pants and long sleeves when outside in woods or yard.
  • Wash clothes and shoes immediately after being outside.
  • Do not touch a pet that might have been in a poison plant.
  • Wash hands thoroughly.

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• Anatomy of the Skin
  
  

  Facts about the skin:

  The skin is the body's largest organ, covering the entire body. In addition to serving as a protective shield against heat, light, injury, and infection, the skin also:

  • Regulates body temperature;
  • Stores water and fat;
  • Is a sensory organ;
  • Prevents water loss;
  • Prevents entry of bacteria.

  Throughout the body, the skin's characteristics vary (i.e., thickness, color, texture). For instance, the head contains more hair follicles than anywhere else, while the soles of the feet contain none. In addition, the soles of the feet and the palms of the hands are much thicker.

  The skin is made up of the following layers, with each layer performing specific functions:

  • Epidermis
  • Dermis
  • Subcutaneous fat layer

  Epidermis	The epidermis is the thin outer layer of the skin which consists of the following three parts: Stratum corneum (horny layer) This layer consists of fully mature keratinocytes which contain fibrous proteins (keratins). The outermost layer is continuously shed. The stratum corneum prevents the entry of most foreign substances as well as the loss of fluid from the body. Keratinocytes (squamous cells) This layer, just beneath the stratum corneum, contains living keratinocytes (squamous cells), which mature and form the stratum corneum. Basal layer The basal layer is the deepest layer of the epidermis, containing basal cells. Basal cells continually divide, forming new keratinocytes, replacing the old ones that are shed from the skin's surface. The epidermis also contains melanocytes, which are cells that produce melanin (skin pigment).
  Dermis	The dermis is the middle layer of the skin. The dermis contains the following: Blood vessels Lymph vessels Hair follicles Sweat glands Collagen bundles Fibroblasts Nerves The dermis is held together by a protein called collagen, made by fibroblasts. This layer also contains pain and touch receptors.
  Subcutis	The subcutis is the deepest layer of skin. The subcutis, consisting of a network of collagen and fat cells, helps conserve the body's heat and protects the body from injury by acting as a "shock absorber."

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• Atopic Dermatitis
  
  

  What is atopic dermatitis?

  Atopic dermatitis, also called eczema, is a hereditary and chronic skin disorder that mostly affects infants or very young children, and may last until the child reaches adolescence or adulthood. Eczema causes the skin to itch, turn red, and flake.
  
  Parents with eczema are more likely to have children with eczema. Different triggers can make eczema worse, including environmental irritants, allergies, and stress.
  
  The condition tends to flare up during times of stress, when the temperature is extremely high or low, when the patient has a bacterial infection, or when the skin is irritated by fabrics (wool) or detergents. Of children who have eczema, 65 percent will show signs of eczema in the first year of life and 90 percent will show signs of eczema within the first 5 years.

  What are the symptoms of eczema?

  The distribution of eczema may change with age. In infants and young children, eczema is usually located on the face, outside of the elbows, and on the knees. In older children and adults, eczema tends to be on the hands and feet, the arms, and on the back of the knees. The following are the most common symptoms of eczema. However, each person may experience symptoms differently. Symptoms may include:

  • Dry, scaly skin
  • Small bumps that open and weep when scratched
  • Redness and swelling of the skin
  • A thickening of the skin (with chronic eczema)

  Excessive rubbing and scratching can tear the skin and result in an infection. The symptoms of eczema may resemble other skin conditions. Always consult your physician for a diagnosis.

  How is eczema diagnosed?

  Atopic dermatitis is very common. Over 15 million American adults and children have atopic dermatitis. The National Institute of Arthritis and Musculoskeletal and Skin Diseases estimates that at least 20 percent of infants and children experience symptoms of atopic dermatitis. In addition to a complete medical history and physical examination, diagnostic procedures for eczema may include the following:

  • Family history (Children born to a mother who has allergic conditions are more prone to eczema.)
  • Personal history of allergies or asthma
  • Blood tests

  
  

  Treatment for eczema:

  Specific treatment for eczema will be determined by your physician based on:

  • Your (your child's) age, overall health, and medical history
  • Extent of the reaction
  • Your (your child's) tolerance for specific medications, procedures, or therapies
  • Expectations for the course of the reaction
  • Your opinion or preference

  There is no cure for eczema. The goals of treatment are to reduce itching and inflammation of the skin, moisturize the skin, and prevent infection.

  Management of eczema symptoms:

  The following are suggestions for the management of eczema:

  • Avoid contact with irritants, as determined by your physician.
  • Take brief baths or showers using lukewarm water.
  • Practice good skin care techniques.
  • Do not use harsh soaps. Ask your physician to recommend a brand.
  • Dress in light clothes - sweating can make eczema worse.
  • Use lubricating lotions at least once a day. Ask your physician to recommend a brand.
  • Avoid scratching the affected area.
  • Minimize stress.

