Acanthosis Nigricans



Acanthosis Nigricans - Right Axilla



Acanthosis Nigricans - This condition (in great need of a renaming) appears most commonly in skin of color and usually effects flexural areas like the armpits, groin, and neck. Affected areas are described in velvety in appearance. There is some link to families with a history of diabetes. Very benign and very refractory to treatment, although exfoliants are sometimes helpful to lighten the skin in the area.

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Epidermal Inclusion Cyst (EIC)

Epidermal Inclusion Cyst (EIC) - These benign cysts can be found anywhere on the body where there are hair follicles. If the base of a hair follicle weakens, it can become dilated. Dead skin, instead of making a clean eggress to the surface, moves retrograde and enlarges the cyst. Sometimes a cheesy white material that smells musty can exude from a central pore overlying the cyst. They are benign, but can sometimes become infected. Surgical excision is the treatment of choice.
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Confluent and Reticulated Papillomatosis (CARP)



CARP - upper back

 Confluent and Reticulated Papillomatosis (CARP) - Ok, last obscure one for a while. CARP is a condition of unknown cause. It's more common in skin of color and is characterized by a thickening of the epidermis. Treatments range from creams that exfoliate to minocycline. Can be cosmetically unsettling but is always benign.

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Macular Amyloidosis

Upper Back - Macular Amylodosis

Macular Amyloidosis. Here's an obscure one. See the brown discoloration between the purple pen marks? A condition brought about by vigrous scratching or rubbing, leaves behind this obscure protein called amyloid. Typically found on the upper back. Totally benign, but cosmetically undesireable. A real challenge to treat, but should subside with decreased scratching.


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SPIDER ANGIOMA

Spider angioma. These vascular lesions are dilations of small blood vessels (capillaries) near the skin's surface. They are never dangerous and tend to be more prominent in sun-exposed areas. One or 2 zaps with the  pulsed-dye laser does a nice job of getting rid of these without a scar.

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Acne Scarring

Acne Scarring - What the inflammation of acne leaves behind in its path (even acne that hasn't been picked!) can be just as emotionally impactful as acne itself. Deep or rolling scars such as these are commonly treated with a mix of technologies ranging from subcision (wherein a needle is introduced underneath the skin to break up fibrous bands), to pulsed-dye laser therapy, to deep dermal chemical peels like trichloracetic acid.

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Freckles

Ephelids or Freckles. We sometimes use glycolic acid or hydroquinone for these benign lesions, but nothing works quite like the Pulsed Dye Laser. 1 or 2 sessions usually does the trick and takes years off!

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Common Warts

Back to basics with warts. Hands and feet are usually the most recalcitrant to therapy. Usual therapies begin with liquid nitrogen or excision. 2nd line therapies include candida antigen and the pulsed dye laser. Always benign, always annoying with potential for self-esteem impact.

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