Dermatologists are trained to treat patients of all ages, from newborns to the elderly. This includes the diagnosis, treatment and prevention of problems of the skin, hair and nails. Conditions common among children are moles and birthmarks, dermatitis, acne, warts, vitiligo, insect bites and birth defects. In adults we treat a range of conditions such as cancers and pre-cancers, rosacea, psoriasis and shingles. We also treat eczema, allergies and other disorders that occur in all age groups, and carefully examine moles or other growths to determine whether they are or may become cancerous.
Full-body Skin Exams/Skin Cancer Screening
Full-body Skin Exam
Full-body skin exams are an important tool in screening patients for benign or cancerous lesions that they may not have been able to see or recognize on their own. From head to toe and back to front, we inspect the skin for any suspicious growths. This quick and painless preventive measure is an invaluable tool in the early detection of skin cancer as well as many other dermatological conditions. We recommend annual skin checks to ensure any changes in the skin are monitored appropriately.
Skin Cancer Screening
Early detection is valuable in successfully treating skin cancer. Therefore, regular full body screenings are recommended. A biopsy may be performed at the time of visit to properly diagnose suspected cancerous growths.
Skin cancer can often be identified as a new or changed growth on the skin that may often occur on the scalp, face, lips, ears, neck, chest, arms, hands or legs. The appearance of the growth depends on the type of cancer, but can appear as:
- Pearly or waxy bump
- Flesh-colored or brown scar-like lesion
- Firm, red nodule
- Crusted, flat lesion
- Large brown spot with darker speckles
- Mole that changes shape or color
- Shiny, firm bumps
As our skin ages, it loses fat and elasticity, becomes drier, and starts to sag, forming wrinkles. Years of sun exposure causes damage, sometimes invisible or barely visible and sometimes harmful. Our office treats signs and problems associated with aging skin, including age and liver spots (lentigines), wrinkles, telangiectasias (broken capillaries), bruising, cherry angiomas, assorted skin diseases (shingles, leg ulcers, seborrheic dermatitis) and cancerous and pre-cancerous problems including actinic and seborrheic keratoses, melanoma, basal and squamous cell carcinomas. Common elective procedures are BOTOX® injections, laser rejuvenation and chemical peels.
Acne is a common inflammatory skin condition resulting from clogged sebaceous glands. There are many different processes involved in the formation of acne, from genetics to bacterial infections. Everyone’s skin is different, thus everyone’s acne type is different. Here at Batra Dermatology, we customize an acne regimen that is right for your skin and follow your progress over the years to maximize your results. Don’t let acne rule your life. Our treatments include prescribed medications as well as cosmetic treatments. In recent years, lasers have been proven to be very effective adjunctive treatment of acne. The laser light is absorbed by water underneath the skin, shrinking oil glands and decreasing the counts of bacteria that contribute to acne.
The terms “eczema” or “dermatitis” are used to describe certain kinds of inflamed skin conditions including allergic contact dermatitis and nummular dermatitis. Eczema can be red, blistering, oozing, scaly, brownish, or thickened and usually itches. A special type is called atopic dermatitis or atopic eczema.
In teens and young adults, the patches typically occur on the hands and feet. However, any area such as the bends of the elbows, backs of the knees, ankles, wrists, face, neck, and upper chest may be affected. When it appears on the palms, backs of the hands, fingers, or on the feet, there can be episodes of crusting and oozing.
Other eczema patches in this stage are typically dry, red to brownish-gray, and may be scaly or thickened. The thickened areas may last for years without treatment. The intense, almost unbearable itching can continue, and may be most noticeable at night. Some patients scratch the skin until it bleeds and crusts. When this occurs, the skin can get infected.
Since the disease does not always follow the same pattern, proper, early, and regular treatment can bring relief and may reduce the severity and duration of the disease.
Psoriasis is a group of chronic skin disorders that cause itching and/or burning, scaling and crusting of the skin. Over 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 medication (for severe symptoms).
Allergic reactions can be triggered by many different sources, from new skin products to construction zones. Reactions from these triggers can manifest in skin rashes, hives, watery eyes, runny nose, etc. They best way to treat these reactions is to investigate the source of the trigger to inform the doctor at your time of visit. Here at Batra Dermatology, we can relieve your symptoms, but identifying and removing the trigger for the reaction is the only way to eradicate your reaction.
Vitiligo is a common skin condition in which patches of the skin lose pigmentation and appear white. These patches develop when melanin is not produced properly, and tend to spread over time as the condition progresses. Some patients may also experience premature whitening of the hair and a loss of color inside the mouth. Although not harmful, patients with vitiligo are often bothered by their appearance and may seek treatment to correct their skin tone.
