Dermatology

                                                                                                                       Robert M Rosen, D. O.

 

Dermatology Procedures

Shave biopsy (or "tangential excision") slices a surface growth off using a blade. A "curette" does a similar task with a special scraping tool. These are often done to remove a small growth and confirm it's nature at the same time.

A "Punch" biopsy is typically used by dermatologists to sample skin rashes and small growths. After a local anesthetic is injected, a biopsy punch, which is basically a small (1 to 4 mm  diameter) version of a cookie cutter, is used to cut out a cylindrical piece of skin. The hole may be closed with a suture and heals with minimal scarring.

Grenz rays are a form of black light classified as ultrasoft radiation.  Grenz ray treatments should not be confused with the "Superficial radiation therapy" or "superficial X-Ray" which were used for everything from acne to eczema back 30 to 40 years ago, and are still used in the treatment of malignant skin cancers today.

UVB Phototherapy is a treatment for skin eruptions using artificial ultraviolet light. The initials UVB stand for the type B ultraviolet, the part of sunlight that gives you sunburn. Carefully controlled, it is an extremely effective tool for significant skin disease.

PUVA is a combination of psoralen (P) and long-wave ultraviolet radiation (UVA) that is used to treat several severe skin conditions. Psoralen is a drug taken by mouth that makes the skin disease more sensitive to ultraviolet light. This allows the deeply penetrating UVA band of light to work on the skin.

ED+C: Scraping or burning-off skin growths (also known as  curettage and electrodessication) can be used for less serious skin cancers, pre-cancers and benign growths. A local anesthetic is injected, then the abnormal tissue is scraped off with a special tool. The area is then cauterized until bleeding stops. This may be repeated if the growth is cancerous. The wound will need to be dressed until it heals, and it usually leaves a small white mark.

Intralesional injections are the direct placement of a medication into a problem skin area through a very fine needle. Most often, a dilute solution of triamcinalone (Kenalog) is used. Acne cysts, psoriasis and chronic forms of eczema are treated this way. If too much medication is used, a white spot or dent develops, but eventually goes away,

Cryosurgery, also known as cryotherapy, is used frequently by dermatologist to treat many skin problems. Liquid nitrogen is sprayed on to the area of skin freezing it. Light freezing causes a peeling, moderate freezing a blistering and hard freezing a scabbing. It is used for acne, scars, growths and some skin cancers. Older dermatologists still use a swab to apply it, but the result is the same.

Acne surgery is the removing of acne lesions, usually by opening up comedones and pimples by using a needle or small pointed blade and expressing the lesions with an extractor.