  Your physician may also prescribe medications in severe cases. The following medications are most commonly used to treat eczema:

  • Antihistamines
    These medications help to decrease the amount of itching. Some examples include diphenhydramine (Benadryl ®) or hydroxyzine (Atarax ®). These medications may cause drowsiness. Some new antihistamines are also available that do not cause drowsiness. Consult your physician for more information.
  • Steroid creams
    These topical medications help to decrease the inflammation in the skin, thus decreasing the itching and swelling. Many topical steroids in various strengths are available. Steroids, if overused, are potentially damaging to the skin. Consult your physician for more information.
  • Oral antibiotics
    These medications are derived from mold or bacteria and slow the growth of specific microorganisms. A sample from the body part thought to be infected may be taken and cultured in a lab to determine what type of antibiotic to use for the most effective treatment.
  • Oral cyclosporine
    This medication is used primarily to prevent rejection after organ transplantation. It suppresses the immune system and has other side effects that should be considered. Consult your child's physician as needed.
  • Phototherapy (light therapy)
    It is safest to have this treatment under medical supervision, but light therapy is not offered at all dermatology clinics. Home light therapy devices are available, but may not be covered by insurance. Narrow band UVB (ultraviolet B) light units are the most effective. Be sure to follow the manufacturer's instructions carefully to avoid injury.
  • Topical immunomodulator (TIMs)
    Topical immunomodulators are a new class of drugs for the treatment of eczema. These drugs are applied directly to the skin to alter the immune response.

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• Bacterial Skin Infections

  The skin is the body's first barrier against bacteria that cause infections. Even though many bacteria live on the surface of our skin, healthy skin can usually protect us from infection. However, bacterial skin infections can affect a small spot or may spread, affecting a large area. They can range from a treatable infection to a life-threatening skin condition.

  Any one who has a break in the skin is at risk for infection. However, certain conditions or diseases can put a person at greater risk for infection, including the following:

  • diabetes (which causes poor blood flow to the skin)
  • acquired immune deficiency syndrome, or AIDS (because of a depressed immune system that is unable to fight the infection
  • skin damaged by sunburn or scratching

  There are many types of bacterial skin infections that require clinical care by a physician or other healthcare professional. Listed in the directory below are some, for which we have provided a brief overview.

  • Cellulitis
  • Folliculitis, Boils, and Carbuncles
  • Staphylococcal Scalded Skin Syndrome
  • Other Bacterial Skin Infection
    
• Baldness-Alopecia
  What is baldness?

  Baldness, also known as alopecia, is hair loss, or absence of hair. Baldness is usually most noticeable on the scalp, but can occur anywhere on the body where hair grows. The condition is more common in men than in women.

  What causes hair loss?

  Hair loss is believed to be primarily caused by a combination of the following:

  • Aging
  • Change in hormones
  • Illness
  • Family history of baldness
  • Burns
  • Trauma
  • However, hair loss is not caused by the following:
  • Poor circulation to the scalp
  • Vitamin deficiencies
  • Dandruff
  • Excessive hat-wearing
  • A gene passed on from an individual's maternal grandfather
  • Generally, the earlier hair loss begins, the more severe the baldness will become.

  What are the different types of baldness?

  Baldness can be classified into various types, depending on the cause. Several of the many different types of baldness include the following:

  • Female-pattern baldness
    Although less common, female-pattern baldness differs from that of male-pattern baldness in that the hair generally thins all over the head, but the frontal hairline is maintained. Female-pattern baldness rarely results in total hair loss.
  • Male-pattern baldness
    Male-pattern baldness usually is a hereditary condition. The condition may begin at any age. Hair loss often begins on the front, sides, and/or on the crown of the head. Some men may develop a bald spot or just a receding hair line, while others may lose all of their hair.
  • Alopecia areata
    This hair loss disorder is characterized by sudden loss of hair in one particular area, which grows back after several months. However, if all body hair is suddenly lost, regrowth may not occur. The cause of this type of hair loss is unknown.
  • Toxic alopecia
    Toxic alopecia may occur following a high fever or severe illness. Certain medications, especially thallium, high doses of vitamin A, and retinoids, may cause toxic alopecia. Medical conditions, such as thyroid disease, and after giving birth may also trigger toxic alopecia. The condition is characterized by temporary hair loss. Also, some cancer medications can cause hair loss.
  • Scarring alopecia
    Scarred areas may prevent the hair from growing back. Scarring may occur from burns, injury, or x-ray therapy. However, other types of scarring that may cause hair loss can be caused by diseases such as lupus, bacterial or fungal skin infections, lichen planus, sarcoidosis, tuberculosis, or skin cancer.
  • Trichotillomania (hair pulling)
  • Hair pulling, a habit most common among children, may cause hair loss.

  How is the type of baldness diagnosed?

  In addition to a medical history and physical examination, a biopsy of the skin area may help to identify the type of baldness and/or its cause.

  Treatment for baldness:

  Specific treatment for baldness will be determined by your physician based on:

  • Your age, overall health, and medical history
  • Extent of the condition
  • Your tolerance for specific medications, procedures, and therapies
  • Expectation for the course of the disease
  • Your opinion or preference
  • Most forms of baldness have no cure. Some types of baldness will disappear on their own. Treatment may include:
  • Certain medications to promote hair growth (such as minoxidil and finasteride)
  • Corticosteroid injections (when treating alopecia areata)
  • Treating any underlying condition or disease
  • Hair transplants
  • Scalp reduction
  • Skin lifts and grafts

  What is hair replacement surgery?