Treatment for vitiligo depends on the severity of the condition, and may include oral or topical medications, UVB phototherapy, depigmentation or skin grafts. While there is no cure for this condition, treatment is often effective in improving the appearance of the skin.
Melasma results from sun exposure, causing a darkening of the skin. While there are no other symptoms or serious side effects, melasma can be cosmetically frustrating. Certain skin types are predisposed to develop melasma as well as those taking hormone supplements, such as birth control. Common affected areas include patches scattered on the face, the upper lip, and cheeks. There are many cosmetic treatments directed towards lightening the pigmented skin resulting from melasma, including chemical peels and laser skin resurfacing. We recommend a physical block sunscreen with active ingredients of zinc oxide or titanium dioxide to prevent your skin from developing melasma.
Sun-damage has varying degrees of presentation on the skin. A freckles, or lentigines, are actually a mild version of sun-damage! After years of sun-damage, the skin can develop solar elastosis, causing color and texture changes of the skin, giving it a red hue with crepiness. The more worrisome type of sun-damage presents as actinic keratoses. Actinic keratoses (Aks) are considered the earliest stage in the development of skin cancer. They are common lesions of the epidermis (outermost layer of the skin), and are caused by long-term exposure to sunlight. AKs are most likely to appear after age 40, however, in geographic areas with year-round high-intensity sunlight such as Florida and southern California, AKs may be found in persons as young as the teens and twenties. Half of all older, fair-skinned persons who live in hot, sunny areas have AKs. The most significant predisposing factor to AKs is fair skin and long-term sun exposure.
Chronic sun exposure causes skin cells to change size, shape, and the way they are organized. The skin cells affected in AKs are the keratinocytes. Keratinocytes are the tough-walled cells that make up 90 percent of the epidermis and give the skin its texture.
Changes in keratinocytes can be seen when the skin becomes rough, scaly, or mottled, and develops bumps or small horn-like growths. Further changes in cell growth can turn AKs into squamous cell carcinoma, a type of skin cancer.
Mohs Micrographic Surgery
Developed by Frederic E. Mohs, M.D. in the 1930s, Mohs Micrographic Surgery for the removal of skin cancer is a highly precise, effective method that excises not only the visible tumor but also any “roots” that may have extended beneath the skin surface. Five-year cure rates have been demonstrated up to 99 percent for first-treatment cancers and 95 percent for recurrent cancers.
Mohs surgery involves the systematic removal and microscopic analysis of thin layers of tissue at the tumor site until the last traces of the cancer have been eliminated. The immediate and complete microscopic examination and evaluation of excised tissue is what differentiates Mohs surgery from other cancer removal procedures. Only cancerous tissue is removed, minimizing both post-operative wound size and the chance of recurrence. In addition, the entire tumor is cleared and the site repaired in one session.
Mohs physicians are highly trained to function as surgeon, pathologist and reconstructive surgeon during the cancer removal process. Dr. Batra completed advanced training after her residency in a procedural fellowship accredited by the American College of Mohs Surgery as well as performed numerous skin cancer surgeries as Section Head of Dermatology and Dermatologic Surgery at renowned cancer hospital City of Hope National Medical Center. Mohs surgery is performed under local anesthetic in our state-of-the art office equipped with surgical and laboratory facilities, and supported by Mohs-trained nursing and technical staff.
Mohs surgery is most commonly used for basal and squamous cell carcinomas, although it can be recommended for the eradication of other cancers such as melanoma. Cancers that are likely to recur or have already recurred are often treated using this technique because it is so thorough. High precision makes Mohs surgery ideal for the elimination of cancers in cosmetically and functionally critical areas such as the face, hands, feet and genitals.
For more information, visit the American College of Mohs Surgery at http://www.mohscollege.org
Surgical excision is recommended for malignant (cancerous) and certain benign (non-cancerous) skin lesions. This procedure is performed under local anesthetic in our fully-equipped office and takes approximately 30 minutes, depending on the size of the lesion. Depending on the treatment area, it takes approximately 2-6 weeks to heal from an excisional procedure. Once the target lesion is removed, the area is brought back together with stitches to allow a faster healing time. These stitches may be dissolvable, where they will be absorbed by your body over the next 90 days, or non-dissolvable, where they will need to be removed in 7-14 days. We always recommended follow-up appointments after excisional procedures to address the cosmetic results of the scar. We optimize your scarring results with many tricks, including cortisone injections and laser treatments.