Atlantic Dermatology Associates, P.A. provides comprehensive medical dermatology services including:
Skin Cancer Screening The American Academy of Dermatology recommends that everyone has a skin exam at least once a year. If you have a personal or family history of skin cancer you should have skin exams more frequently. During a skin exam, the physician or physician’s assistant will exam you from head to toe looking for suspicious lesions. These lesions may appear to be bleeding, scaly, red, or dark in color or not healing properly. The lesions would be treated accordingly; either with a biopsy or liquid nitrogen. Often times, if caught early, some lesions may be treated with topical creams. The goal of screenings is to catch changing lesions early to minimize the risk of major surgery.
A biopsy is generally warranted for any lesion that is new, changing, or acting suspicious. A biopsy is a fairly simple procedure. The patient does feel slight discomfort during the numbing process; however, the local anesthesia generally kicks in within ten to fifteen seconds. Once the patient is numb, a small blade is used to scrape the lesion off and then the area is cauterized. Once removed, ploysporin and a band aid are applied. The results of the biopsy are available for the patient within ten to fourteen days.
One common sexually transmitted infection (STI) is the Human Papilloma Virus (HPV), which is commonly known as condyloma or genital warts. According to the Center for Disease Control (CDC), approximately twenty million Americans are currently infected with HPV. This statistic confirms that HPV is prevalent and highly contagious. The treatment for this condition is liquid nitrogen which is typically repeated every two weeks until the warts are clear. There are also topical prescriptions (Aldara, Condylox, and Veregen) that can be used in conjunction with cryotherapy. It is important to remember if you have been diagnosed with condyloma that your partner also needs an evaluation to help minimize spreading the infection back and forth. It is important for females to also follow up with their gynecologist to rule out any internal lesions and cervical cancer.
During a surgical procedure, a flap may be needed to ensure the best cosmetic result. Flaps are typically utilized on certain areas of the body such as the back, shoulders, legs, and arms. In these areas of the body the skin is generally taught and a flap is needed to help minimize the risk of the sutures popping out or the edges puckering.
During a surgical procedure a graft may be needed. This is a surgical technique where you remove a piece of skin from one area, and then use it on the surgical site to cover up the excision.
There is many strains of warts and they are all caused by a virus. Warts can occur anywhere on the body; however, the hands and feet are the most commonly affected areas. The wart virus is contagious and only needs a microscopic crack in the skin to invade. Warts are treated most commonly with liquid nitrogen, squaric acid, prescriptions, or bleomyocin injections. Follow up in the office is generally at two week intervals until the warts are clear.
Pediatric Dermatology We see patients from infants to adolescents. Commonly we treat atopic dermatitis (eczema), warts, molluscum, acne and hemagiomas. The providers at Atlantic Dermatology Associates, P.A., work together with children and parents to help them understand and manage their skin disorders.
Our office commonly removes basal cell carcinomas, squamous cell carcinomas, moderately dysplastic nevi, severely dysplastic nevi, and melanoma in-situ’s with surgical excisions. Generally, all excisions require absorbable sutures which are put underneath the skin and polypropyl sutures are applied on top of the skin. The sutures on top of the skin will need to be removed within seven to fourteen days. A pressure bandage is applied and will need to be kept dry and remain on for forty-eight hours. After that time, it can be removed and cleaned with a Q-Tip and warm soapy water. Bactroban will be applied to the surgical site twice a day. An oral antibiotic will also be given and taken for ten days. Remember, after surgery, the patient needs to avoid strenuous activity for at least two weeks to optimize healing.
If you have been diagnosed with non-melanoma skin cancer, SRT is a safe and effective non-surgical option for your treatment. Superficial Radiotherapy (SRT), a low-energy radiotherapy that penetrates only a short distance below the surface of the skin, is a highly effective, painless, and cosmetically attractive alternative to surgery in selected cancers and patient populations. The SRT-100™ is the new and most advanced choice for superficial radiotherapy available today, is painless, and very similar to having an x-ray.
