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General Dermatology

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The specialty of general dermatology includes the medical and surgical diagnosis and treatment of diseases and conditions affecting the skin, hair and nails. Although many of these skin conditions are quite rare, others are very common, affecting millions of people. Some common skin conditions diagnosed and treated in general dermatology include;

Acne

As the most common skin disorder in the United States, acne affects nearly 50 million Americans. Acne is typically characterized by the presence of pimples, cysts, nodules and blackheads/whiteheads that form on the face, neck, upper chest and back. Although it occurs most frequently among teenagers, acne can occur in all age groups. Many new and effective therapies are available to treat acne and help prevent the scarring that can result.

Actinic Keratosis

Actinic keratoses (AKs) are premalignant skin lesions caused by frequent or excessive sun exposure. AKs are among the most common skin lesions treated by dermatologists, affecting half of the global population. These lesions appear as scaly or crusty areas on sun-exposed skin, gradually thickening into larger, wart-like growths. Since many actinic keratoses will progress into skin cancer (squamous cell carcinoma), treatment and eradication is recommended. Several treatment modalities including topical creams, liquid nitrogen (cryosurgery), light therapy and surgery are used by dermatologists to destroy AKs before skin cancer develops. Most people diagnosed with an actinic keratosis are likely to develop more lesions as they age, emphasizing the importance of periodic dermatologic skin examinations and treatments.

Hair Loss (Alopecia)

The average person loses 50-100 hairs daily. Gradual permanent hair thinning is part of the normal aging process. However, sudden hair loss in greater amounts than normal can be caused by certain diseases, illnesses, hormone-related disorders, nutritional deficiencies, medication, stress, pregnancy and other factors. In many of these cases, identifying and treating the underlying cause can stop hair loss and promote regrowth of hair.

Dermatitis (Eczema)

There are many types of dermatitis including atopic dermatitis, contact dermatitis, seborrheic dermatitis (seborrhea) and nummular dermatitis. This type of inflammation of the skin usually causes swelling, redness, itching and burning of the affected areas. Dermatitis can occur at any age and is commonly seen in infants and young children. Since certain infections of the skin can mimic dermatitis, an accurate diagnosis is critical in establishing an effective treatment plan.

Nevi (Moles)

Most people have several, if not many, benign moles called nevi. Changes in the size, shape or color of a mole may be indicative of the transformation of a benign mole into an abnormal mole (atypical or dysplastic nevus). Such changes could also represent a skin cancer (malignant melanoma) developing within a mole. Dysplastic nevi (atypical moles) can look very similar to lesions of melanoma. It is important to recognize such changes and have any changing mole evaluated by a dermatologist.

Psoriasis

Psoriasis is a common skin condition that can affect small areas of the skin surface or the entire body. The most common form, plaque psoriasis, appears with raised, red, scaly patches most often located on the elbows, knees and scalp. However, these patches can appear anywhere on the body. Topical therapies are useful in controlling mild and moderate cases of this chronic skin condition. Systemic drugs and biologic agents are used for more severe cases when topical treatment proves ineffective.

Rosacea

Rosacea is an adult form of acne which consists of redness, acne-like blemishes and prominent capillaries of the face. This condition is usually exacerbated by hot beverages (coffee, tea), certain foods and sun exposure. Treatment with topical and/or systemic therapies is effective in controlling this chronic skin condition.

Skin Cancer

The three most-common types of skin cancer include basal cell carcinoma (BCC), squamous cell carcinoma (SCC) and malignant melanoma.

Basal cell carcinoma is the most common form of skin cancer. Although these cancers most commonly develop on sun-exposed areas, basal cell carcinomas can be diagnosed anywhere on the body. These lesions can appear similar to other benign growths (moles) and conditions (dermatitis) of the skin. Small basal cell carcinomas often appear as skin-colored or pink, dome-shaped growths. They can also present as red, scaly patches that can be mistaken for eczema or as waxy-appearing, hard growths that resemble scars. In most cases, basal cell carcinomas grow more slowly than squamous cell carcinomas and do not spread to other parts of the body.

As the second most common form of skin cancer, squamous cell carcinoma usually develops on sun-exposed skin but can form anywhere, including the lips. These skin cancers often appear as red, rough, crusted or scaly bumps on the surface of the skin. They can also appear as red, scaly patches or as nonhealing, bleeding sores. Squamous cell carcinomas are considered to be more serious than basal cell carcinomas because they have a greater ability to metastasize (spread) to nearby lymph nodes and internal organs. 25% of all skin cancer deaths are caused by squamous cell carcinomas.

Malignant melanoma is the most serious of the three common forms of skin cancer. Melanomas can be life-threatening if not diagnosed and treated early, so it is important to check moles regularly for signs of change that could signal transformation into melanoma.

Dermatologists refer to the ABCDEs of malignant melanoma to watch for: Asymmetry (one-half of the lesion looks different from the other half); Border (the outer edge of the lesion is irregular or poorly defined); Color (the lesion has a variety of colors rather than the same even tan color throughout); Diameter (larger than 6 mm - the size of an eraser on the end of a pencil); and Evolving (the lesion looks different from other moles on the body or is changing in size, shape or color). Any mole or skin lesion with any of these characteristics should be evaluated by a dermatologist as soon as possible.

Warts (Verrucae)

Warts are noncancerous, but contagious, skin growths caused by the human papilloma virus (HPV). Warts are typically skin-colored with rough surfaces but can also appear brown or gray, smooth and flat. Warts can grow anywhere on the body but are most often found on the hands, feet (plantar warts), face (flat warts) and legs. There are numerous treatment options for warts including topical acid therapy, cryotherapy (liquid nitrogen freezing), cauterization (burning), curettage (scraping) and laser surgery.