  The interest in hair replacement has significantly increased over the past 10 years. Two out of every three men, and one in five women, suffer from hair loss. For men, the main cause of a diminishing hairline is heredity. Hormonal changes such as menopause can cause both thinning and hair loss in women.

  There are a number of hair replacement techniques that are available, although hair replacement surgery cannot help those who suffer from total baldness. Candidates for hair replacement must have a healthy growth of hair at the back and sides of the head. The hair on the back and sides of the head will serve as hair donor areas where grafts and flaps will be taken.

  There are four primary different types of hair replacement methods, including the following:

  • Hair transplantation
    During hair transplantation, the surgeon removes small pieces of hair-bearing scalp grafts from the back or sides of the head. These grafts are then relocated to a bald or thinning area.T
  • Tissue expansion
    In this procedure, a device called a tissue expander is placed underneath a hair-bearing area that is located next to a bald area. After several weeks, the tissue expander causes the skin to grow new skin cells. Another operation is then required to place the newly expanded skin over the adjacent bald spot.
  • Flap surgery
    Flap surgery is ideal for covering large balding areas. During this procedure a portion of the bald area is removed and a flap of the hair-bearing skin is placed on to the bald area while still attached at one end to its original blood supply.
  • Scalp reduction
    Scalp reduction is done in order to cover the bald areas at the top and back of the head. This technique involves the removal of the bald scalp with sections of the hair-bearing scalp pulled together filling in the bald area.

  Possible complications associated with hair transplantation procedures:

  Possible complications associated with hair transplantation procedures may include, but are not limited to, the following:

  • Patchy hair growth
    Sometimes, the growth of newly placed hair has a patchy look, especially if it is placed next to a thinning area. This can often be corrected by additional surgery.
  • Bleeding and/or wide scars
    Tension on the scalp from some of the scalp reduction techniques can result in wide scars and/or bleeding.
  • Grafts not taking
    Occasionally, there is a chance that the graft may not "take." If this is the case, surgery must be repeated.
  • Infection
    As with any surgical procedure, there is the risk of infection.
• Basal Cell Carcinoma
  What is basal cell carcinoma?

  Basal cell cancer, sometimes called non-melanoma skin cancer, usually appears as a small, fleshy bump or nodule on the head, neck, or hands. Occasionally, these nodules appear on the trunk of the body, usually as flat growths. Basal cell carcinoma accounts for more than 90 percent of all skin cancers in the United States. It is often easily detected and has an excellent record for successful treatment.

  According to the American Academy of Dermatology, the cure rate for basal cell carcinoma is 95 percent, when properly treated. Although this type of cancer rarely spreads to other parts of the body, it can extend below the skin to the bone and cause considerable local damage. And, non-melanoma skin cancer places people at high risk for developing additional skin cancers.

  Who is at risk for basal cell carcinoma?

  Basal cell carcinoma is the most common skin cancer found in Caucasians. It seldom occurs in dark-skinned persons. People who have this cancer frequently have light hair, eyes, and complexions, and they do not tan easily. Risk for basal cell carcinoma includes:

  • excess exposure to UV radiation (sunlight or tanning beds)
  • chemical exposure
  • radiation exposure
  • long-term skin inflammation or injury
  • treatment of psoriasis
  • immunosuppression such as in persons who have had organ transplants
  • history of skin cancer

  How does basal cell carcinoma develop?

  This highly treatable cancer starts in the basal cell layer of the epidermis (the top layer of skin) and grows very slowly. A basal cell carcinoma usually appears as a small, shiny bump or nodule on the skin, and mainly on the areas exposed to the sun, such as the head, neck, arms, hands, and face.

• Basal Cell Nevus Syndrome (Gorlin Syndrome)

  The risk for ovarian cancer and skin cancer is increased with basal cell nevus syndrome (also called Gorlin syndrome and nevoid basal cell carcinoma), a rare autosomal dominant cancer genetic syndrome. Features associated with basal cell nevus syndrome may include the following:

  • development of more than two basal cell carcinomas (cancer of the outer layer of the skin) before the age of 30
  • cysts in the jaw
  • characteristic facial appearance (60 percent of people)
  • calcification of the falx (a variation in the appearance of the skull that is visible on x-rays)
  • pits in the palms and soles of the feet
  • eye abnormalities
  • rib or vertebral abnormalities
  • increased risk of medulloblastoma
  • increased risk of cardiac and ovarian fibromas (benign, or noncancerous, tumors)

  Basal cell nevus syndrome is caused by a tumor suppressor gene, called PTCH, located on chromosome 9. Mutations in this gene may increase the risk of ovarian cancer.
  
  Tumor suppressor genes usually control cell growth and cell death. Both copies of a tumor suppressor gene must be altered, or mutated, before a person will develop cancer. With basal cell nevus syndrome, the first mutation is inherited from either the mother or the father in 60 percent to 80 percent of cases. In 20 percent to 40 percent of cases, the first mutation is not inherited and arises de novo (for the first time) in the fertilized egg from which the person with symptoms was conceived. Whether de novo or inherited, this first mutation is present in all of the cells of the body and, as such, is called a germline mutation.
  
