Dermatological Conditions

Peraza Dermatology Group provides the highest quality diagnostic and therapeutic services to patients of all ages suffering from common or complicated skin conditions. In addition to mole and skin cancer evaluations, we offer several methods of treatment for benign and cancerous skin growths including basal cell carcinoma, squamous cell carcinoma, and melanoma.

Whatever the nature of your issue or the type of care you seek, you can expect respectful consideration and a comfortable environment at Peraza Dermatology Group.

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Acne is the most common skin disorder in the United States, with nearly 85% of people suffering from the condition at some point in their lives. More than 40% of teenagers develop acne scarring requiring treatment by a dermatologist. Acne is a chronic inflammation of the skin that often affects the face, neck, chest, back, shoulders, and upper arms. There are several types of acne—comedones (whiteheads and blackheads), pimples, and deeper bumps (nodules or cysts). The exact cause is unknown, but many factors contribute to acne—overactive oil glands, pores in the skin becoming plugged, the bacterium P. acnes (present on everyone’s skin) causing inflammation in the skin, while genetics, hormones, menstruation, and emotional stress can worsen acne. Prevention of scarring is most important. Squeezing, popping, and picking can cause scarring. If over-the-counter medications do not work, there are many other treatment options and choosing the most appropriate—oral or topical antibiotics, oral or topical retinoids, chemical peels, laser treatments – (PDT), Dermapen®, or hormonal therapy—should be discussed with your dermatologist. Often combination therapy is needed, but acne treatments are usually extremely effective if used consistently and appropriately.

These common, crusted, red-yellow spots often develop in patients over the age of 40 in sun-exposed areas — the face, head, ears, neck, and tops of the hands. They are usually less than half an inch in size. Risk factors for having actinic keratosis include a history of extensive sun exposure and fair complexion. Some actinic keratoses can become squamous cell carcinomas, although some go away on their own. An individual spot’s behavior can’t be predicted. Multiple treatment options exist, including but not limited to liquid nitrogen, topical medicine, or laser treatments, such as Photodynamic Therapy (PDT). Patients with multiple actinic keratoses require annual visits and aggressive sun protection practices — sunscreen, sun protective clothing, and sun avoidance — to limit development of new actinic keratoses.

Currently, we perform two types of PDT — a special treatment performed with a topical photosensitizing agent, AMELUZ® (aminolevulinic acid hydrochloride) gel or Levulan® (5-aminolevulinic or ALA), activated by the correct wavelength of light, the BF-Rhodo LED® or Blu-U®, respectively — at our office. Your provider will select the most appropriate for your condition.  These treatments are designed to remove actinic keratosis, but PDT treatments also have the unique ability to minimize pore size and reduce oil glands; therefore, it can be used to treat acne and lessen the appearance of some acne scars.

Please click on the link below to view the AMELUZ® (aminolevulinic acid HCI) gel, 10% and BF-Rhodo LED® Photodynamic Therapy Patient Educational Video:

These common, brown, flat lesions occur on sun-exposed skin—face, chest, back, tops of feet, backs of hands—in people with fair complexions. Also referred to as solar lentigines, “brown spots”, or “liver spots”, these age spots can increase in size and number with advancing age. They resemble freckles, moles, or skin cancer, so examination by your dermatologist is important.

Various treatments are available to eliminate or reduce the appearance of solar lentigines, including but not limited to, liquid nitrogen, IPL, chemical peels, and retinoid creams. Aggressive sun protection practice scan prevent development of these lesions.

Basal cell carcinoma (BCC) represents the most common skin cancer. Nearly one million cases are diagnosed each year in the United States. BCC occurs slightly more often in men. People over the age of 40, with a fair complexion, and a history of long-term sun exposure are most at risk for developing these cancers. BCC arises in the top layer of the skin and is most common on the face, neck, and ears, but can occur on the chest, back, abdomen, arms, and legs. They are often pearly-white to pink in color with a rolled edge. Some can have central crusting. A skin biopsy confirms the diagnosis. If not treated, these cancers can enlarge and damage surrounding healthy skin, but rarely are life-threatening. A variety of treatment options exist, including, but not limited to, surgery, superficial radiotherapy (SRT),electrosurgery, and Mohs micrographic surgery. Annual skin examinations and aggressive sun protection practices—sunscreen, sun protective clothing, and sun avoidance—are mandatory.

