Did you know that one in five Americans will develop Melanoma in their lifetimes? Early detection is key! Now is the time to schedule your skin check and download SpotCheckApp for your convenience!
We are here for you seven days a week, NYC. Let's have a healthy and safe summer!
www.bobbybukamd.com
www.drbobby.com
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Tuesday, May 14, 2013
Tuesday, April 23, 2013
Patient Question: How Does Accutane Work?
Isotretinoin (Accutane) is perhaps the most powerful medication we have in our armamentarium against acne. Not only does it greatly decrease active acne lesions, it has a remarkable durability, usually resulting in clearance for years after the end of a therapeutic course. Your medication course is typically weight-based and can last 4-6 months depending upon how many milligrams you take each day. Side effects are dose-dependent, meaning the more Accutane, the more side effects. Dryness is far-and-away the most common side effect we notice in patients receiving Accutane. It's not a good or bad sign and won't affect the overall length of your course; it's just one of the common side effects experienced on this medication. Very severe acne sufferers may notice a temporary worsening of their acne prior to overall improvement, but usually it's a steady improvement from Day 1. In my experience, the most notable results are seen during months #2-3.
Acne scarring is unfortunately a separate topic altogether. Accutane may make scars appear redder, but typically won't improve them. It just works on active acne lesions. But don't despair! There are presently amazing treatments for acne scarring, with laser and chemical peels being the most routinely used among them.
www.bobbybukamd.com www.drbobby.com www.wbderm.com www.williamsburgderm.com
Wednesday, April 10, 2013
Patient Question:
A patient recently asked a fantastic question that we think makes sense to share with all of you!
"I Have a Birthmark Which is Lighter Than my Surrounding Skin. Is There Any Treatment for That?"
Lighter or "hypopigmented" birthmarks can range from collections of pigment high in the dermis (rather than spread throughout) to vascular insufficiencies that result in a harmless patch of whitish skin. Nearly all hypopigmented birthmarks are benign, however, there are a few that may be a indication of an inherited syndrome (like ash leaf spots in Tuberous sclerosis).
Admittedly, no matter what the cause, repigmenting skin is far more challenging for dermatologists than lightening darker birth marks which can be a challenge in its own right. If the hypopigmented birthmark is small enough, we can excise it and bring normally colored skin on either side together to even the skins appearance.
www.bobbybukamd.com www.drbobby.com www.wbderm.com www.williamsburgderm.com
"I Have a Birthmark Which is Lighter Than my Surrounding Skin. Is There Any Treatment for That?"
Lighter or "hypopigmented" birthmarks can range from collections of pigment high in the dermis (rather than spread throughout) to vascular insufficiencies that result in a harmless patch of whitish skin. Nearly all hypopigmented birthmarks are benign, however, there are a few that may be a indication of an inherited syndrome (like ash leaf spots in Tuberous sclerosis).
Admittedly, no matter what the cause, repigmenting skin is far more challenging for dermatologists than lightening darker birth marks which can be a challenge in its own right. If the hypopigmented birthmark is small enough, we can excise it and bring normally colored skin on either side together to even the skins appearance.
www.bobbybukamd.com www.drbobby.com www.wbderm.com www.williamsburgderm.com
Wednesday, March 6, 2013
Burns: New Treatments!
Burn injuries have afflicted mankind since the dawn of history. Today, they represent one of the most potentially devastating and challenging conditions in medicine. Over one million burn injuries occur annually in the United States, with the majority being treated in an outpatient setting. Children up to 4 years of age and working age adults comprise nearly 90% of patients with burn injuries. Injuries to children largely involve scald injuries whereas flame burns are predominant in the working age population. Their presentation varies considerably, from simple sunburns requiring no more than counseling and a topical agent to extensive tissue loss resulting in multi-organ system failure and a protracted ICU course. In more serious cases, it is imperative that burn care extend far beyond the initial insult. Burns can significantly alter quality of life and are a common cause of disability. Debilitating contractures and cosmetically unacceptable scars can have long-lasting physical and psychological consequences, requiring the physician to be supportive and dedicated to continuing patient care.
