The General Dermatology Program provides a full range of high quality services for our adult and pediatric population. Headed by the Department’s Acting Chair, Dr. Babar Rao, and Program Director Dr. Amy Pappert, our team offers special expertise in skin care of common diseases of the skin such as psoriasis, rosacea, contact dermatitis, acne,warts and various skin cancers as well as rare skin diseases such as blistering diseases, hair loss disorders and lupus.
Patients with more complicated dermatologic problems that require closer monitoring, or those with associated medical conditions are seen in our Medical Dermatology clinics, which are also held most days of the week. We see patients with blistering diseases such as pemphigus vulgaris and bullous pemphigoid, moderate to severe psoriasis, unusual infections, skin lymphomas and other less common skin conditions. Treatments may include immunosuppressants, biologic agents and others systemic medications.
Although patients of any age are seen in the General Dermatology clinics, we also have a specialty Pediatric Dermatology clinic on Wednesday mornings. This clinic is staffed by a pediatric dermatologist who is an expert in the diagnosis and treatment of skin, hair and nail conditions in children.
The types of conditions that are generally seen in this clinic are eczema, acne, warts, viral rashes and other minor skin problems. In addition, children may get more uncommon types of skin conditions, such as psoriasis, hair loss, and contact dermatitis, which are evaluated and treated here. Birthmarks, hemangiomas, and other skin growths are evaluated, diagnosed and treated if needed. Minor surgical procedures (those that can be performed without general anesthesia or those that can be performed under local anesthesia) are done in the clinic. These procedures include treatment of warts, removal orbiopsy of skin growths, and some laser procedures.
Contact Allergy Testing Clinic
A common cause of skin rashes in people of all ages is allergy to any of a number of materials they encounter in the home and in the workplace. This is called “contact dermatitis,” and the rash may look something like eczema. The allergens, which are products, ingredients, chemicals, or materials that people may have an allergy to, include preservatives, fragrances, metals, cleansers, topical antibiotics, other topical creams and ointments, dyes, flavorings, and many others. In order to identify the cause of the rash, contact allergy testing also known as “patch testing”, may be done. This is different from the types of allergy testing that most allergists do like “prick testing” and RAST testing, in that no needles are used and no blood tests are done, instead, the allergens are taped onto the back. The taped allergens or “patches” are left on for 2 days, removed and read, then read again after 2 more days. In many cases, the cause of the rash is identified and the responsible allergen can then be avoided by the patient. In other cases, no allergy is found, and patients can be reassured that there is no allergy to the most common allergens.
Dermatologic Surgery and Other Procedures
A variety of procedures are performed in our clinics, and two afternoons per week are devoted solely to surgeries and procedures. Some of the procedures and treatment we offer are:
- Mohs Micrographic Dermatologic Surgery (chemosurgery): Mohs surgery is a precise method of tumor removal developed by Dr. Frederic E. Mohs. It is the most advanced and effective treatment for the eradication of basal cell carcinoma and squamous cell carcinoma with nearly a 100 percent cure rate. The procedure involves removal of the entire skin cancer layer by layer, while leaving as much of the normal skin as possible. It is the treatment of choice for facial skin lesions and recurrent lesions elsewhere. Many types of skin cancers can be treated in several hours, with reconstruction of the defect the same day. Dr. B. Rao leads the team in doing Mohs Micrographic Surgery in the clinic.
- Shave biopsy: Shave biopsy or “tangential excision” is a procedure which uses a sterile blade or a curved sterile razor blade to remove a skin surface growth off under local anesthesia. A “curette” does a similar task with a special scraping tool. These are often done to remove a small growth and confirm its nature by sending it for pathologic analysis, at the same time.
- Punch biopsy: Punch Biopsy is typically used by dermatologists to sample skin rashes or to remove small growths. After a local anesthetic is injected, a biopsy punch, which is basically a small (1 to 4 mm diameter) version of a cookie cutter, is used to cut out a cylindrical piece of skin. The hole may be closed with a suture and heals with minimal scarring.
- Excisional biopsy: Excisional biopsy is the process of removing the entire skin growth with the use of a sterile scalpel. Local anesthesia is injected to the area before the tissue is removed and the wound is repaired using sterile sutures. The skin growth removed is then sent for pathology for diagnostic purposes.