Eczema is a skin reaction that often starts in early childhood. The skin can be red and very itchy. Often, patients rub and scratch to the point of damaging the skin. There is usually a strong family history of eczema and some patients may also suffer from asthma and environmental allergies. Treatment with topical and oral medicines is very important to prevent skin infections and worsening skin disease.

Melanoma, a skin cancer from the pigment producing cells, melanocytes, represents the most deadly skin cancer. The incidence of melanomas has been increasing for the past 30 years. Melanoma is the most common form of cancer for young adults, aged 25-29, and the second most common form of cancer for people aged 15-29. Approximately 1 in 75 Americans will develop this tumor during their life. Melanoma can develop in an existing mole, but, often, suddenly appears without warning.

Melanomas are more common in people who have a fair complexion and tan poorly, have a history of blistering sunburns, or have a personal or family history of atypical moles (nevi) or melanoma. Bleeding, itching, skin breakdown, and tenderness can represent early warning signs. Melanomas usually develop on the legs in women and the backs in men. Detecting melanomas early, before they spread to lymph nodes and other internal organs, is essential as late detection can limit treatment options and shorten a patient’s life. Based on depth of invasion by the tumor cells, surgical excision, topical medication, or lymph node sampling may be required. The most important signs for new skin spots that can potentially represent an early melanoma include:

A. Asymmetry—one half of the spot is unlike the other half
B. Border irregularity
C. Color irregularity or multiple colors
D. Diameter greater than 6mm (size of a pencil eraser)

All suspicious skin spots require a skin biopsy. Regular skin examinations and aggressive sun protection practices—sunscreen, sun protective clothing, and sun avoidance—are mandatory and required to monitor for recurrence or new tumors.

Pigmented moles are referred to as nevi. Common in men and women, they can appear at birth and it is normal to make new moles until age 30. After this age, any changing or new moles should be evaluated by a dermatologist. Exposure to sun appears to contribute to the development of moles. Over years, moles can become more raised and lighter in color. Most moles are harmless, but some can turn into melanoma, a type of skin cancer. Any mole that is asymmetric, has an irregular border, multiple colors, itches, bleeds, or is larger than six millimeters (the size of a pencil eraser) should be examined immediately by your physician. A skin biopsy may be needed to exclude melanoma.

This common, chronic, and relapsing inflammatory disease of the immune system can affect any skin site. Nearly 7 million people in the United States have psoriasis. This disease primarily affects adults and appears equally in men and women. The most common type—plaque psoriasis—is characterized by raised, reddish skin with thick silver-white scale on the scalp, elbows, knees, hands, and feet. In addition people with psoriasis can develop joint inflammation with symptoms of arthritis—psoriatic arthritis. Choosing the most appropriate therapy—topical creams and ointments, ultraviolet light therapy, pills by mouth, or injectable medicines—should be discussed with your dermatologist as many new treatments have become available during the past few years.

XTRAC excimer laser is a new treatment option for psoriasis and vitiligo. This laser delivers a highly targeted therapeutic beam of ultraviolet B (UVB) light to areas of skin affected by vitiligo and psoriasis without harming the surrounding skin. XTRAC clears the symptoms, prolongs the remission, and returns skin to a clinically healthy state quickly.

The cause of this common, chronic, facial rash affecting millions of Americans over the age of 30 remains unknown. Often, patients have red bumps and noticeable vessels on the cheeks, nose, forehead, and around the eyes. Uncommonly, swollen bumps and skin thickening of the nose, rhinophyma, can occur. Treatment often includes avoidance of hot liquids, spicy food, and wine. Sun protection practices are important. Green-tinted cosmetics, topical and oral medications, and laser therapy, specifically targeting the excess blood vessels, represent effective treatment options.