  Whether a person who has a germline mutation will develop cancer and where the cancer(s) will develop depends upon where (which cell type) the second mutation occurs. For example, if the second mutation is in the skin, then skin cancer may develop. If it is in the ovary, then ovarian cancer may develop. The process of tumor development actually requires mutations in multiple growth control genes. Loss of both copies of PTCH is just the first step in the process. What causes of these additional mutations to be acquired is unknown. Possible causes include chemical, physical, or biological environmental exposures (such as sunlight) or chance errors in cell replication.
  
  Some individuals who have inherited a germline tumor suppressor gene mutation may never develop cancer because they never get the second mutation necessary to knock out the function of the gene and start the process of tumor formation. This can make the cancer appear to skip generations in a family, when, in reality the mutation is present. Persons with a mutation, regardless of whether they develop cancer, however, have a 50/50 chance to pass the mutation on to the next generation.
  
  It is also important to remember that the gene responsible for basal cell nevus syndrome is not located on the sex chromosomes. Therefore, mutations can be inherited from the mother or the father's side of the family.

• Bed Sores
  
  

  What are bed sores?

  Bed sores can occur when a person is bedridden, unconscious, unable to sense pain, or immobile. Bed sores are ulcers that occur on areas of the skin that are under pressure from lying in bed, sitting in a wheelchair, and/or wearing a cast for a prolonged period of time.

  Why does a bed sore develop?

  A bed sore develops when blood supply to the skin is cut off for more than two to three hours. As the skin dies, the bed sore first starts as a red, painful area, which eventually turns purple. Left untreated, the skin can break open and become infected. A bed sore can become deep, extending into the muscle. Once a bed sore develops, it is often very slow to heal. Bed sores often occur in the buttocks area (on the sacrum or iliac crest), or on the heels of the feet.

  Preventing bed sores:

  Bed sores can be prevented by inspecting the skin for areas of redness (the first sign of skin breakdown). Other methods of preventing bed sores and preventing progression of existing bed sores include the following:

  • frequent turning and repositioning
  • providing soft padding in wheelchairs and beds to reduce pressure
  • providing good skin care by keeping the skin clean and dry 

  
  

  Treatment for bed sores:

  Specific treatment of a bed sore is determined by your physician and based on the severity of the condition. Treatment may be more difficult once the skin is broken, and may include the following:

  • removing pressure on the affected area
  • protecting the wound with medicated gauze or other special dressings
  • keeping the wound clean
  • transplanting healthy skin to the wound area
  • medication (i.e., antibiotics to treat infections)
• Birthmarks

  What are birthmarks?

  Birthmarks are areas of discolored and/or raised skin that are apparent at birth or within a few weeks of birth. Birthmarks are made up of malformed pigment cells or blood vessels. About 10 in every 100 babies have vascular birthmarks (birthmarks made up of blood vessels).

  Although the cause of birthmarks is not known, most of them are benign (non-cancerous) and do not require treatment. Babies with birthmarks should be examined and diagnosed by a physician.

  What are the most common types of vascular birthmarks?

  The following are the most common types of vascular birthmarks:

  • flat not elevated stains ("angel's kisses" or "stork bites")-the most common type of vascular birthmark, characterized by pink to red marks that may appear anywhere on the body;
  • "angel's kisses"-marks located on the forehead and eyelids, which usually disappear after age 2 years;
  • "stork bites"-marks on the back of the neck, which may last into adulthood;
  • hemangioma-a common vascular birthmark. Hemangiomas become visible within the first few weeks of life and continue to grow rapidly for about six to nine months. Then, they gradually lose this red color and also shrink. They are called strawberry hemangiomas;
  • port-wine stains-a port-wine stain, also called a nevus flammeus, is a flat, pink, red, or purple mark that appears at birth, often on the face, arms, and legs, and continues to grow as the child grows. Port-wine stains do not go away and often require treatment if located on the eyelid or forehead. Port-wine stains involving the face may cause eye problems.

  
  
• Blisters

  >What causes a blister?

  Blisters are caused by injury, allergic reactions, or infections, which may include the following:

  • burns/scalds
  • sunburns
  • friction (from a shoe, for example)
  • eczema (also known as atopic dermatitis)
  • impetigo - a contagious infection of the skin
  • pemphigus - a rare, blistering skin disease often occurring in middle-aged and elderly adults
  • pemphigoid - a blistering autoimmune disorder
  • dermatitis herpetiformis - a blistering autoimmune disorder
  • viral infections (including chickenpox and herpes zoster)

  The symptoms of a blister may resemble other skin conditions. Always consult your physician for a diagnosis.

  First-aid for blisters

  Blisters often heal spontaneously. Treatment will vary, depending on the cause. Some general guidelines for first-aid may include:

  • Wash the area with soap and water.
  • A cold or ice pack may help reduce swelling and discomfort.
  • Keep the area clean and dry - do not burst or puncture the blister.
  • If the blister bursts, place an adhesive bandage or dressing on the area to keep it clean.

  Observe the area for signs of infection such as increased warmth, swelling, redness, drainage, pus formation, or pain. If you notice any signs of infection, call your physician. Antibiotics may be needed.

