HEALTHY SKIN LOOKS GOOD ON YOU

VISIT A BOARD CERTIFIED DERMATOLOGIST IN SAN DIEGO COUNTY (LOCATED IN CHULA VISTA AND CORONADO)

Taking care of your skin is essential to your overall health. The Dermatology Institute has been taking care of our community for over 35 years and we continue to be dedicated to taking care of you and helping you achieve your healthy skin goals. A board certified dermatologist will work with you to establish a skin care treatment that eliminates dangerous conditions and leaves you with beautiful, healthy skin.
 

THE IMPORTANCE OF ROUTINE SKIN EXAMS

The primary purpose of routine skin screenings is to detect and prevent skin cancer. Nearly 1.5 million people in the United States are diagnosed each year with skin cancer and early detection is key. One person dies an hour of melanoma in the world, and early detection by having an exam by an expert can lead to early detection. Over 68,000 are diagnosed with melanoma annually. The most important means of detecting a melanoma is regular skin checks. Self-exams monthly, evaluating moles for the ABCDEs, as well as an annual skin examination, are the keys to the early detection of melanoma.

 

SOME OF OUR SPECIALTIES

Hair Loss

Hair loss is caused by various reasons such as autoimmune conditions, genetic factors, hormone changes, tissue scarring from injury, stress etc. It may manifest as gradual thinning, circular bald spots, sudden loss of hair, full body hair loss or patches of scaling that spread over the scalp. Treatments can include medications (topical or systemic) and/or PRP (platelet rich plasma). We also offer a treatment call PRF (platelet rich fibrin) by Selphyl which is very effective in promoting hair growth. We provide prescription treatments including oral therapies with either finasteride, minoxidil, or spironolactone. In addition, we prescribe topical minoxidil regimens that are more effective than over the counter readily available foams.

Acne

Acne or acne vulgaris is a skin condition that affects the skin's hair follicles. Acne is most common amongst teenagers, however can often affect adults as well. Multiple factors contribute to breakouts, including bacteria, hormones, genetics and inflammation. We pride ourselves on offering comprehensive treatments including acne facials, acne surgery, intralesional kenalog and drainage of cysts, chemical peels for acne, in addition to a thorough topical regimen.

Moles / Melanoma

Advanced Mole and Skin Cancer Procedures in the San Diego Area Including Chula Vista, Imperial Beach, and Coronado

Benign moles are referred to as “melanocytic nevi.” They appear as tan to dark brown spots or bumps on the skin, lips, and even eyes. Moles are nests of melanocytes—the pigment producing cells in the skin. Moles are present on almost every individual and develop in the first few decades of life. Moles can occur anywhere including the scalp, genital area, and mucous membranes. A birth mole is called a “congenital nevus.” Birth moles should grow proportionately with the body and be monitored regularly. The tendency to develop great numbers of moles runs in families. Having approximately 40-50 moles or more increases the chance of developing melanoma. Heavy sun exposure, including tanning beds, also increases the number of moles.

The ABCDEs have been developed to help patients recognize changes in moles. These changes could herald a transformation into atypical moles called “dysplastic nevi” or even melanoma. An explanation of the ABCDEs rule is explained below:

“A” = Asymmetry:

Moles should be symmetrical. If one side is different from the other, the mole should be investigated.

“B” = Border:

The border of the mole should be regular, sharp, and well-defined.

“C” = Color:

Uniform color should exist in the mole. More than 2 colors indicate an atypical mole.

“D” = Diameter:

Moles should usually be 6 mm or smaller in diameter. This is about the size of an eraser on a pencil.

“E” = Evolution:

New or changing moles should be examined by a physician. These changes can include changes in how the mole looks or new symptoms to the mole including itching, pain, bleeding, or ulceration.

Dysplastic Nevi

Atypical moles or “dysplastic melanocytic nevi” or “Clark’s nevi” are terms reserved for unusual moles. These moles look atypical both clinically and under the microscope. Dysplastic nevi are genetically inherited. The presence of dysplastic nevi greatly increases the risk of melanoma. Dysplastic nevi can be precursor lesions to melanoma. Individuals with 10 dysplastic nevi increase their risk of melanoma 12-fold compared to the general population (according to the Skin Cancer Foundation). Individuals with atypical moles should conduct monthly self-examinations and be examined at least annually by a dermatologist. Patients with larger numbers of dysplastic nevi should undergo a full skin examination every 6 months. New or changing moles should be evaluated and may require a biopsy to evaluate for cellular changes under the microscope.

