Medical Dermatology Answers

What are Actinic Keratoses?

Actinic keratoses (AKs) are lesions on the surface layer of the skin (epidermis) caused by chronic exposure to sunlight, particularly ultraviolet light. AKs occur when the cells that comprise 90 percent of the epidermis, the keratinocytes, change their size, shape or/and organization in a process called cutaneous dysplasia. This alters the texture of the skin surface and may extend deeper, into the dermis. AKs are only one of many kinds of keratinocyte lesions, which can be caused by factors other than sunlight (such as chemical carcinogens, x-rays, heat, papillomavirus infection and scarring).

What are The Symptoms of AKs?

AKs typically manifest as rough or scaly skin, bumps, mottled patterns and cutaneous horns. They may appear anywhere on the skin surface exposed to sunlight, but common areas include the face (including ears and lips), neck, arms and hands. Lesions range in size from a pinpoint to several centimeters in diameter and may be yellow, brown, red or violet, smooth, wrinkled or furrowed.

Are AKs the Same as Skin Cancer?

Actinic keratoses can signal the onset of skin cancer. AKs can progress to squamous cell carcinoma, the second-most common form of epidermal skin cancer.

Do AKs Only Occur in Older People?

While AKs most often appear in people ages 40-50, anyone who has had extended exposure to sunlight, especially if they have pale skin, is susceptible to developing them. For example, in sunny areas such as Florida and southern California, teenagers are routinely diagnosed with AKs.


Accutane®

Acne can be unsightly and painful. In addition to the physical toll, it can also saddle sufferers with poor self-esteem and even depression. A drug called Accutane® (isotretinoin) offers acne sufferers a potent, highly-effective option for clearing even the most stubborn acne. For more than 20 years, Accutane® has successfully helped patients with severe recalcitrant nodular acne. The small Accutane® capsules are taken orally in several courses for four-to-six months each.

What is Eczema?

Elbow Eczema

Eczema on the elbow

Eczema refers to a group of inflamed skin conditions that cause chronic, relapsing, itchy rashes. It is also known as atopic dermatitis, and can be triggered by contact with coarse or rough materials touching the skin, excessive heat or sweating, or allergen triggers.

What are The Symptoms of Eczema?

  • Rash
  • Dryness
  • Itching
  • Scaling
  • Leathery skin texture

Who Gets Eczema?

About 15 million people in the U.S. suffer from some form of eczema, including 10 to 20 percent of all infants. It is most common in infants and children under the age of five. While there is no known cause for this condition, it appears to involve an overactive immune system in the presence of certain materials. Many people with eczema also have allergies, asthma, or family members with these conditions.

Infants with eczema usually have itchy patches on the scalp and face, although the condition tends to go away on its own over time. Teenage and young adult patients with eczema often have itchy patches of skin on the elbows and knees, although they may also develop on the hands, feet, ankles, wrists and face.

What is Melanoma?

Suspicious Looking Mole

A suspicious looking mole

Melanoma is a potentially life-threatening skin cancer of the melanocytes, the cells that make melanin (brown pigment). Almost half of the incidences of melanoma occur in new (dysplastic) moles or moles already present (congenital) on the skin surface.

Is Melanoma Fatal?

Melanoma can be life-threatening and has a fatality rate higher than those for basal cell and squamous cell cancers – it accounts for more than 80 percent of all deaths from skin cancer. Of the estimated 50,000 new cases of melanoma diagnosed each year, about 8,000 result in death.

Can Early Detection Lower My Risk of Serious Harm?

Yes. Surgery usually removes all traces of cancer when melanoma is detected early in its development. Survival rate drops once cancer has spread to the lymph nodes (30-40% after five years) and again when it begins to impair the major organs (12% after five years).

Am I at Risk For Developing Melanoma?

The causes of melanoma are not yet known, although there are many suspected risk factors, including:

  • Familial tendency to develop freckles or prominent or atypical (unusual-looking) moles
  • Presence of many freckles, moles, large moles or atypical moles
  • Family member with melanoma
  • Overexposure to ultraviolet radiation, especially sunbathing
  • Overexposure to sunlight before age 18
  • Caucasian ancestry, with fair skin (although all races/skin tones are susceptible)
  • Sun sensitivity/poor tanning ability
  • Immune system deficiency due to disease or organ transplantation
  • Previous presence of melanoma

Psoriasis

Psoriasis is a group of chronic skin disorders that cause itching and/or burning, scaling and crusting of the skin. More than seven million men and women in the U.S. of all ages have some form of psoriasis, which may be mild, moderate or severe. The most commonly affected areas are the scalp, elbows, knees, hands, feet, and genitals.

Psoriasis cannot be cured but it can be treated successfully, sometimes for months or years at a time and occasionally even permanently. Treatment depends on the type, severity and location of psoriasis. The patient’s age, medical history, and life may also have a significant impact on the methods utilized. The most common treatments are topical medications, phototherapy, photochemotherapy (PUVA), and oral or injectable medications (for severe symptoms).


Rosacea

Rosacea is a chronic skin condition that causes redness and swelling primarily on the face, but can also affect the scalp, neck, ears, chest, back or eyes. The symptoms of rosacea tend to come and go over time, but can usually be treated.

What are The Symptoms?

  • Redness
  • Pimples
  • Swelling
  • Dryness
  • Burning
  • Eye irritation

Who Gets Rosacea?

Rosacea affects more than 14 million Americans, and while anyone can develop this condition, it is most common in light-skinned, light-haired adults between the ages of 30 and 50. It also tends to run in families and affect people of Northern or Eastern European descent. The cause of rosacea is unknown.

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