  Treatment for blisters

  A blister will usually heal on its own. Treatment may include:

  • keeping the area clean
  • antibiotics (to treat infections)
  • dressings on burst blisters
• Burns

  What are burns?

  Burns are a type of traumatic injury caused by thermal, electrical, chemical, or electromagnetic energy. An open flame is the leading cause of burn injury for adults, while scalding is the leading cause of burn injury for children. Both infants and the elderly are at the greatest risk for burn injury.

  What are the different types of burns?

  A burn injury usually results from an energy transfer to the body. There are many types of burns caused by thermal, radiation, chemical, or electrical contact:

  • thermal burns-burns due to external heat sources which raise the temperature of the skin and tissues and cause tissue cell death or charring. Hot metals, scalding liquids, steam, and flames, when coming in contact with the skin, can cause thermal burns.
  • radiation burns-burns due to prolonged exposure to ultraviolet rays of the sun, or to other sources of radiation such as x-ray.
  • chemical burns-burns due to strong acids, alkalies, detergents, or solvents coming into contact with the skin and/or eyes.
  • electrical burns-burns from electrical current, either alternating current (AC) or direct current (DC).

  How are burns classified?

  Burns are classified as first-, second-, or third-degree, depending on how deep and severe they penetrate the skin's surface:

  • First-degree (superficial) burns
    First-degree burns affect only the epidermis, or outer layer of skin. The burn site is red, painful, dry, and with no blisters. Mild sunburn is an example. Long-term tissue damage is rare and usually consists of an increase or decrease in the skin color.
  • Second-degree (partial thickness) burns
    Second-degree burns involve the epidermis and part of the dermis layer of skin. The burn site appears red, blistered, and may be swollen and painful.
  • Third-degree (full thickness) burns
    Third-degree burns destroy the epidermis and dermis. Third-degree burns may also damage the underlying bones, muscles, and tendons. The burn site appears white or charred. There is no sensation in the area since the nerve endings are destroyed.

  The effects of burns:

  A severe burn can be a seriously devastating injury - not only physically but emotionally - and not only to the burn victim, but to the entire family. Persons with severe burns may be left with a loss of certain physical capabilities, disfigurement, a loss of mobility, scarring, infection, nightmares or flashbacks from the traumatizing event, loss of a limb, and/or loss of a friend or family member and possessions in the fire. In addition, severe burns are capable of penetrating deep skin layers, causing muscle or tissue damage, virtually affecting every system of the body.

  Treatment for burns

  Specific treatment for burns will be determined by your physician based on:

  • your age, overall health, and medical history
  • type, classification, location, and severity of the burn
  • your tolerance for specific medications, procedures, or therapies
  • expectations for the course of the burn injury
  • your opinion or preference

  Treatment may include:

  • wound care
  • intravenous (IV) fluids and electrolytes
  • pain management
  • physical therapy
  • occupational therapy
  • skin grafting
  • functional and cosmetic reconstruction
• Calluses and Corns

  What are calluses and corns?

  Calluses are protective pads made up of the thickened upper layer of skin due to repeated rubbing of the area. Corns are small calluses that develop on the top of the toes due to pressure or rubbing against shoes or other toes.

  Treatment for calluses and corns:

  Calluses are usually painless, but corns can be quite painful. Sometimes, corns are confused with warts. Calluses can be avoided by removing the source of the rubbing and thinning the callus with a pumice stone. Treatment for corns may include:

  • applying pads around the corn area
  • wearing larger, more comfortable shoes
  • surgery
• Candidiasis (Yeast Infection)

  What is candidiasis?

  Candidiasis, sometimes called moniliasis or a yeast infection, is an infection caused by yeast on the skin and/or mucous membranes. Although yeast is normally a harmless inhabitant of the digestive system and vaginal area, it may cause an infection when the skin is damaged, when conditions are warm and humid, and/or when a person has a depressed immune system. Antibiotics can also cause yeast to grow, because the normal bacteria in tissues are killed, letting the yeast grow unhampered.

  What are the symptoms of candidiasis?

  The symptoms of candidiasis vary depending on the location of the infection. The following are the most common symptoms of a yeast infection. However, each individual may experience symptoms differently. Symptoms may include:

  Location	Symptoms
  Skin folds or navel	Rash Patches that ooze clear fluid Pimples Itching or burning
  Vagina	White or yellow discharge from the vagina Itching Redness in the external area of the vagina Burning
  Penis	Redness on the underside of the penis Scaling on the underside of the penis Painful rash on the underside of the penis
  Mouth (thrush)	White patches on tongue and inside of the cheeks Pain
  Corners of the mouth (perleche)	Cracks and/or tiny cuts at the corners of the mouth
  Nail beds	Swelling Pain Pus White or yellow nail that separates from the nail bed

  The symptoms of candidiasis may resemble other skin conditions. Always consult your physician for a diagnosis.

  How is candidiasis diagnosed?

  In addition to a medical history and physical examination, your physician may scrape off a skin sample to confirm the diagnosis with a microscope or a culture.

