Transcription:
Common Skin Lesions

Disclaimer: The medical health information provided during this program is for general information and educational purposes only, and is not a substitute for professional advice. None of the given information is for the purpose of diagnosis or treatment. Neither does this program serve as approval for any health product or brand.

This program aims to enhance your personal health and wellness through the adoption of healthy lifestyles and your prompt presentation to the health professional whenever you suspect that you are ill. For treatment and professional advice ensure you consult your physician.

Melanie Cole (Host): Welcome to Say Yes To Good Health with Memorial Hospital. I'm Melanie Cole and I invite you to join us as we go over many common skin conditions, diseases such as moles and acnes. You don't want to miss this really informative show. And joining me is Krista Carle. She's a Medical Provider of Dermatology at Memorial Hospital. Krista, always a pleasure to have you on. So first I just want to get a kind of a rundown from you, the most common skin lesions, things that you see that you deal with on a very daily basis.

Krista Carle, DNP, APRN-FNP (Guest): Yes. Well I'd say the most common, there are a lot of different skin lesions, whether they are benign or cancerous or viral or bacterial. All have, there's a lot of different ones in those categories, but specific and frustrating is warts. Whether that be common warts, planter warts, flat warts, genital warts. It's most commonly a virus known as HPV, human papillomavirus. That these benign growths actually develop. And I don't know about you, but I think the majority of our population has been frustrated with warts somewhere on them in the past. And this is something in dermatology. You would think we just have a shot or a pill just to remove them forever. But unfortunately the treatment, it can be very frustrating also.

Host: So they come back, right? I mean, warts can come back. Like my daughter had one on her pinky, which was weird and it was growing upward. Cause her pinky was so small and then the, you know, he removed it, but then we saw it start to come back.

Krista: Yes. Well, unfortunately it's a virus and that virus just sorta hangs out in that area. And generally, the reason why we get these is because our skin is either cracked, dry, our immune systems are down. Sometimes when people are biting their fingers, biting their nails, even chewing on their skin, it can create an inflammation and increase our risk for the virus.

And then also dry skin. I always say. The most frustrating warts are usually those on dry skin, kids, adults. And if you moisturize and really make your skin healthier than a lot of the times, it's easier for the, your own immune system to kick in and fight off this wart. You know if we could just cut them out and they'd be gone forever. This wouldn't be so frustrating, but the thing is a lot of the times this virus is hidden in there. And so the treatment regimen is really set towards destructing it every two to six weeks to therefore wake up your immune system to recognize this virus and fight it off itself. So, it's not the treatment itself that kills the wart. It's your immune system that kills the wart from the repetitive waking up, trying to destruct that area to wake up your immune system to recognize it. And therefore, like I said, fight it off.

Host: But now what about the things we see on the pharmacy shelves? I mean, we tried some of those too. They burn them off. There's a band-aid that we, you know had her wear for a little while that has that chemical in there, that medicine in there there's, you know what I mean? We ended up at the dermatologist, but there are a lot of these products on the market. Do any of them work? Should we be trying them first?

Krista: Actually a lot of them can work. Salicylic acid, Compound W but then other salicylic acid regimens, whether it be in a band-aid is a destructive means to try to wake the immune system up and you can try those. Now, usually I recommend to most of my patients to try to suffocate the virus every single night for six to eight hours per night, putting on salicylic acid, which is Compound W, letting it dry and then putting duct tape over the top.

Host: I was going to say that.. We used duct tape. Cause that's what we were recommended. Oh, that's so cool.

Krista: Right. But the problem is if you even forget one night, that virus can all of a sudden come back and it can come back with a vengeance. So I, I have four kids. One of my daughters had one on, well, several of my kids have had different types of warts, but one specifically on their knees. And we would do it every single night.

And when she would forget at night, she would even wear the duct tape to school the next day. And like I said, I would always do the salicylic acid underneath it. But it was frustrating because you do that. You need to do that every night, six to eight hours for about two months before it will work. So, a lot of the times coming in to see the dermatology specialist might just give it a punch right off the bat if you do get maybe a stronger treatment with cryotherapy or with yeast injections. We do. We also can use cautery. There are certain lasers out there that can treat it and then we can also try to remove the wart like you had discussed. And sometimes, like I said, it is either any of those are successful, but if you start the treatment with the over the counter means you just might not have to make so many appointments to dermatology specialists because you already are, the immune system is almost ready to wake up.

Host: What a great bit of information that was, that was awesome. That's what these shows are completely about. Now, as long as you mentioned your kids. And so did I let's talk about acne. Some people get it. Some don't. I didn't, I, I maybe got a pimple here or there. My husband didn't but one of our children did and it was a viral you know, or bacterial, whatever it was, but it was like rashy acne. It wasn't just pimples. What, tell us what acne is. And really, we don't have a lot of time, but talk to parents here of kids who have acne and how you can help them.