Seborrhea is a common, chronic skin condition with redness and flaking on the face, scalp, and chest. Mild seborrhea causes flaking (dandruff). Often, aggressive topical medicine can control the condition.

Superficial radiotherapy (SRT) is a new, safe, effective, and non-surgical treatment option for certain non-melanoma skin cancer (basal cell carcinoma and squamous cell carcinoma). SRT is a low-energy radiotherapy that penetrates only a short distance below the skin surface. This allows for a highly effective, painless, and cosmetically attractive alternative to surgery in selected cancers and patients.

The SRT-100™ is the new and most advanced choice for superficial radiotherapy. It is very similar to having an x-ray. Cancers of the arms, legs, back, and trunk can be easily treated, but the SRT is especially well suited for skin cancers of the head and neck regions–the fold in the nose, eyelids, lips, corner of the mouth, and the lining of the ear–that may otherwise lead to a less than desirable cosmetic outcome. Also, SRT is a great treatment option for patients considered high risk for surgical procedures.

SRT procedures do not require the use of anesthetics. Multiple sessions, each lasting approximately 90 seconds to deliver the therapy, over several weeks are required. The treatment sessions are painless, but you may experience redness at the end of the first week of therapy. After the treatment is completed, a scab will form and the new, healthy skin will develop underneath.

Superficial Radiotherapy (SRT) Before and After

Squamous cell carcinoma (SCC) represents the second most common skin cancer, after basal cell carcinoma. The majority of these cancers occur in areas of heavy sun exposure—head, neck, and hands. They can develop from actinic keratosis or appear without warning. Patients over 50, with a history of heavy sun exposure, and a fair complexion are at highest risk for developing these cancers. In addition, patients who have received an organ transplant and require medicines to decrease their immune system have an increased risk of developing SCC. A small percentage of cases can spread from the skin to the lymph nodes. A skin biopsy confirms the diagnosis. Treatment options include surgery, superficial radiotherapy (SRT), electrosurgery, and Mohs micrographic surgery. Annual skin examinations and aggressive sun protection practices—sunscreen, sun protective clothing, and sun avoidance—are mandatory.

Approximately 1% of the population suffers from this skin condition characterized by white patches. The cause of these white patches, destruction of the pigment producing cells, the melanocytes, is unknown. A major medical problem for persons of color, vitiligo can result in severe difficulties in social adjustment. Patients with vitiligo should be managed by a dermatologist as there are other skin conditions with white spots that can mimic vitiligo. Aggressive sun block is imperative, but is an exciting new treatment option.

XTRAC excimer laser is a new treatment option for psoriasis and vitiligo. This laser delivers a highly targeted therapeutic beam of ultraviolet B (UVB) light to areas of skin affected by vitiligo and psoriasis without harming the surrounding skin. XTRAC clears the symptoms, prolongs the remission, and returns skin to a clinically healthy state quickly.

Common warts (verruca vulgaris) are caused by an infection with the human papilloma virus (HPV). They can be spread by simple contact, often at sites where the skin is broken. They are very common, especially in children, but adults are frequently affected. Warts can occur anywhere in the skin, but usually they are found on the hands, fingers, and knees. They can persist for several years and sometimes go away without treatment. For those warts that are uncomfortable or not going away, multiple treatment options exist. As warts can be stubborn, several treatment sessions are usually required for resolution.

Sun exposure is the main cause of premature aging. A patient’s skin color and history of long-term, intense sun exposure contribute to the amount of skin wrinkling. People with a fair complexion and a history of heavy sun exposure will develop more skin damage than those with dark skin. To prevent sun damage and skin wrinkling, daily broad-spectrum sunscreen with a Sun Protection Factor (SPF) of 30 or higher that protects against ultraviolet A (UVA) and ultraviolet B (UVB) rays is needed. In addition, there are several treatments that can help reduce wrinkling— Botox®, dermal fillers, Pelleve™, chemical peels, and Dermapen®.