  Treatment for candidiasis:

  Specific treatment for candidiasis will be determined by your physician based on:

  • your age, overall health, and medical history
  • extent of the condition
  • your tolerance for specific medications, procedures, or therapies
  • expectations for the course of the condition
  • your opinion or preference

  Candidiasis is highly treatable with medicated ointments. Yeast infections in the vagina or anus can be treated with medicated suppositories. Thrush may be treated with a medicated mouthwash or lozenges that dissolve in the mouth. Severe infection or infections in an immunocompromised person may be treated with oral anti-yeast medications.

• Cellulitis

  What is cellulitis?

  Cellulitis is a deep bacterial infection of the skin. The infection usually involves the face, or the arms and legs. It may happen in normal skin, but it usually occurs after some type of trauma causes an opening in your child's skin. This opening can lead to an infection.

  What is the cause of cellulitis?

  Cellulitis is usually caused by a bacterial infection of a wound or area of skin that is no longer intact. The most common bacterial causes of cellulitis include the following:

  • group A ß - hemolytic streptococcus
  • Streptococcus pneumoniae
  • Staphylococcus aureus

  Other causes may include human or animal bites, or injuries that occur in water.

  What are the symptoms of cellulitis?

  The following are the most common symptoms of cellulitis. However, each child may experience symptoms differently. Symptoms may include:

  swelling of the skin tenderness warm skin pain bruising

  blisters fever headache chills feeling weak red streaks from the original site of the cellulitis

  Some cases of cellulitis are considered an emergency. Consult your child's physician immediately if you notice any of the following symptoms in your child:

  • a very large area of red, inflamed skin
  • fever
  • if the area affected is causing your child to complain of numbness, tingling, or other changes in a hand, arm, leg, or foot
  • if the skin appears black
  • if the area that is red and swollen is around your child's eye(s) or behind his/her ear(s)
  • if your child has diabetes or has a weakened immune system and develops cellulitis

  The symptoms of cellulitis may resemble other skin conditions. Always consult your child's physician for a diagnosis.

  How is cellulitis diagnosed?

  Diagnosis is usually based on a medical history and physical examination of your child. Blood and skin samples may be taken to confirm the diagnosis and the type of bacteria that is present.

  Treatment for cellulitis:

  Specific treatment for cellulitis will be determined by your child's physician based on:

  • your child's age, overall health, and medical history
  • extent of the disease
  • your child's tolerance for specific medications, procedures, or therapies
  • expectations for the course of the disease
  • your opinion or preference
  • Immediate treatment can help prevent the spread of cellulitis. Treatment may include:
  • oral or intravenous (IV) antibiotics
  • warm, wet dressings on the infection site
  • surgical intervention
  • if your child has an extremity (arm or leg) that is affected, his/her physician may have you elevate the extremity and decrease the amount of activity
  • rest

  Based on the physical examination, your child's physician may treat your child in the hospital depending on the severity of the cellulitis. In the hospital, your child may receive antibiotics and fluids through an intravenous (IV) catheter.

  Are there any complications from cellulitis?

  Complications can be reduced with prompt and accurate treatment by your child's physician. The most common complications include the following:

  • meningitis-an inflammation of the membrane of the brain and the spinal cord.
  • septic (infectious) arthritis-an infection of a joint caused by bacteria.
  • glomerulonephritis-an inflammation of the kidneys.
• Chemical Peels

  What is a chemical peel?

  Chemical peeling uses a chemical solution to improve the skin's appearance. It can reduce or eliminate fine lines under the eyes and around the mouth, correct uneven skin pigmentation, remove precancerous skin growths, and soften acne or treat scars caused by acne. The procedure can also treat wrinkles caused by sun damage and scarring, as well as skin blemishes common with age and heredity. Chemical peels can be performed on the face, neck, chest, hands, arms, and legs.

  Possible complications associated with chemical peels

  Possible complications associated with chemical peels may include but are not limited to the following:

  • Change in skin tone color
    For certain skin types, there is a risk of developing a temporary or permanent skin color change. Taking birth control pills, being pregnant, or having a family history of brownish discoloration on the face may increase the possibility of developing the abnormal pigmentation.
  • Scarring
    Chemical peels can cause scarring. However, if scarring occurs, it can usually be treated effectively.
  • Cold sores and fever blisters
    Those who are susceptible to cold sores, or herpes simplex infections, may have a reactivation of cold sores or fever blisters following a chemical peel.

  A chemical peel is most commonly performed for cosmetic reasons to enhance appearance and self-confidence and may be performed in conjunction with a facelift. However, a chemical peel is not a substitute for a facelift and does not prevent or slow the aging process.

  What substances are used for chemical peels?

  Phenol, trichloroacetic acid (TCA), and alphahydroxy acids (AHAs) are used for chemical peels. The precise formula used may be adjusted for each patient.

  Alphahydroxy acids (AHAs)

  Alphahydroxy acids (AHAs) such as glycolic, lactic, or fruit acids are the mildest of the peel formulas and produce light peels that can often provide smoother, brighter-looking skin. AHA peels may be used to accomplish the following:

  • reduce fine wrinkling
  • treat areas of dryness
  • reduce uneven pigmentation
  • aid in control of acne
  • smooth rough, dry skin
  • improve texture of sun-damaged skin

  AHA peels may cause the following:

  • stinging
  • redness
  • irritation
  • crusting, flaking, or scaling
  • dryness

  Generally, no anesthesia is needed for AHA peels since they cause only a slight stinging sensation during application.
  Protecting skin from the sun is important following AHA peels.

