Psoriasis is a skin condition characterized by inflammation, pain, itching, and bleeding when the skin is broken. There are multiple types of psoriasis but they are commonly distinguished by elevated, red plaques of skin that are covered with white to silver scale. Psoriasis is frequently associated with pain, discomfort, and social embarrassment. There is no cure for psoriasis, but recent therapeutic advances have given new hope to patients who suffer from this disease.
What is Psoriasis?
Psoriasis is a common and recurring condition in which the skin develops red patches of various sizes, covered with dry, silvery scales. Most often, it affects the scalp, the trunk of the body and the outer side of the arms and legs, especially the elbows and knees. The palms and soles may also be involved. Fortunately, the face is usually spared.
How is it treated?
Naturally, your doctor knows best what is likely to help your particular case. He or she will discuss your psoriasis with you and choose the treatment that seems most suitable.
One excellent treatment for Psoriasis is XTRAC Laser Treatment. Dermatology & Advanced Skin Care is pleased to be the only office in Howard County to offer XTRAC Laser Treatment for psoriasis.
Using an intense beam of focused laser light, the XTRAC laser gets right to the area of concern, leaving healthy surrounding tissue alone.
The XTRAC excimer laser treatment system offers psoriasis sufferers many benefits. Depending on the extent and severity of your psoriasis, these can include:
- Effective clearing—generally in 10 or less brief sessions
- Provides long-lasting relief—typically several months free of symptoms
- Quick, easy, painless treatment—sessions last only a few minutes
- Relief without messy creams and daily skin care regimen
- Covered by most major insurance companies
Surgery Preparation and Wound Care
Preparation Checklist for Minor Surgery
7 days prior to surgery avoid:
- Prescription blood thinners
- DO NOT discontinue any medication unless instructed by your physician
3 days prior to surgery avoid:
- Ibuprofen (e.g. Advil, Nuprin, Motrin)
- Herbal supplements (e.g. Garlic, Ginko, Ginseng)
- Arthritis pain relief medication (e.g. Celebrex, Vioxx, Naprosyn, Aleve)
- Alcohol consumption
- Vitamin E
Please let us know if you have or ever had any of the following conditions:
- High blood pressure
- Heart disease
- Mitral valve prolapse
- A cardiac pacemaker
- Bleeding problems or taking blood thinners
- Kidney trouble
- Poor healing or bad scarring
- Herpes virus infection of the face (fever blisters, cold sores)
- Yellow jaundice
Valve damage or Endocarditis may require pre-operative antibiotics. Please consult with us.
You may eat regularly scheduled meals prior to your surgery. Surgeries are performed under a local anesthetic. You should be able to drive yourself to and from your appointment.
If you develop any illness with a fever less than 48 hours prior to your scheduled surgery, please call the nurse's line at 410-203-0607 Extension 203.
Wound Care Instructions
- Within 24 hours, remove the dressing. If showering/ bathing at this time you can gently wash the wound with soap and water. Otherwise, follow the directions below.
- Twice daily, clean wound with Hibiclens (Clorhexidine). This can be purchased at your grocery store or pharmacy. After cleansing, apply Vaseline or Aquaphor to the wound. Use a topical antibiotic ointment only if instructed by your physician. Cover with a band-aid or gauze dressing until the wound heals smooth to the surface (usually 7-14 days). Vaseline and Aquaphor will speed the wound healing process.
- DO NOT allow a thick crust to form. This will increase scarring. If the wound develops a crust, use warm compresses for 10 minutes, 2 to 3 times daily to remove crusting and then reapply Vaseline.
- If Duoderm pad is used, it may remain in place up to 24-48 hours this pad make its own healing gel and some may ooze out from the edges of the pad. This is normal. If the oozing is excessive (or after 48 hours), change the pad. Clean the area with Hibiclens (Clorhexidine) and reapply new patch as instructed.
- If the wound develops a thickening scar after 4 to 8 weeks, call the office to schedule a follow-up appointment to have the scar examined and to discuss possible treatments.
- The wound may stay pink for several months. Protect it from the sun with SPF-30 sunscreen.
- Infection: Tenderness, swelling, redness, pus, and odor can be signs of infection. Please monitor this closely. If there is no improvement in 12 to 24 hours, call the office at 410-203-0607.
This special advanced technique involves removing skin cancer and examining inked and stained sections of frozen skin under the microscope. The skin cancer is carefully and completely mapped until all areas in which cancer has been demonstrated are shown to be free of any tumor. The main difference between Mohs micrographic surgery and traditional methods of treating skin cancer is this immediate microscopic control.
When is Mohs micrographic surgery indicated?
Mohs is now recognized as the most precise method of removing skin cancer. It is especially effective in treating cancers of the face and other cosmetically sensitive areas because it can virtually eliminate all cancer cells while causing minimal damage to the surrounding normal skin. It is also ideal in removing recurrent skin cancers because in these tumors the clinical margins are often hard to appreciate and subtle nest of cancer can be embedded within scar tissue and normal-appearing skin. Extremely high cure rates (97-99%) can be achieved with Mohs micrographic surgery even for recurrent cancer. Other considerations in choosing Mohs micrographic surgery include an invasive or aggressive appearance under the microscope, an excessively large or very deep tumor, any tumor with poorly borders that are difficult to see, areas known to have high recurrence rates (for example nose, ear, eyelid), and any cosmetically or functionally important area (for example nose, ear, eyelid, digits, penis).
How is Mohs micrographic surgery performed?
The first step involves removing the visually apparent tumor with a surgical scalpel. The specimen is then cut into pieces as if a pie. Each piece is color-coded and systematically mapped onto a precise diagram of the site so that a carefully created depiction of the tumor area and the pieces of the removed skin is created. A trained Mohs histotechnician then prepares frozen sections of these tumor pieces under the supervision of the Mohs surgeon. The tumor is removed and tissue processed in such a way that the depth of the tissue submitted and the most peripheral skin edge will be available for microscopic examination. In this way, both the deep and lateral margins can be completely examined. If residual tumor is identified additional stages are undertaken until a cancer-free plane is achieved.