Careful assessment of burn depth is a critical step in determining appropriate management. It is important to keep in mind that most burns represent a mixture of different depths. Superficial or first-degree burns involve only the epidermis. They are painful and have an erythematous, glistening appearance without blister formation. Capillary refill is brisk, as is bleeding on pin-prick. The classic example is a sunburn, although superficial burns are frequently caused by flash burns as well.
Partial-thickness or second-degree burns involve the epidermis and part of the dermis. They are further subdivided into superficial and deep partial thickness burns depending on the depth of dermal involvement. Superficial partial-thickness burns are pink and painful with delayed capillary refill. They will generally heal in 2 to 3 weeks without any significant amount of scarring, although depigmentation of the affected skin is possible. Scald burns typically result in superficial partial-thickness burns.
Deep partial-thickness burns are characterized by injury extending into the reticular (upper) dermis. They appear "cherry red" or pale and dry with mottling. Sensation is variable and these burns are generally less painful to touch. They will not blanch with gentle pressure and bleeding from pin-prick will be delayed. The rate of healing is variable, depending on the number of intact adenexal structures left in the skin. As a result, thin, hairless skin (e.g. eyelids) will heal more slowly than thick or hairy skin (e.g. back, scalp). Typically, these burns will heal in 1 to 3 months, but with a significant amount of scarring and possible contractures. Often, they are best treated by excision and grafting.
Full-thickness or third-degree burns extend through the entirety of the dermis. They appear dry, leathery and can be white, brown, or black. These wounds are insensate, do not blanch, and do not bleed upon pin-prick. Thrombosed vessels may be visible and are pathognomonic for third-degree burns. Some clinicians describe fourth degree burns, which extend completely through the skin and subcutaneous tissues, affecting underlying muscle and bone.
Assessing burn depth requires experience and often takes several days of observation to determine the appropriate management. Patients may be admitted for observation and re-examined every day as the appearance of the wound becomes clearer. Generally, the wounds that appear likely to heal within three weeks can be managed conservatively, whereas those that will take longer may require grafting.
www.bobbybukamd.com www.drbobby.com www.wbderm.com www.williamsburgderm.com
Tuesday, December 4, 2012
Weathering The Storm...
We were half-way through the rebuild of our South Street Seaport office last month when the Buildings Department condemned our entire block.Front Street has been evacuated by the Mayor’s Office, so that the City can focus on badly damaged underground sewage and electric systems. The estimated shut-down of power, running water, and heat is expected to last 4-6 months.In the meantime, our Upper West Side and Williamsburg locations remain open and we’ve expanded hours to include weekends. That’s right, Saturday and Sunday 9am-7pm!We recognize that our downtown patients still need great dermatologic care, and have begun construction of a new office on Sullivan and West 3rd Street in Greenwich Village. I will do everything I can to open our doors there by February 2013. (www.greenwichvillagedermatology. com) Our Financial District, Tribeca, C-Town, and Battery Park neighbors have gone through a tremendous disaster. Patients have shared with us devastating stories of homes lost, businesses destroyed, and families still without power for weeks.
For those patients experiencing financial hardship because of Hurricane Sandy, we are waiving all medical co-pays through February 2013.
Simply alert our front desk when checking-in at your next visit.
We deeply value your loyalty to our practice now more than ever. You’ve placed your confidence in us through 5 years of caring and we will return to the Seaport when the City deems it safe again.And now on to news and our quarterly newsletter…We’ve published a book! It’s not exactly bedtime reading, but for those of you “armchair dermatologists” out there, I believe you’ll find plenty of great information on Skin Emergencies.
Wishing you all the happiest of holidays and thank you so very much for all your support! Please check our website for updates on the new Greenwich Village office! Looking forward to getting back to work downtown!
www.bobbybukamd.com www.drbobby.com www.wbderm.com www.williamsburgderm.com
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