  Trichloracetic acid (TCA)

  Trichloroacetic acid (TCA) can be used in many concentrations and is used to accomplish the following:

  • smooth fine surface wrinkles
  • remove superficial blemishes
  • correct pigment problems

  TCA can be used on the neck or other body areas, and may require pretreatment with Retin-A or AHA creams. This procedure is preferable for darker-skinned patients.
  
  Anesthesia is not usually required for TCA peels because the chemical solution acts as an anesthetic. Although, sedation may be used before and during the procedure to help the patient relax. Two or more TCA peels may be needed over several months to obtain the desired result, although mild TCA peels may be repeated more frequently.
  
  The results of a TCA peel are usually less dramatic than and not as long-lasting as those of a phenol peel. More than one TCA peel may be needed to achieve the desired result.
  TCA-peel patients are advised to avoid sun exposure for several months. The procedure also may produce some unintended color changes in the skin.

  Phenol

  Phenol is the strongest of the chemical solutions and produces a deep peel. A phenol peel is mainly used to accomplish the following:

  • correct blotches caused by sun exposure, birth control pills, or aging
  • smooth out coarse wrinkles
  • remove precancerous growths

  Phenol:

  • should be used on the face only, as scarring may result if used on the neck or other body areas.
  • is not recommended for darker-skinned individuals.
  • may pose risk for patients with heart problems.
  • may permanently remove facial freckles.
  • may cause permanent skin lightening.
  • may leave lines of demarcation.

  Recovery may be slow and complete healing may take several months.
  After a phenol peel, new skin may lose its ability to produce pigment. The skin will be lighter and will always have to be protected from the sun.

  About the procedure:

  The procedure involves a chemical solution that is applied to the skin. The solution causes a layer of skin to separate and peel off. The new, regenerated skin underneath is usually smoother, less wrinkled, and more even in color than the old skin.

  Considerations Before Having a Chemical Peel

  It is very important to find a physician who has adequate training and experience in skin resurfacing.

  In some states, a medical degree is not required to perform a chemical peel - even the strongest phenol peels - and many states have laws that permit non-physicians to administer certain peel solutions but regulate the strengths which they are permitted to apply.

• Cold Sores

  What are cold sores?

  Cold sores are small blisters around the mouth, caused by the herpes simplex virus. The most common strain of the virus is herpes simplex virus 1.

  Herpes simplex is not curable, but may lie dormant for long periods of time. Episodes of the cold sores last no longer than two weeks. Hot sun, cold wind, a cold, or a depressed immune system can cause an outbreak of herpes simplex virus.

  What are the symptoms of cold sores?

  Some people never experience any symptoms with the first attack; others have severe flu-like symptoms and ulcers in and around the mouth. The following are the most common symptoms of cold sores. However, each individual may experience symptoms differently. Symptoms may include:

  • tingling of the lips
  • small blisters on the lips and mouth that enlarge, burst, then crust over
  • itching and irritation of the lips and mouth
  • soreness of the lips and mouth

  The symptoms of cold sores may resemble other skin conditions. Always consult your physician for a diagnosis.

  Treatment for cold sores

  Cold sores cannot be cured, but, if symptoms are severe, treatment may help alleviate some symptoms. Treatment may include:

  • antiviral topical ointments (such as acyclovir and penciclovir)
  • antiviral oral medications (such as acyclovir, famciclovir, and valaciclovir)
• Common Dermatological Procedures

  The skin, the largest organ of the body, helps define a person's look. Any unsightly skin appearance, such as scarring, can affect both mental and physical well-being. In addition, because the skin is on the outside of the body, it is more susceptible to growths, discolorations, and disease.

  There are many different dermatological procedures designed to improve the condition or appearance of the skin. Listed in this directory  are some, for which we have provided a brief overview.  

  • Acne Scar Removal
  • Treating Aged or Sun-Damaged Skin
  • Chemical Peels
  • Dermabrasion/Dermaplaning
  • Laser Surgery Overview
  • Laser Surgery for Skin Conditions
• Contact Dermatitis

  What is contact dermatitis?

  Contact dermatitis is a physiological reaction that occurs after skin comes in contact with certain substances.

  The majority of these reactions are caused by irritants to the skin. The remaining reactions are caused by allergens, which trigger an allergic response. In allergic reactions, the reaction may not start until after several days. Contact dermatitis caused by an irritant that is not an allergic response occurs from direct contact with the irritant.
  Adults are affected by allergic contact dermatitis more than young children or the elderly.

  What causes allergic contact dermatitis?

  The most common causes of allergic contact dermatitis in adults and children include the following:

  soaps drool different foods

  detergents harsh baby lotions perfumes

  Plants, as well as metals, cosmetics, and medications may also cause a contact dermatitis reaction:

  Poison Ivy

  Poison ivy, which is part of a plant family that includes poison oak and sumac, is the most common cause of a contact dermatitis reaction.

