Visiting the doctor is sometimes nerve-wracking for young patients, but here at CU Dermatology - Boulder, we make it a point that those nerves are soothed. Our staff takes great care in ensuring our pediatric patients are comfortable and at ease for their treatment. We see a wide variety of conditions, but the most common include bacterial, viral, and fungal infections; atopic dermatitis; eczema; hemangioma; birth marks; and diaper rash.
General dermatology covers any condition affecting the skin, hair, and nails. It encompasses a wide variety of diseases, disorders, discolorations, and growths, as well as damage from the environment to the aging process. Our providers treat young adult and adult patients for the diagnosis as well as the medical and surgical management of these conditions. Our providers are always keeping up with the latest technologies and advances in dermatology so you can be certain you are receiving the highest quality of care.
We see patients with a wide range of skin conditions:
- Actinic Keratosis
- Adult acne
- Mole & skin tag removal
- Skin cancer (melanoma, basal cell carcinoma, squamous cell carcinoma)
- Viral, bacterial, and fungal infection
- Scalp hair loss
- Psoriasis of the scalp
- Seborrheic dermatitis of the scalp
- Ingrown nails
- Nail psoriasis
- Color changes
- Splitting, peeling, or brittle
Skin Cancer Treatments
Skin cancer begins in cells, the building blocks that make up the skin. Normally, skin cells grow and divide to form new cells. Everyday skin cells grow old and die, and new cells take their place. Sometimes, this orderly process goes wrong. New cells form when the skin does not need them, and old cells do not die when they should. These extra cells can form a mass of tissue called a growth or tumor, which can be benign (non-cancerous) or malignant (cancerous).
Common types of skin cancer:
- Basal Cell Carcinoma: This is the most common type of skin cancer. Basal cell carcinoma can look like an open sore, red patch, pink growth, shiny bump, or scar. While typically slow growing, treatment is important as basal cell carcinoma can grow deep and wide.
- Squamous Cell Carcinoma: This type of skin cancer can appear as scaly red patches, open sores, elevated growths with central depression, or warts. They may crust or bleed. Treatment is important for squamous cell carcinoma as it can become deadly.
- Melanoma: This is the most serious type of skin cancer. Melanomas often resemble moles and are typically brown or black in color, but can be other colors. Early recognition and treatment can prevent the melanoma from spreading. If skin cancer is detected, the provider will compile a tissue sample (biopsy) which will be examined microscopically and if cancer is confirmed, it will be removed with the most appropriate treatment.View Skin Cancer Gallery
Mohs Skin Cancer Removal
The Mohs Skin Cancer Removal procedure involves a layer-by-layer removal of skin that contains cancer cells. The steps of the procedure are as follows:
- The skin around the cancer cells is numbed with an anesthetic.
- Any visible, raised area of the tumor is removed.
- A thin, circular layer of tissue is removed first.
- The tissue is marked in a manner to identify right and left as well as top to bottom sections.
- The entire bottom side and outer edges of the removed tissue layer are examined under a microscope immediately in the doctor's office.
- If any cancer cells are seen under the microscope, its location is identified (according to the marked section) and an additional thin layer of tissue is removed only from the identified section where the cancer cells remain.
- The process of microscopic examination and removal of additional layers of tissue continue until no more cancer cells are seen under the microscope.
Advantages of Mohs Micrographic Surgery
- Procedure performed from the start to finish by a skin cancer expert
- Highest cure rate available for skin cancer
- Visualizes 100% of margin of excision vs. the 1% with normal pathology
- Smallest amount of normal skin is removed
- Preserves cosmetics and function of treated areas
- Smallest possible defect results in smallest possible scar
- Reconstruction performed immediately after tumor is removed
- All done under local anesthesia in office
What Types of Cancer Can Be Removed with Mohs Surgery?
Basal cell and squamous cell carcinoma are two of the most common skin cancers and also the two that Mohs surgery treats. But it is also helpful for the following:
- Skin cancers near vital functional or cosmetically important areas such as near eyes, eyelids, nose, ears, lips, forehead, scalp, fingers, or genital area
- Skin cancer that is large (1 inch) or larger on any area other than the face
- Skin cancer with borders that are not clearly defined
- Skin cancers in which other treatments have been tried and failed (cancer comes back)
- Skin cancer in areas where scar tissue is already present
The cure rate for basal and squamous cell skin cancer is close to 100% when detected and treated at an early stage. That is why a yearly professional skin cancer exam is highly recommended. In between the yearly exams, once a month examine your skin from head to toe and focus on the ABCDEs (comparing to melanoma forms of skin cancer since it is the most serious form).
Photodynamic Therapy with Levulan® for Treatment of Skin Cancer and Pre-Cancers
Actinic Keratoses (AK) is a rough-textured, dry, and scaly patch on the skin that is caused by excessive exposure to ultraviolet light (UV) such as sunlight. AKs develop as the result of years of sun exposure. AKs are considered to be the first step in the development of skin cancer. They have the potential to progress to squamous cell carcinoma (SCC). While most AKs remain benign, a study has shown that approximately 10 percent develop into SCC within an average of two years. It is very important to have routine skin examinations with a dermatologist to prevent any AKs from progressing into SCC.
How PDT with Levulan® Works
- Levulan® will be uniformly applied to your AK lesions.
- The provider will direct you to wait the recommended time in order to allow the solution to penetrate the targeted cells.
- Your face will be rinsed in between treatment steps.
- Then you will begin the second part of your treatment which includes illuminating your treated lesions with the BLU-U light. The blue light activates the Levulan® solution so it attacks the diseased cells, while preserving the healthy ones.
- Frequent skin examinations are the key to early detection and prevention.
What are the side effect of PDT treatment?
The most common side effects include scaling/crusting, hypo/hyper-pigmentation, itching, burning/stinging, redness and/or swelling. These symptoms can last up to 24 hours after your treatment.
How long will the treatment take? The treatment can take 2-3 hours depending on the area that is being treated.
How long will I need to remain out of the sun? Avoid exposing the treated area to sunlight and other forms of bright light for at least 40 hours post treatment. (Sunscreen will not protect against photosensitivity reactions caused by exposure to light and sunlight)
What should I bring to my appointment? Since the Levulan® has to sit on your skin for one to two hours, electronic reading material is recommended as you will be waiting in an unlit room. A wide brimmed hat to wear home after your treatment is highly recommended.
Frequent skin examinations are the key to early detection and prevention.