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Skin cancer, the gift that keeps on giving
February 4th, 2012
…well at least it’s not genital warts (see previous post). Once you get a skin cancer, unfortunately, you often will get more. The younger you are when you get one, the more likely you will have more in your lifetime. Almost everyone we treat with Mohs surgery has had a previous skin cancer elsewhere. It is important to prevent skin cancer in the first place by avoiding prolonged sun exposure and practicing common sense sun protection. Does that mean you have to be a recluse? No, but purposefully sunbathing is not very smart.
An experienced dermatologist can often recognize a skin cancer in its earliest stages, though every dermatologist has missed something at some point in their careers. (And if they claim they have not, they are big fat liars!). Therefore, we rely on patients to do their own self exam and observe any suspicious lesions for changes in color, shape, size and border, and to come in for periodic exams. Don’t let anyone freeze any lesions more than once without discussing the possibility of a biopsy for any persistent or recurrent lesion. The person that set the record in my office for the longest time spent in Mohs surgery in one day was a celebrity in his 40’s who had had a lesion frozen twice with two different dermatologists. He pulled through wonderfully and took it very well considering, but we were both dumbfounded at the extent that this tumor had grown.
I love what I do and I get the most satisfaction from educating my patients on their skin lesions and skin cancer, but I would rather not be cutting off parts of your nose, eyelids, lips, etc for your sake. Preventative care is really important.
Tags: basal cell cancer los angeles, basal cell carcinoma los angeles, dermatologist los feliz, dermatologist malibu, dermatologist pasadena, dermatologist san fernando valley, dermatologist santa monica, dermatologist west la. dermatologist glendale, melanoma los angeles, mole check los angeles, skin cancer los angeles, skin cancer screening los angeles, squamous cell cancer los angeles, squamous cell carcinoma los angeles
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What people in LA say
February 4th, 2012
Warning-offensive language. Funny video for the weekend. Scary thing is, I have said, “I just saw David Spade” (he saw my daughter and said, “look at the little girl in the hot pants” a bit disturbing?!), I take care of a star on Dexter, I love In and Out Burger, hiking in Runyon Canyon (but haven’t done it in about 5 years!), Intelligentsia coffee (which is from Chicago, not LA) and kale. I wish for parking karma, have misread parking signs even though I was a star student in AP English lit, and have sworn at parking enforcement. But don’t worry, I don’t hang out with Skeet Ulrich.
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RIP Robert Hegyes; RIP La Cachette
January 28th, 2012
Juan Epstein RIP
So sad to hear that he died. I loved Welcome Back Kotter as a kid. This was probably one of the only shows my brother made me watch that we both actually enjoyed. It had great characters including Juan Epstein, the Puerto Rican Jew, and a great theme song. He was my favorite Sweathog on the show. I liked the twinkle in his eye. He was a sweet-talker and a bit of a smart alec. The funniest running bit about his character were the fake excuse notes for missing class signed by “Epstein’s mother.” It is pretty funny reading some people’s comments on the internet today about his passing, “Juan won’t be in class today, he is in heaven. Signed, Epstein’s mother.”
Also, I was disappointed to hear that La Cachette just closed on the Eater LA blog that I follow. We had such a good time there recently.
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What is a dysplastic (atypical) nevus?
January 27th, 2012
This is a common diagnosis in Caucasian patients. A dysplastic (atypical) nevus is a mole that clinically (to the doctor’s eye) and microscopically has features that are atypical for a mole, but not quite enough to categorize as melanoma. They often look like large (>4 mm) or two-toned “fried eggs” and may be asymmetric or have blurry borders. However, I have diagnosed many under 4 mm in diameter. Many Caucasian patients have one or more of these and some have “dysplastic nevus syndrome” where the patient may have ten’s to more than one hundred atypical moles.
Not all dysplastic nevi need to be biopsied, however it is important to have an experienced dermatologist do regular total body exams and for the patient to do self exams. Often times, not all lesions need to be removed. We even do total body photography on some patients. Dysplastic nevi are now categorized as having mild, moderate or severe atypia on a biopsy report. This determines whether they need to be cut out again. Dysplastic nevi with severe atypia are what I like to call “pre-melanomas” which absolutely need to be removed.