  Metals

  Nearly 3,000 chemical agents are capable of causing allergic contact dermatitis. Nickel, chrome, and mercury are the most common metals that cause contact dermatitis:

  • Nickel is found in costume jewelry, belt buckles, and wristwatches, as well as zippers, snaps, and hooks on clothing.
  • Contact with objects that are chrome-plated, which contain nickel, will probably cause skin reactions in people sensitive to nickel.

  • Mercury, which is found in contact lens solutions, can cause problems for some sensitive individuals.

  Cosmetics

  Many types of cosmetics can cause allergic contact dermatitis. Permanent hair dyes that contain paraphenylenediamine are the most frequent causes. Other products that may cause problems include dyes used in clothing, perfumes, eye shadow, nail polish, lipstick, and some sunscreens.

  Medications

  Neomycin, which is found in antibiotic creams, is the most common cause of medication contact dermatitis. Penicillin, sulfa medications, and local anesthetics, such as novocaine or paraben, are other possible causes.

  What are the symptoms of contact dermatitis?

  The following are the most common symptoms of contact dermatitis. However, each individual may experience symptoms differently. Symptoms may include:

  • mild redness and swelling of the skin
  • blistering of the skin
  • itching
  • scaling and temporary thickening of skin

  The most severe reaction is at the contact site. The symptoms of contact dermatitis may resemble other skin conditions. Always consult your physician for a diagnosis.

  Treatment for contact dermatitis:

  Specific treatment for contact dermatitis will be determined by your physician based on:

  • your age, overall health, and medical history
  • extent of the reaction
  • your tolerance for specific medications, procedures, or therapies
  • expectations for the course of the reaction
  • your opinion or preference

  The best treatment is to identify and avoid the substances that may have caused the allergic reaction. The following is recommended by the American Academy of Allergy, Asthma, and Immunology, for mild to moderate reactions:

  • Thoroughly wash skin with soap and water as soon after the exposure as possible.
  • Wash clothing and all objects that touched plant resins (poison ivy/oak) to prevent re-exposure.
  • Use wet, cold compresses to soothe and relieve inflammation if blisters are broken.
  • For severe reactions, always contact your physician.
• Creeping Eruption

  What is creeping eruption?

  Creeping eruption is a skin infection caused by hookworms, which normally are found on dogs and cats. The parasite spreads to humans through skin contact with the eggs found in dog and cat feces on the ground. Characterized by severe itching, the infection usually appears on the feet, legs, buttocks, or back.

  What are the symptoms of creeping eruption?

  The following are the most common symptoms of creeping eruption. However, each individual may experience symptoms differently. Symptoms may include:

  • winding rash - usually the hookworm burrows along a tract which creates a winding rash
  • itching

  The symptoms of creeping eruption may resemble other skin conditions. Always consult your physician for a diagnosis.

  Treatment for creeping eruptions:

  Creeping eruption may be treated with liquid thiabendazole and other topical treatments.

• Cutaneous T Cell Lymphoma

  What is cutaneous T-cell lymphoma?

  Cutaneous T-cell lymphoma is a disease caused when T-lymphocytes become malignant and affect the skin. T-lymphocytes are the infection-fighting white blood cells in the lymph system that kill harmful bacteria in the body, among other things. Cutaneous T-cell lymphoma usually is a slow-growing cancer that often develops over many years.

  What are the symptoms of cutaneous T-cell lymphoma?

  Symptoms of cutaneous T-cell lymphoma depend on the stage of the cancer (how far it has spread). The following are the most common symptoms of cutaneous T-cell lymphoma. However, each individual may experience symptoms differently. Symptoms may include:

  Stage	Symptoms
  Stage I	dry, red, scaly patches on skin lymph nodes are normal
  Stage II	dry, red, scaly patches on skin lymph nodes are normal or larger than normal, but not cancerous tumors on the skin (called mycosis fungoides)
  Stage III	most of the skin is dry, red, and scaly lymph nodes are normal or larger than normal, but not cancerous
  Stage IV	skin is dry, red, and scaly cancer cells are in the lymph nodes cancer has spread to other organs

  The symptoms of cutaneous T-cell lymphoma may resemble other dermatological conditions. Always consult your physician for a diagnosis.

  How is cutaneous T-cell lymphoma diagnosed?

  In addition to a medical history and physical examination, a physician may order a biopsy of a skin tumor to confirm the diagnosis. A biopsy is a procedure in which tissue samples are removed (with a needle or during surgery) from the body for examination under a microscope; to determine if cancer or other abnormal cells are present.

  Treatment for cutaneous T-cell lymphoma

  Specific treatment for cutaneous T-cell lymphoma will be determined by your physician based on:

  • your age, overall health, and medical history
  • extent of the disease
  • your tolerance for specific medications, procedures, and therapies
  • expectations for the course of the disease
  • your opinion or preference

  Treatment may include:

  • chemotherapy-treatment with drugs to destroy cancer cells.
  • radiation therapy-uses a radiation machine that emits x-rays to kill cancer cells and shrink tumors.
  • photodynamic therapy-uses a certain type of light and a special chemical to kill cancer cells.

  Clinical trials are currently being conducted using biological therapy, also called biological response modifier (BRM) therapy, or immunotherapy. Biological therapy tries to get your own body to fight cancer by using materials made by your own body, or made in a laboratory, to boost, direct, or restore your body's natural defenses against disease.