Dr. Paul B. Dean welcomes
you to Grossmont Dermatology. He and his partners, Dr. Bushman and Dr.
Goskowicz, love practicing dermatology and would like to meet you personally
in an effort to help you with your specific concerns.
Dr. Dean's major interests, in addition to general dermatology, are moles,
growths, and skin cancer. Most of the patients that he sees in his office
come because of a specific concern about a lesion of some sort.
LESIONS- Moles and Growths
Sometimes lesions are pigmented as in moles, sometimes they are
bright red as in blood vessel collections, and sometimes they are crusty,
scaly or pearly as in skin cancer.
Dr. Dean's job is to explain the nature of moles, growths, and skin cancers
to patients and then recommend either reassurance or specific treatment.
One of the most common things people ask us about are moles. Here are
some pictures of normal looking moles.
Click on photo in order to enlarge.
Moles are pigmented spots on the skin and
they are genetic, the vast majority of moles being inherited. Most moles
are perfectly benign and require no treatment. If a mole has symptoms
such as itching, burning, change in color, change in size, bleeding, or
anything that makes you more aware of the mole, have the mole removed.
Do not simply observe the mole and do not allow a physician to tell you
to "watch and wait". By watching and waiting, you may be allowing
the mole to develop into something harmful called a melanoma. You do not
want to have one of these! Therefore, any moles that are symptomatic should
be removed.
Most moles can be removed by a simple technique called shave removal where
the mole is anesthetized, shaved off the surface of the skin, and sent
to the lab for examination. This usually painless method allows quick
and easy removal with a microscopic analysis of the mole. Frequently after
removing a mole, my patients will say, "If I had known it was that
easy, I would have done it years ago." If a mole is found to be a
melanoma, which by the way is quite unusual, the lesion then needs additional
treatment by wider excision. This will be discussed much more extensively
by your dermatologist.
KERATOSES & SKIN CANCER
Another very common lesion that is seen particularly on the face
and arms is a scaly, rough growth called actinic keratosis. A keratosis
can be a pre-skin cancer. Non-melanoma skin cancer, by the way, is usually
not dangerous and is distinct from melanoma in that it does not usually
have a tendency to spread internally.
Most skin cancers are either basal cell or squamous cell and are sunlight
induced, not sunlight you got yesterday, but sunlight you received over
the last 10-20 years of exposure. Some skin cancers will go through an
initial phase called actinic keratosis and then evolve into cancer. If
they are found early as small, scaly, rough areas, they can usually be
treated with liquid nitrogen spray, which freezes and destroys them. If
the lesion is already raised or suspicious for a skin cancer, it can be
anesthetized, removed from the surface of the skin, and sent to the lab
for examination. The vast majority of skin cancers can be treated by this
simple technique if found early. If skin cancers are found later, or if
they have features which, show deeper roots, they may need additional
treatment by a variety of techniques which can be explained by your dermatologist.
Here are pictures of actinic keratoses and various types of skin cancer.
Click on photo in order to enlarge.
Actinic Keratoses
Actinic Keratoses
Actinic Keratoses
Basal Cell Cancer
Basal Cell Cancer
Basal Cell Cancer
Basal Cell Cancer
Squamous Cell Cancer
Squamous Cell Cancer
Squamous Cell Cancer
Seborrheic Keratosis
Seborrheic Keratosis
Seborrheic Keratosis
SUNLIGHT
Sunlight protection is critical since exposure to the sun causes
Actinic Keratoses and skin cancer. Remember, sunlight has a cumulative
effect so even if you are only getting 10 minutes of sun a day, over a
week's time these 10 minutes per day translate to an hour per week. As
far as your skin knows, you went to the beach for an hour. You must protect
yourself on a daily, ongoing basis, particularly if you are fair complected,
Northern European, or blue-eyed. Remember to avoid mid-day sun, wear protective
clothing, and use appropriate sunscreens containing the state-of-the-art
sunscreen ingredient, Parsol, which blocks out both UVA and UVB. Click
here for information on some excellent sunscreens, which can be used
on a daily basis without fear of blemishes or irritation. These products
feel quite pleasant on your skin and are meant to be used daily by both
men and women.
OTHER KERATOSES
Seborrheic keratosis is another very common lesion that I see
in my office daily. These are crusty, rough looking growths, which vary
in color from pink to black, but are most often tan. These are benign
growths that do not evolve into skin cancer or melanoma and usually require
no treatment. They can be of significant cosmetic annoyance and can be
treated by a variety of methods including shave removal or freezing if
they are of concern. Irritating or inflamed lesions should be removed.
Some non-dermatologists have difficulty distinguishing seborrheic keratoses
from significant moles or even from skin cancer, and patients often see
me because they have been told by their physician that they may have a
significant lesion. These lesions usually require no specific treatment.
Here are several photographs of seborrheic keratoses.
Lactic acid moisturizers may make these lesions feel better.
Click on photo in order to enlarge.
