Dermatologist is the medical and surgical expert you should consult if you have any significant problem with your skin. Dermatology is the science that is concerned with the diagnosis and treatment of diseases of the skin, hair and nails.

The skin is the largest and most visible organ of the body. It reflects the health of the body and acts as a barrier against injury and bacteria. Common skin problems seen in dermatology office include: acne, psoriasis, eczema, allergic dermatitis, irritating or suspicious moles, various skin growths, boils, ringworm, herpes, warts to name a few. Unfortunately, at one time or another, nearly everyone has some type of skin disease - infants, children, teenagers, adults and the elderly. One in six (15%) of all visits to the family doctor (GP) involves a skin problem.

Comprehensive Dermotology Center offers these skin care services:

Patch Testing for Contact Allergens

For patients with chronic eczema or those who do not respond well to therapy, patch testing may be indicated. This diagnostic test provides information regarding possible sources of an allergic or irritant contact dermatitis.

For this diagnostic test, large pieces of medical tape with chemicals applied to small disks are placed on the back of unaffected skin. The patches remain on the person for 2 days (48 hours) and removed. Sensitivities to the chemical agents are identified at that time, and patients are asked to return in 1-3 days for a 2nd reading. Showers and baths are not permitted during the patch test, but patients are allowed to sponge bathe. At that time, literature is provided to the patient regarding his/her sensitivities, and the patient is instructed to avoid these chemicals. Patients follow up in 2 weeks to further discuss results and additional treatment options.

Patch testing is different from allergy testing. Allergy testing allows the physician to identify causes of allergies, including foods, dust, mites, grass, etc. Patch testing, on the other hand, helps identify causes of rashes. For example, hair dressers are often sensitive to paraphenylenediamine, a substance used in hair dyes; atopic dermatitis patients are typically sensitive to nickel.

Most dermatologists use the pre-packaged 24 panel Alloderm True Test patch test kits, primarily because of its convenience. However, we have found that we are only able to detect a subset of relevant allergens using the True Test. Thus, at Comprehensive Dermatology Centre, we perform a 45 panel patch test that is used and approved by the North American Contact Dermatitis Group. In addition to standard allergens, we test for steroid sensitivities, preservatives, rubber products, metals, and clothing dyes.

Chemical Peels

Chemical peeling uses a chemical solution to improve the skin's appearance. It can reduce or eliminate fine lines under the eyes and around the mouth, correct uneven skin pigmentation, remove precancerous skin growths, and soften acne or treat scars caused by acne. The procedure can also treat wrinkles caused by sun damage and scarring, as well as skin blemishes common with age and heredity. Chemical peels can be performed on the face, neck, chest, hands, arms, and legs. Depending on the depth of treated areas, chemical peels can be classified into superficial peels such as Glycolic acid and Jassners' chemical peels, and medium depth peel such as Trichloracetic Acid (TCA) Peel. Depending on the individual need, Dr. Xue will recommend different type of peel for proper indication.

Sclerotherapy - Leg Vein Treatments

We can successfully treat spider veins with a minimally invasive procedure called sclerotherapy. Spider veins are small, dilated skin veins. The microinjection technique (sclerotherapy) consists of instilling a solution into these tiny capillaries using very fine needles. Fading of spider veins is a slow process and improvements may continue over the course of several months. Sclerotherapy can remove spider and varicose veins but it does not prevent recurrence.

Moles

Everyone has moles, sometimes 40 or more. Most people think of a mole as a dark brown spot, but moles have a wide range of appearance. Normal Mole Moles can appear anywhere on the skin, alone or in groups. They are usually brown in color and can be various sizes and shapes. The brown color is caused by melanocytes, special cells that produce the pigment melanin.

Different Types of Moles

Recent studies have shown that certain types of moles have a higher-than-average risk of becoming cancerous. Some may develop into a form of skin cancer known as malignant melanoma. Sunburns may increase the risk of melanoma. People with many more moles than average (greater than 100) are also more at risk for melanoma.

Moles known as dysplastic nevi or atypical moles are larger than average (usually larger than a pencil eraser) and irregular in shape. They tend to have uneven color with dark brown centers and lighter, sometimes reddish, uneven borders or black dots at edge. These moles often run in families.

Persons with dysplastic nevi may have a greater-than-average chance of developing malignant melanoma. These people should be seen regularly by a dermatologist to check for any changes that might indicate skin cancer. They should also learn to do regular self-examinations, looking for changes in the color, size or shape of their moles or the appearance of new moles. They should also shield their moles from sun exposure using sunscreen and/or clothing.

Recognizing the early warning signs of malignant melanoma is important. Remember the ABCD's of melanoma when examining your moles.

A stands for ASYMMETRY, when one half of the mole doesn't match the other half.	B stands for BORDER, when the border or edges of the mole are ragged, blurred or irregular.
C stands for COLOR, when the color of the mole is not the same throughout or if it has shades of tan, brown, black, red, white or blue	D stands for DIAMETER, when the diameter of a mole is larger than 6mm, about the size of a pencil eraser.