Mole Removal

If a mole is changing or is otherwise concerning, a shave biopsy may be recommended. This quick in-office procedure consists of injecting local numbing medicine and removing the affected mole. The procedure takes approximately 5 minutes and leaves a minimally detectable scar. Benign moles may either be removed by shave or surgical excision.

Melanoma

Melanoma is a deadly form of skin cancer. Early detection is the key to long-term survival. In 2010, melanoma was the 6th most common form of skin cancer. There is a strong genetic linkage to melanoma. Risk factors for melanoma include a personal history of melanoma, a first-degree relative with melanoma, a personal history of atypical moles, a history of sunburns, and light skin, hair, or eye color. UV tanning booth exposure has also been linked recently to the development of melanoma. Melanomas often appear as multicolored or very dark atypical moles. Melanomas can often be flat, although raised or nodular melanomas also occur. Amelanotic melanomas can be tan or pink in color. Melanoma can occur anywhere on the body including sun-protected areas. The palms and soles, genitalia, anus, eyes, and mouth all may develop melanoma. Melanoma is a life-threatening diagnosis. Survival from melanoma is directly related to the thickness of a melanoma. Thin melanomas have a very high cure rate following surgical excision. Thick melanomas may metastasize to lymph nodes or other organs. Important prognostic factors from the microscopic examination of melanomas include first and foremost, the melanoma thickness (measured in mm), the presence or absence of ulceration, cellular mitoses, and lymphocytic response. The most important means of detecting a melanoma is regular skin checks.

If you are in the San Diego area and would like to discuss your skin cancer treatment options or would like to set up a skin cancer screening, call Dr. Peter (father) or Dr. Jennifer (daughter) Rullan at 619-426-9600 to schedule your appointment.


 

Other Dermatologic Conditions We Treat

  • Psoriasis
  • Ichthyosis
  • Vitiligo
  • Hives
  • Seborrheic Dermatitis
  • Birthmarks
  • Blistering disorders
  • Connective tissue disorders (Lupus, Morphea, Scleroderma, Dermatomyositis)
  • Herpes
  • Keratosis pilaris
  • Nail disorders (bacterial and fungal)
  • Infections of the skin (bacterial, fungal, viral)
  • Scabies
  • Tinea Versicolor
  • Alopecia / Hairloss

    Hair loss is caused by various reasons such as autoimmune conditions, genetic factors, hormone changes, tissue scarring from injury, stress etc. It may manifest as gradual thinning, circular bald spots, sudden loss of hair, full body hair loss or patches of scaling that spread over the scalp.  

    Treatments can include medications (topical or systemic) and/or PRP (platelet rich plasma). We also offer a treatment call PRF (platelet rich fibrin) by Selphyl which is very effective in promoting hair growth. We provide prescription treatments including oral therapies with either finasteride, minoxidil, or spironolactone. In addition, we prescribe topical minoxidil regimens that are more effective than over the counter readily available foams.  

    PRF (platelet rich fibrin) or PRP (platelet rich plasma)

  • Eczema

    WHAT IS ATOPIC DERMATITIS

    Learn about the most common form of eczema.
    Also called: Eczema
    This is a common skin disease in children. It is so common that people have given it a few names:

    • Eczema (name most people use)
    • Dermatitis
    • Atopic eczema
    • Atopic dermatitis

    To avoid confusion, we’ll use the medical term atopic dermatitis.

    Children often get atopic dermatitis (AD) during their first year of life. If a child gets AD during this time, dry and scaly patches appear on the skin. These patches often appear on the scalp, forehead, and face. These patches are very common on the cheeks.

    No matter where it appears, AD is often very itchy. Infants may rub their skin against bedding or carpeting to relieve the itch.