- Electrodessication and curettage (ED&C): ED&C is the scraping and burning of skin growths which is done for less serious skin cancers, pre-cancers and benign growths. A local anesthetic is injected, and then the abnormal tissue is scraped off with a curette. The area is then cauterized until bleeding stops. This may be repeated if the growth is cancerous. The wound will need to be dressed until it heals, and it usually leaves a small white mark after it heals.
- Intralesional Injections: Intralesional injection is the direct placement of a medication into a problem skin area through a very fine needle. Most often a dilute solution of triamcinolone (Kenalog) is used. Acne cysts, keloid scars, alopecia, psoriasis and chronic forms of eczema may be treated this way. If too much medication is used, a white spot or dent may develop, which is usually temporary.
- Cryosurgery (cryotherapy): Cryosurgery is used frequently by dermatologist to treat various skin problems. Liquid nitrogen is sprayed on to the area of skin involved. Light freezing causes peeling, moderate freezing may form blisters and hard freezing may form a scab. It is used for acne, scars, growths, pre-cancerous lesions and some skin cancers.
- Acne Surgery: Acne surgery is the process of removing acne lesions, usually by opening up comedones (blackheads) and pimples by using a needle or small pointed blade and expressing the keratin plug with an extractor.
Photodynamic Therapy and Phototherapy
These two procedures involve the use of light in the treatment of skin diseases. Phototherapy uses ultraviolet (UV) light to treat disorders such as psoriasis, vitiligo, severe eczema, and a certain type of skin cancer called cutaneous T-cell lymphoma. Patients come to our office to receive phototherapy treatments (narrow band UVB or PUVA) usually 2-3 times per week, while standing in a phototherapy booth. Although dermatologists generally recommend avoiding exposure to UV light, these skin problems may actually be helped by light treatments in many people. Since so many different skin conditions can look alike and each patient has different skin types, the UV treatments are designed to treat the specific condition in that specific patient unlike commercially available UV light, or “tanning” which should never be used.
Narrow UVB Phototherapy
Narrow UVB Phototherapy is a treatment for skin eruptions using artificial ultraviolet light. The initials UVB stand for the type B ultraviolet, the part of sunlight that gives one sunburn. Carefully controlled, it is an extremely effective tool for several serious skin diseases.
PUVA is a combination of psoralen (P) and long-wave ultraviolet radiation (UVA) that is used to treat several severe skin conditions. Psoralen is a drug that makes the skin disease more sensitive to ultraviolet light. This allows the deeply penetrating UVA band of light to work on the skin.
Photodynamic Therapy (PDT)
Photodynamic therapy (PDT) is also called photoradiation therapy, phototherapy, or photochemotherapy. It involves using drugs, called photosensitizing agents, along with light to kill cancer cells. The drugs only work after they have been activated by certain kinds of light. Depending on the part of the body being treated, the photosensitizing agent is either injected into the blood stream or applied to the skin. After the drug is absorbed by the cancer cells a light source is applied only to the area to be treated. The light causes the drug to react with oxygen, which forms a chemical that kills the cancer cells. PDT may also work by destroying the blood vessels that feed the cancer cells and by alerting the immune system to attack the cancer.
The Department of Dermatology at UMDNJ offers total patient care in regard to treatment of melanoma and pigmented lesions. Our physicians/ clinicians are at the forefront of the latest techniques and approaches to identify melanomas in patients with pigmented lesions and further identifying the best treatment options. Dr. Babar Rao is known nationally and internationally for his teaching and experience in Dermatoscopy which is one of the latest and most accurate methods of managing pigmented lesions. He is also currently involved in promoting confocal microscopy, which is another non-invasive diagnostic aid to differentiate malignant from non malignant lesions. Our staff is committed to the prevention, education, treatment and subsequent monitoring of patients presently suffering from these conditions as well as those individuals at risk.
- Screening and management of nevi and melanoma.
- Dermatoscopy, image analysis and dermatopathology.
Cosmetic and Laser Dermatology
The faculty physicians and staff of UMDNJ-RWJMG, Department of Dermatology are board-certified and highly trained to deliver high quality state-of-the-art aesthetic treatment options. If your interests include achieving a more youthful appearance, correction of fine lines/ wrinkles, scar treatment, removing unwanted hair and/or veins or elimination of age spots, we will help you to reach your goals. Together with the faculty physicians and staff, you will set expectations and develop a plan to best meet your needs.
We offer the following procedures:
- Laser assisted hair removal
- Laser treatment of vascular and pigmented lesions
- Laser skin rejuvenation
- Dermal Fillers
- Botox Cosmetic Treatment
- Chemical Peels