Ask the Dermatologist!

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Things are very serious in the WCCO studios!

Hey hey!

A couple of weeks ago on the Healthy Matters radio show we featured two of my colleagues from Dermatology, Drs. Jenny Liu and Erin Luxenberg.  You’ll find us in the photo to the left in the WCCO studios in downtown Minneapolis getting ready for the show.

We’re obviously a pretty tense and serious group, eh?

We mostly focused on skin cancer during that show and it was really informative and fun.  If you missed the show, you can listen to the commercial-free podcast by clicking here (Healthy Matters show #434, April 30, 2017).

As usual, we get way more calls, texts, and tweets than we can get to on the live broadcast.  So for this blog post we are continuing the show, in a way, by having Dr. Luxenberg and Dr. Liu respond to some of the text questions from that show.  So if we didn’t get to your question on the air, maybe we will cover it here.

Here goes . . . 

Q&A with Dermatologists Dr. Jenny Liu and Dr. Erin Luxenberg

These questions are taken straight from the text-line at WCCO radio studios.   The responses are from Drs. Liu and Luxenberg, unless it says DH in front of it, then it’s me talking.

Since there are 18 questions and answers and maybe you don’t want to read them all, here are links based on the subject of each question.  Click the keyword and jump right to the question!  Remember these were simply text messages to the radio show, so the questions are short and the responses are short as well.  Always consult your own doctor to evaluate your specific situation.

On to the questions!

Dermatologist Dr. Jenny Liu

Q1:  I have a raised red “line” ¼’ x 1/8’ on my forearm. If my clothing or I brush up against or lightly touch, it burns.

A1:  Could be benign keratosis all the way to skin cancer.  We would need to see lesion for diagnosis.

DH:  It is often the case for skin problems that the dermatologist needs to see the lesion directly.  My take on it is that if you are worried about a thingie on your skin, have it checked out.

Dermatologist Dr. Erin Luxenberg

Q2:  I’ve wondered about two very small itchy bumps – one on back of leg just above crease of knee, and on one side of neck near neckline. Thought they might be bug bites, but they haven’t gone away or stopped itching for a few months.  I’m in my 60s.  Fair skin.  Should I ignore them or have them checked?

A2:  Same answer as above.  If its symptomatic, we recommend seeing a dermatologist for diagnosis and treatment

Q3:  Is there a way to remove keratosis other than freezing?

A3:  Shave biopsy can be used instead.

Q4: I was also diagnosed with mycosis fungoides and receiving light therapy that seems to be working well.  How long can remission last.  Would I need to continue maintenance therapy after that?

A4:  The prognosis of patients with MF is dependent on the stage, and in particular the type and extent of skin lesions and the presence of extracutaneous involvement. Patients with limited patch/plaque stage MF have a similar long-term life expectancy as an age-, sex-, and race-matched control population. Remission and maintenance depends on the extensive of disease.

Q5:  Why are some people more susceptible to hyperpigmentation and are laser treatments a good option?

A5:  Skin type is a huge factor in hyperpigmentation. Darker skin individuals tend to discolor more.  Laser can be safe depending on skin type and condition being treated.

Q6:  The faces takes a sun beating. How safe are dental x-rays?

A6:  Very safe with the current standard and frequency of recommended dental x-rays.

Drs. Jenny Liu & Erin Luxenberg

Q7:  I am being treated by a dermatologist for psoriasis on my elbows and shins using UVB lamps. Should I be worried about skin cancer or skin aging?  My doctor says this therapy is very safe.

A7:  Narrow band UVB is very safe, no reports of skin cancer have been documented. However it is recommended patient undergoing phototherapy to be followed by a dermatologist regularly for skin checks.

Q8:  Does sunscreen get “old”?

A8:  Yes, most have an expiration date, would recommend tossing it out after expiration date.

Q9:  We like the look of a nice natural tan but is there a “safe” way to get a nice tan?

A9:  Yes, spray on tans or self tanning lotions can be a great alternatives.

DH:  You didn’t really think a dermatologist would ever say its OK to tan in the sun, did you?  🙂

Q10:  I was recently diagnosed with basal cell cancer on my face. I have a dime size sore near my eye.  What kind of scar will I end up with?  Would a plastic surgeon help?

A10:  Scar and whether plastic surgery is involved depends on the extent of the surgery and that is hard to predict.

Q11:  I have skin damage on my calves obtained many years ago. Discolored purple and red very dry and it itches.  What should I do?

A11:  Sounds like it could be eczema. Gentle skin care, using moisturizer after bathing, and if does not resolve, see a dermatologist for prescription medications.

Drs. Jenny Liu & Erin Luxenberg

Q12:  Hi, I am bald on the top of my head. Have various dry spots.  Some get better when I use lotion but they don’t seem to go away.  My scalp also is tender to the touch.  I have had many sunburns on my scalp over the years.  Why so tender and any concern for cancer?

A12:  Yes, the tender spots are concerns for precancerous or cancerous change, please see a dermatologist.

Q13:  My husband’s arms bleed with even light impact on his arms. The doctor has said that he has thin skin” caused by aging.  His mother had it also.  Is there anything that can be done to help him?

A13:  Yes, this is commonly seen as we get older. Moisturizers and protecting skin from trauma is the best thing. You can try DerMend, which can help a bit with the bruising.

Q14:  Is fluorouracil safe to use on a spot? I understand it contains chemo which makes me uncomfortable to use it.

A14:  Yes, it is safe. It is FDA approved to treat skin cancer and sun damage. There can be associated mild to moderate discomfort depending on the individual.

Q15:  I have a spot on the top of head. Having surgery Monday what kind of cancer might it be?

A15:  Hard to say without looking at it.  (DH:  See Q1 and Q2).

Q16:  Does skin cancer go from basal to squamous to melanoma or do you just get that one type?  I have had a squamous spot on my left arm and had it removed down to 3 layers of skin.  Am I “cured”? Do I have to say “yes” to having cancer on medical forms?

A16:  No, skin cancers do not transform into another skin cancer. Usually surgery is the way to cure SCC and BCC.

DH:  Not sure what to tell you about the medical form bit.  I would always advise full disclosure on medical forms, but write in the specific type of skin cancer (basal, squamous, melanoma, etc) since they can mean very different things.

Q17:  My granddaughter has contracted molluscum contagiosum under her armpit and on the side of her chest. How to treat? Are there any treatments that can be done at home?

A17:  This is a common condition we see in kids. Often a dermatologist will perform in office treatments or prescription treatments.

Q18:  What is the recommendation for skin cancer screenings?

A18:  It depends on one’s history. Recommend people >40 years old should have their skin checked at least once. Usually check every 6 months to 1 year for those with history of non-melanoma skin cancer or have history of extensive sun damage. Melanoma skin cancer screening depends on the how long ago the melanoma was diagnosed.

HCMC Dermatology team

I often ask Dr. Liu and Dr. Luxenberg to help me out with skin issues here on Healthy Matters.   But they are only part of the terrific HCMC Dermatology team.  Dr. Bruce Bart and Dr. Sara Hylwa round out just a great bunch of doctors ready to help out with skin care.  Click on their picture for more info!

Thanks for checking in with me.  Maybe subscribe by e-mail below, leave me a comment, check me out on Twitter @DrDavidHilden.

-David

 

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2 Responses to Ask the Dermatologist!

  1. Thanks for the great questions about skin care. I had no idea that sunscreen could expire, so that is good to learn! The one we have in our beach bag is almost definitely past that date, but I’ll have to check.

  2. David Hilden, MD MPH says:

    Hey, Ridley, thanks for the comment. Time to go buy new sunscreen, methinks!

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