    In children of all ages, the itch can be so intense that a child cannot sleep. Scratching can lead to a skin infection. Because atopic dermatitis can be long lasting, it is important to learn how to take care of the skin. Treatment and good skin care can alleviate much of the discomfort.

    It is rare for adults to get AD. Most people (90%) get AD before age 5. About half (50%) of people who get AD during childhood continue to have milder signs and symptoms of AD as an adult. When an adult has AD, it often looks different from the AD of childhood. For adults, AD often:

    • Appears in the creases of the elbows or knees and nape of neck
    • Covers much of the body
    • Can be especially noticeable on the neck and face
    • Can be especially bad around the eyes
    • Causes very dry skin
    • Causes non-stop itch
    • Causes scaly skin — more scaly than in infants and children
    • Leads to skin infections

     

    Years of scratching caused permanently thickened skin on this woman’s hand and wrist. This skin always itches. If a person has had AD for years, patches of skin may be thick and darker than the rest of the skin (or lighter). Thickened skin can itch all the time. Adults who had AD as a child and no longer have AD can have the following:

    • Extremely dry skin
    • Skin that is easily irritated
    • Hand eczema
    • Eye problems (eczema on eyelids, cataracts)
  • Acne & Rosacea

    Acne or acne vulgaris is a skin condition that affects the skin's hair follicles. Acne is most common amongst teenagers, however can often affect adults as well. Multiple factors contribute to breakouts, including bacteria, hormones, genetics and inflammation. We pride ourselves on offering comprehensive treatments including acne facials, acne surgery, intralesional kenalog and drainage of cysts, chemical peels for acne, in addition to a thorough topical regimen.

    Rosacea is an inflammatory skin condition that is characterized by facial redness, small and superficial dilated blood vessels on facial skin, papules, pustules, and swelling. Rosacea is a very common skin condition affecting all skin types and ages. Treatment for Acne and Rosacea is multifaceted and best when customized by a dermatologist. Dermatology Institute will provide you with the best prescription regimen available, in addition to supplemental topical regimens. The various means of treatment include oral & topical antibiotics, isotretinoin (for the treatment of oily skin with red bumps), and laser with Vbeam Perfecta Pulse Dye Laser.

 

LASERS THAT MAKE OUR CLINIC UNIQUE

TARGETED 311NM PHOTOTHERAPY (EXIMER LASER)


The excimer laser is an effective form of treatment for inflammatory skin conditions such as psoriasis. This advanced device offers patients a safe, successful and minimally invasive solution to the red, itchy skin caused by psoriasis flare-ups. The excimer laser delivers targeted beams of intense laser light to clear lesions and provide significant relief without damaging nearby healthy skin. Each excimer laser treatment session takes only a few minutes to perform in the doctor’s office, with no anesthesia needed. The laser energy can be precisely delivered to lesions nearly anywhere on the body, including previously hard-to-treat areas such as the elbows and knees. The results of the excimer laser treatment can last for six months or longer.


NARROW BAND UVB LIGHT THERAPY


Ultraviolet light B (UVB) therapy is a minimally invasive procedure used to effectively treat the itching, burning and crusting of psoriasis. By exposing the skin to an artificial UVB light source on a regular schedule, growth of abnormal skin cells is slowed and the condition slowly heals. In addition to treating psoriasis, UVB therapy can also be used to treat vitiligo.


PHOTODYNAMIC THERAPY (PDT)


Photodynamic therapy (PDT) uses light and a light-sensitive dye to treat acne and other skin condition. It is also being tested for the treatment of bacterial infection and skin conditions such as psoriasis and sun-damage. The number of non-melanoma skin cancers is increasing worldwide, and so also the demand for effective treatment modalities. Topical photodynamic therapy (PDT) using aminolaevulinic acid (Levulan®) is especielly helpful when treating large areas with pre-cancers (actinic keratoses) and areas with field cancerization. The cure rates are usually good, and the cosmetic outcomes excellent. The only major side effect reported is the pain experienced by the patients during treatment, although for many it is mild or tolerable. The main advantages of topical PDT are that the method is non-invasive and effective, and generally gives a good cosmetic outcome.


EDUCATIONAL RESOURCES

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