Dysplastic nevi are not necessarily going to turn into melanoma, but are a marker for a much higher risk of melanoma in general. Therefore, anyone with these lesions should take extra precautions in the sun, as we know that sun does cause direct damage to moles as well as the skin in general. Because this also tends to be an inherited trait, it is important to have family members also screened
Tags: atypical mole, dysplastic nevi, dysplastic nevus, mohs surgery los angeles, skin cancer los angeles, skin cancer screening los angeles
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The gift that keeps on giving…
January 26th, 2012
…Not in a good way. Lately, we have had a streak of young men under the age of 40 with genital warts. Most of them were self-discovered, some on total body skin exams. It is an unpleasant and embarrassing subject and highly distressing for those who have them, since recurrences are frequent and the observation period for recurrence is prolonged. Luckily these days we have more treatments available than 15 years ago. We just got in some samples of Veregen ointment today which is based on green tea. I don’t think I’d use it as a first line treatment but definitely a good option for those worried about recurrence who’ve already been treated. If you are already in a relationship, it pays off to have both partners checked, as I had one married patient who had a recurrence after 15 years. If you aren’t, be careful out there!
My experiences lately are bringing back memories from my dermatology residency in NYC. Bellevue was the mecca of STD treatment for the NYC county clinics and I treated my share of them. One of my attendings in this clinic was a complete hoot and I have a funny story to share that shall go untold here in cyberspace.
Tags: condyloma, genital warts, veregen
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Restylane and laser for under eye bags
January 25th, 2012
Many patients ask about what can be done for the bags and wrinkles underneath their eyes. Luckily these days we have procedures which are minimally invasive that can make a significant difference. Last night I had the opportunity to attend a local dermatology meeting where colleagues could discuss their experiences with lasers and fillers for this problem. It is amazing how much we can do without any cutting these days and how little needs to be done.
Tags: laser, Restylane, restylane brentwood, Restylane Juvederm Malibu, restylane los angeles, restylane pasadena, restylane santa monica, restylane sherman oaks, resytlane glendale, tear troughs, under eye bags, under eye wrinkles
Posted in Juvederm, Restylane, Uncategorized | No Comments »
Brotox
January 11th, 2012
Apparently Dr. Oz had a segment about Bro-tox (men who get Botox). It is a popular procedure for men in business and the entertainment industry. While Botox is not a complicated procedure, because men require a larger dose of Botox, it is important that you choose a doctor who understands how to properly inject Botox and tailor treatment to your specific wrinkles, skin type and face. The biggest complications a male patient can have is having too much Botox put in, which can cause heavy brows and a frozen look, or improperly placed Botox which can feminize the eyes
Tags: botox beverly hills, Botox Brentwood, botox glendale, Botox Los Feliz, Botox Malibu, botox pacific palisades, botox pasadena, botox san fernando valley, botox san gabriel valley, botox santa monica, botox west la, brotox, brotox los angeles
Posted in Uncategorized | No Comments »
Restylane Discount Offer
January 11th, 2012
Restylane is offering a rebate of $40 per syringe (minimum 2) next month
Step 1: Receive Treatment February 1–March 31, 2012
Step 2: Postmark Submission by April 30, 2012
Complete the redemption form, include the product box end flap(s) showing the hologram, and mail it to us with your itemized treatment receipt (credit card receipts are not accepted).
Tags: restylane beverly hills, restylane brentwood, restylane los angeles, restylane los feliz, restylane malibu, restylane pacific palisades, restylane pasadena, restylane san fernando valley, restylane san gabriel valley, restylane santa monica, restylane sherman oaks, restylane west la, resytlane glendale
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Happy New Year!
January 5th, 2012
Hope you all had a nice holiday. We had a nice stay-cation in LA. My daughters got more Xmas gifts in one year than I think I received my entire childhood. One of my kids already figured out I am Santa 
The Escalade seen here stayed at Toys R’Us, but gave me visions of 14 years into the future. Yikes! I am totally exhausted from one of them running into my bed every night. I guess this will go on for possibly a couple of years.
This is a good time to initiate your fractionated CO2 laser treatments, Efudex, etc. I’ve been performing a lot of laser on brown spots, wrinkles and scars with very good results. They do often take multiple treatments so this is a good time to start.
Anyone remember the Ronco Mr. Microphone commercial?
Tags: fractionated CO2 laser, fraxel los angeles, fraxel pasadena, fraxel san fernando valley, fraxel santa monica, laser wrinkles brown spots los angeles, laser wrinkles brown spots pasadena, laser wrinkles brown spots san fernando valley, laser wrinkles brown spots santa monica
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