Services
Medical procedures available
Skin-care screenings
Skin cancer prevention and treatment is a very important part of our practice. For high-risk patients, we recommend an annual skin examination as a proactive approach to skin health and safety. Early detection is invaluable, while a delayed diagnosis can have damaging effects. A baseline skin cancer screening is recommended for most of our adult patients.
Patch testing
Patch testing is a common diagnostic tool used to identify specific substances that trigger contact dermatitis. Contact dermatitis is a localized irritation of the skin in response to a certain substance that is for most people harmless. A common example is poison ivy, although poison ivy is unusual because 70% of the population is allergic to it. Other substances cause allergy in a much lower percentage of patients. Symptoms may include redness, rash, blisters, hives, itching, and burning. The best protection against contact dermatitis is to identify the specific triggers that cause reactions, so that patients can avoid these substances as often as possible.
Although allergic contact dermatitis is similar to other allergies in that it triggers an immune system response, these triggers are external rather than internal. So testing for this condition is also done externally and does not require the use of any needles or injections.
The patch testing procedure is simple and painless. In order to identify specific triggers, your doctor will tape small metal cups that contain various potential allergens to the skin on the back. These chemicals are then left on the skin for 48 hours, and must remain dry during this time. The patient is then seen back in the office 1–3 days after removing the patches, to read the result. If a specific substance can be identified as the cause, avoidance of that substance can result in complete clearing of the skin rash.
Photodynamic therapy
Photodynamic therapy (PDT) is a three-step treatment used to treat actinic keratosis (pre-cancerous lesions) of the face through the use of a photosensitizing drug and a light source to activate it. PDT destroys abnormal cells that cause actinic keratosis. It can also minimize pores and reduce oil glands to treat acne.
During the PDT procedure, a topical photo sensitizer called Levulan (aminolevulinic acid) is applied to the skin and left for an incubation period of 30–60 minutes. After incubation, the Levulan is activated with a blue light for 8–16 minutes. Patients may experience sensations of warmth, tingling, heat, or burning during this part of the treatment. After light activation, the treated area is washed and patients can return home, but must stay indoors for 36 hours after treatment. Patients may experience slightly irritated skin for 1–3 days after treatment. One treatment may be all that is necessary for actinic keratosis, but treatments may be repeated as needed. This treatment may also be used to treat acne, which requires three treatments about two weeks apart. Treatment of actinic keratosis is covered by insurance, but acne treatments are not.
Ultraviolet light treatment
Ultraviolet light treatment uses a particular band of the nonvisible light spectrum to treat psoriasis and a variety of other skin diseases. Dr. Goldstein uses two types of ultraviolet light. Broadband UVB is a safe effective treatment for mild psoriasis which has been used since the 1920s. Three to five treatments a week for 4–6 weeks can lead to remission of psoriasis. PUVA is an acronym that stands for UVA light and a pill called psoralen that makes you sensitive to UVA light. The psoralen is taken 1½ hours before each treatment. This treatment is effective for moderate to severe psoriasis with three treatments a week for 4–6 weeks.