If a mole displays any of these signs, it should be checked promptly by a dermatologist; If the appearance of a mole worries you or if it changes suddenly in any way, you should consult a dermatologist. At Comprhensive Dermatology Center, Dr. Xue routinely perform full body skin exam to check suspicious moles especially in high-risk population (red hair and fair skin, history of sun burn and skin cancer and family history of skin cancer) and he has extensive experience in detecting and treating early suspicious moles.

Restylane® Injection Restylane is a safe and natural cosmetic dermal filler that restores volume and fullness to the skin to correct facial wrinkles and folds, such as the ones from the nose to the corners of the mouth. Clinical studies have shown the average Restylane treatment results can last six months or even longer. Restylane is a cosmetic dermal filler made of non-animal based hyaluronic acid. Hyaluronic acid is an natural substance in the human body used to provide fullness and volume to the skin. Restylane is proven to deliver a longer lasting effect than traditional collagen, so treatments are typically scheduled twice a year. (Individual results may vary.) Restylane is injected directly into the skin in tiny amounts by an ultra fine needle, resulting in minimal discomfort. The procedure is simple and convenient and results are practically instantaneous.

Skin Cancer and Treatments

Skin cancer is one of the most common forms of cancer. It can be found in any area of the body, but a large number of them occur in exposed parts of the body e.g. face, neck, arms, and hands. Anybody can get skin cancer, but it is most common in Caucasians. Ultraviolet rays from the sun, sunlamps, and tanning beds are primary reasons for skin cancer.

Fortunately, most basal cell and squamous cell carcinomas can often be completely cured by fairly minor surgery and sometimes by application of medicines to the skin surface. There are many different kinds of surgery for these cancers. The type of treatment chosen depends on how large the cancer is, where it is found on the body, and the specific type of nonmelanoma skin cancer. For certain squamous cell cancers with a high risk of spreading, surgery may sometimes be followed by radiation or chemotherapy. Early melanoma can be excised with excellent cure rate, late stage melanoma however often poses poor prognosis.

Melanoma

Basal Cell Carcinoma

Squamous Cell Carcinoma

Simple excision (this is the same as an excisional biopsy): The tumor is cut out with a surgical knife, along with some surrounding normal skin. The remaining skin is carefully stitched back together. This will leave a scar.

Simple excision with wound closure is still the gold standard for treating a majority of skin cancers of trunk and extremities. Sometimes, the skin cancer of facial areas can also be effectively excised. With careful and skillful stitching technique, the ultimate scar often looks very well. We often burry the sutures under the skin so the cosmetic result is superior to that created by traditional stitching technique

Cryosurgery: This treatment uses liquid nitrogen to freeze and kill abnormal cells. After the dead tissue thaws, blistering and crusting may occur. The wound may take several weeks to heal and will leave a scar. The treated area may have less color after treatment. Cryosurgery is often used for precancerous conditions such as actinic keratosis and for small basal cell and squamous cell carcinomas.

Mohs surgery (microscopically controlled surgery): Using the Mohs technique, the surgeon removes a layer of the skin that the tumor may have invaded and then carefully maps its location. The surgeon checks the sample under a microscope immediately. If it is malignant, more pieces of the tumor are removed and examined until the skin samples are found to be free of cancerous cells. This process is slow, but it means that normal skin next to the tumor can be saved. This creates a better appearance after surgery. This is a highly specialized technique that should be used only by doctors who have been trained in this specific type of surgery.

Early intervention is essential to prevent skin cancer from spreading. As a fellow of the American Society for Dermatologic Surgery, Dr. Xue has excellent skills in advanced skin surgical techniques. He routinely removes these dangerous lesions with optimal cosmetic outcome.

About Dr. Wayne Xue

Dr. Wayne Xue, MD, PhD, FAAD, is board certified and is an American Academy of Dermatology award-winning dermatologist. He obtained his PhD degree in cancer biology at Wayne State University. He trained as both resident and fellow in dermatology at Detroit Medical Center. Dr. Xue was awarded Investigator in Dermatology by the American Academy of Dermatology for his outstanding clinical studies, the prestigious honor awarded to only a few dermatologists nationwide. Dr. Xue has authored numerous publications in peer-reviewed journals including Journal of American Academy of Dermatology, Cancer Research, Journal of Immunology, Journal of Cutaneous Pathology, etc. Over the years, Dr. Xue has developed extensive skills in dermatologic surgery, including Mohs surgery for skin cancers as well as a variety of cosmetic surgeries, such as Botox, Restylane, Sclerotherapy, Chemical peels, and etc. He is also interested in novel treatments for common yet recalcitrant skin problems by developing new lines of skin products, currently he is working with local labs on several clinical studies.

Professional Affiliations:

• Diplomat of the American Board of Dermatology
• Fellow of The American Academy of Dermatology
• Fellow of The American Society for Dermatologic Surgery
• Fellow of The American Society of Mohs Surgery
• Member of The American Society of Cosmetic Surgery
• Dermatology Consultant of Shady Grove Adventist Hospital
• Member of Maryland Medical Society

Dr. Xue's is always compassionate about providing excellent patient care, the philosophy of his practice is: "Patients' needs always come first".