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Hair loss is a common condition that affects both males and females. There are various reasons for hair loss and different types. The most commonly treated types of hair loss include Alopecia Areata, Telogen Effluvium, and male/female pattern baldness. Alopecia areata is a condition that is characterized by circular areas of bald patches and is treated with intralesional steroid injections or topical corticosteroids. Generally, this condition resolves and the hair grows back. Telogen Effluvium is the regular shedding cycle that everyone goes through. It is a common shedding of hair and may seem as if all of the hair will be lost; however, that generally does not occur. No treatment is necessary for Telogen Effluvium as it generally resolves on its own. Male and female pattern baldness is a genetic form of hair loss. There are treatments that help minimize this type of hair loss, such as, over the counter Rogaine. If Rogaine is used twice daily it does help slow down the progression of hair loss. There is a prescription pill for men called Propecia. This prescription requires lab work and regular yearly follow ups. During any hair loss condition we recommend that no chemicals or harsh processes are done as we don’t want to aggravate the condition.
Acne is a common skin condition that affects people of all ages from infancy up to adulthood. Common acne treatments include oral antibiotics and topical creams, gels and ointments. The treatment regimen is predicted by the patient’s skin type and acne type. Acid cleansers and chemical peels can also be used as effective treatments. When acne patients begin treatment it is important to realize that their acne may temporarily get worse before it gets better. It typically takes six to eight weeks to see an improvement as is takes that long for skin cells to turn over.
Nail conditions are a common dermatology concern. Patients come in complaining of discoloration, nails lifting and splitting, and nail thickening. It is our job to determine if there is a medical reason; such as, fungus, psoriasis, or trauma. It will be treated accordingly and cultures may be taken to help determine the diagnosis. Some treatments may require monthly lab work and follow ups.
Skin tags or acrochordons are small pieces of patruding skin that are caused by weight, friction or heredity. Skin tags are commonly found around the neck, underarms, under the breast, or in the thigh area. They are easily removed by snipping them off with a scissor. If they are larger in size, then occasionally it is necessary the numb them with local anesthetic. Many times insurance determines the removal skin tags to be cosmetic in nature and it becomes an out of pocket expense for the patient.
Unfortunately there is no known cause for psoriasis; however, it is believed to be genetically linked. Psoriasis affects a large number of people and interferes with their daily life. The most common type of psoriasis is plaque psoriasis which occurs over the body typically in the scalp, elbow, knees and genitalia. Itching and flaking commonly occurs with psoriasis. Topical steroids and vitamin D ointments are commonly prescribed treatments. If these treatments are not enough, UVB lasers may be used. A more aggressive approach would include biologic medications such as Enbrel, Amevive, Humira, and Stelara. A biologic medication requires insurance approval, lab work, and follow ups in the office.
Treatment-Hyperhidrosis affects many and often times the patient does not mention it to their provider. Some people suffer from excessive sweating under their arms, hands and feet. For underarms, Botox is the treatment of choice which involves several injections. It only takes a matter of minutes to do the procedure. Insurance may cover the treatment but is does require prior approval. The treatment may last from four months to one and a half years depending on the person. The hyperhidrosis treatment for hands and feet is the Fischer Galvanic. This treatment is done in our office and requires thirty minutes to one hour depending on the treatment area. The Fischer Galvanic unit produces an electrical current that travels through water and into the affected area. Initially, this treatment is done in the office; however, in some cases the patient may be able to purchase the machine and can then treat at home. Typically, the patient would be in treatment twice a week with the Fischer Galvanic unit tapering down to once a month.
The incidence of skin cancer is increasing. Excellent ways to lower your skin cancer risks are using sunscreen, avoiding peak hours of sun exposure (between 10AM-4Pm) and covering up. Sunscreen helps block both ultra-violet A and ultra-violet B rating and the higher the number the better. We recommend you use at least an SPF 30. This UVB rating does not inform us about UVA rays. UVA rays penetrate deeper into the dermis and contribute to the skin cancer and premature aging of the skin. UVB rays are the primary cause of sunburn. Because there is no rating system for UVA exposure, we recommend that patients use a sunscreen with either zinc oxide or titanium dioxide as the main ingredient. If your sunscreen has either of these two blocks in a concentration of greater than 3% and is rated at 30 or higher then you are getting effective protection.
Also remember while at the beach apply your sunscreen 30 minutes before you go onto the beach and every two hours or after swimming. It is not uncommon to require a full 8 ounces of sunscreen in the course of a day at the beach. It is important to coat the skin and rub in sunscreen thoroughly. One ounce (or a shot glass full) of sunscreen is the average amount to cover the skin thoroughly. Also, the lips need a lip balm with sunscreen with an SPF of 30 or higher. By using sunscreen on a daily basis, covering up, and avoiding the peak hours of sun exposure you can minimize your chances of dangerous skin cancers.