Surgical Dermatology

Surgical Dermatology

Skin cancer

Mohs micrographic surgery

Actinic Keratoses (pre-cancer)

Skin tags

Cyst removal

Moles

Freckles

Skin cancer

Surgical treatments for skin cancer include:

Mohs Micrographic Surgery - This technique, employed for certain types of skin cancer, saves the greatest amount of healthy tissue and has a very high cure rate for select cancers. Dermatology Associates physicians are fellowship trained in Mohs surgery and have performed the procedure thousands of times.

Excisional Surgery - Physician cuts out the entire growth along with a surrounding border of normal skin as a safety margin.

Electrodesiccation and Curettage - Physician scrapes off the cancerous growth with a circular scalpel known as a curette. An electric needle destroys the residual tumor and controls bleeding.

Cryosurgery - Precancerous or cancerous tissue is destroyed by freezing with liquid nitrogen.

Mohs Micrographic Surgery

Mohs Micrographic Surgery was developed in the 1930s. The technique has been refined into the most advanced, precise, and effective treatment for an increasing variety of skin cancer types. With the Mohs technique, physicians can precisely identify and remove an entire skin cancer while leaving the surrounding healthy tissue intact and unharmed.

Common reasons to use the Mohs technique include:

• Cosmetic preservation of normal skin
• Large skin cancers
• Aggressive skin cancers
• Recurrent skin cancers
• Skin cancers that have invaded nerves

You want your skin cancer treatment to be performed with the highest standards of quality and competency. Dermatology Associates physicians performing Mohs surgery have specialized skills in dermatology, dermatologic surgery, dermatopathology, and Mohs surgery. Dermatology Associates physicians have successfully completed an extensive fellowship that requires at least one year of training and hands on experience performing Mohs surgery, after completing their conventional dermatology residency program. Fellowship trained Mohs College surgeons have specialized reconstructive surgical training for repairing wounds which results in the most optimal aesthetic outcome. Dermatology Associates surgeons are certified by the American College of Mohs Surgery and have performed thousands of surgeries.

The Mohs procedure involves surgically removing skin cancer layer by layer and examining the tissue under a microscope until healthy, cancer-free tissue around the tumor is reached (called clear margins). As a Mohs trained surgeon, your Dermatology Associates physician is specially trained as a cancer surgeon, pathologist, and reconstructive surgeon.

Mohs surgery is unique and so effective because of the way the removed tissue is microscopically examined, evaluating 100% of the surgical margins. The pathologic interpretation of the tissue margins is done on site by the Mohs surgeon, who is specially trained in the reading of these slides and is best able to correlate any microscopic findings with the surgical site on the patient.

Actinic Keratoses

Actinic Keratoses (AKs) are scaly or crusty growths caused by damage from the sun's ultraviolet (UV) rays. They can appear on any sun-exposed area; they are especially prevalent on the scalp, face and hands. They are usually red in color, but can be tan, pink or flesh-colored. If left untreated, AKs can advance to squamous cell carcinoma, the second most common form of skin cancer.

It's estimated that more than 58 million Americans have actinic keratosis (AKs). The closer to the equator that you live, the more likely it is that you will have actinic keratosis. In Florida, we are exposed to the sun's rays much more than most other locations in America. That's why, if you see any changes in your skin you need to see a Dermatology Associates physician.

Treatments for actinic keratosis include cryosurgery, photodynamic therapy (PDT), laser surgery, chemical peeling, and topical chemotherapeutic agents.

Skin Tags

A skin tag is a small flap of tissue that hangs off the skin by a connecting stalk. Skin tags are not dangerous. They are usually found on the neck, armpits, under the breasts, or in the groin area. Skin tags appear most often in women, especially with weight gain, and in elderly people. Skin tags usually don't cause any pain. However, they can become irritated if anything, such as clothing or jewelry, rubs them. Your Dermatology Associates physician can remove a skin tag by cutting it off with a scalpel or scissor, with cryosurgery (freezing it off), or with electrosurgery (burning it off with an electric current).

Cyst Removal

A cyst (frequently referred to as a sebaceous cyst) is a small closed sac that contains fluid or solid material. It usually is a non-tender, small lump beneath the skin. Sebaceous cysts most often arise from swollen hair follicles. Skin trauma can also induce a cyst to form. A sac of cells is created into which a protein called keratin is secreted. Cysts are usually found on the face, neck, and trunk. They are usually slow- growing, painless, freely movable lumps beneath the skin. Occasionally, however, a cyst will become inflamed and tender. Your Dermatology Associates physician can reduce the size of a cyst by the injection of a steroid medication, or completely remove it via excisional surgery.

Moles

Moles, also known as nevi, are growths on the skin that are usually brown or black. They may be normal or abnormal. Moles can appear anywhere on the skin, alone or in groups. It's normal to have between 10-40 moles by adulthood. Moles occur when cells in the skin grow in a cluster instead of being spread throughout the skin. These cells are called melanocytes, and they make the pigment that gives skin its natural color. Moles may normally darken after exposure to the sun, during the teen years, and during pregnancy.

Dysplastic nevi are abnormal moles that can become melanomas. The mere presence of dysplastic nevi can increase a person's chance of having melanoma elsewhere on the skin. Any changes in a mole should be checked by your Dermatology Associates physician to evaluate for skin cancer

If a mole displays any of the signs listed below, have it checked immediately by your Dermatology Associates physician. It could be abnormal or a melanoma.

• Asymmetry. One half of the mole does not match the other half.
• Border. The border or edges of the mole are ragged, blurred, or irregular.
• Color. The color of the mole is not the same throughout or has shades of tan, brown, black, blue, white, or red.
• Diameter. The diameter of a mole is larger than the eraser of a pencil.
• Evolution. The mole is changing in size, shape, or color.

If your Dermatology Associates physician believes a mole needs to be evaluated further, he or she will first take a small tissue sample of the mole to examine thin sections of the tissue under a microscope (a biopsy). This is a simple procedure. If the mole is found to be abnormal or a melanoma, the dermatologist will perform additional treatment to completely remove the lesion.

Freckles

Freckles are harmless brown spots usually found on the face and arms. Freckles are extremely common and are not a health threat. They are more often seen in the summer, especially among lighter-skinned people and people with light or red hair. Causes of freckles include a genetic predisposition and exposure to the sun. As with many skin conditions, it's best to avoid the sun as much as possible, and use a sunscreen with SPF 50 or higher to avoid further freckling. This is especially important because people who freckle easily (for example, lighter-skinned people) are more likely to develop skin cancer.

If you are bothered by the cosmetic appearance of your freckles, your Dermatology Associates physician can provide you with different treatment options including topical medications, chemical peels, and laser therapy.