Krista: Yes, well, acne, I, you know, I see how many different patients at so many different age levels that have acne. There is different types of acne and it can be in different types of stages of our lives. Of course, the most common acne vulgaris is when hormonal shifts happen and we have all this extra bacteria and oil on our face related to puberty. And at that time, we have acne vulgaris with most of our kids. It can be very easily treated, but it also can be pretty severe if not treated. It can cause scarring. It can cause embarrassment, and then also lead to more other skin diseases. That injury, that inflammation, then can progress and it can actually be a cause or then go into eczema, peri oral dermatitis, rosacea.

So a lot of these are treated similar. But not exactly the same. And if you know what to do treatment wise, it does really shorten the course. And then a lot of times people will get frustrated because the treatments might not work overnight. Definitely, anytime you change your skin regimen, you really need to, at three weeks, you may actually get worse before eight weeks.

That is the time to really evaluate, if what you're doing with your skin care products is rebalancing your skin. You want balanced skin to therefore have less irritation, less breakdown and pimples to therefore you know, not cause so many complication and risks later on in life. But like I said, other acnes can happen as we decrease estrogen.

And maybe in the twenties, a lot of times we'll get a different type of acne. And then also post-menopausal and even folliculitises can happen. So, definitely if you treat with some over the counter means, and it's not getting better, it's only getting worse after a month to two months, then definitely making an appointment because you might be fighting it wrong.

It may need maybe not topical antibacterial means with Benzyl peroxides or Salicylic acid. It may need topical antibiotics, or maybe even steroids short term if it is like a dermatitis. I struggled with peri oral dermatitis, and I think this is why I do skin and dermatology because all through school, every summer I played all sports. I would always have this rash underneath my nose that was red and then would get pimply and then would go around my mouth. And it was just treated incorrectly by the providers I was seeing. And I really, you know, just probably should have reached out to dermatology specialist after years of suffering with this, because then now, because of the inflammation it's created, it's easy to come back.

It's super easy to come back and at least now I know how to treat it. So, if I even see a sign of it, then I know immediately what topicals I need to go to and really balancing and recognizing, you know, what we wash our face with, what we lotion with, our foundations, our makeups or even our washes may really cause more irritation than good. So, really figuring out what's the best for our skin may be different than another person's skin.

Host: Well, and also it's really can be devastating to self-esteem for these kids that get it because of course, kids are not always nice to other kids. And so things like different gel and all of that are those the kinds of products that you're talking about. And I'd love for you in about 20 seconds to give us a little face wash lesson.

Krista: Yes. So, always washing your face twice a day. Not using peroxides, not using iodines, nothing too intense for the skin as sensitive soap with maybe a benzyl peroxide for a kid going through puberty. Number one, we face a bacteria and more. So, benzyl peroxides and salicylic acid are number one. You can wash with them or you can treat with them.

But number one, regimen, you wash, you put on a treatment, you moisturize over top. If you don't moisturize with a lotion that is perfect for you, then your skin can actually throw out more bacteria, more oils. So, if you recognize when you wash your face, it feels dry for a second, that's why you're putting on that lotion. It really needs to hydrate the skin. It really needs to, you know, repair the skin so that you have less acne longterm.

Host: So Krista, Now I'd like to talk about moles because there's something that some people have and some people don't and you'll look at them and do they turn into cancer? What are we supposed to know about our moles. If we have a few of them and how do we know if it's a mole versus a freckle?

Krista: Great question. Sometimes you don't know, just by looking whether it's a mole or a sunspot, solar lentigo, freckling. No matter what, you know, monitoring your skin, recognizing where your moles, where your lesions of sun damage are, and definitely watching to see if they change. If they grow rapidly, if they change in color, if they change in border, if they change in size like height, or if they start bleeding, bugging you, itching, irritating; all those are the ABCs of moles of melanoma. That's what you're going to look for, if there are changes. And definitely if you have a lot of the spots that you don't know, if it is a mole or is a sunspot, then definitely getting in so that your dermatology specialist can look with the dermoscope and identify if there's any irregular patterns.

And also measure out those lesions to identify if there is changes when it might need biopsied and when it's more important to you know, follow those lesions. So it's easy. Most of the time, if your moles, it, they do have a different characteristic that might look a different, a little bit different than sunspots. And if you've always had them, but still all of a sudden making changes, those are of any means, definitely a reason to follow up and see you know, a provider.

Host: Well, I personally completely agree with you and if you have moles and you see them change at all, even if they don't change, go see your dermatologist and let them, you know, look at them and determine them cause they can change. They're little scary. Not for the most part. Right? So, I mean, it's something that I think is best served by a specialist, such as yourself and let you guys determine what we should be doing, because I know my daughter had one on her temple removed just a few years ago because we were concerned about it.

But now let's move on. You mentioned earlier eczema, a lot people deal with this. And I think we were told to just, you know, really like Aquaphor and stuff like that. It was really bad on my daughter's hands. So, tell us what eczema is. Is it considered auto-immune Krista? What is it?

Krista: Well, there's different forms. Eczema is most likely, an atopic dermatitis, a dermatitis is a new you know, atopic specifically means a new dermatitis, which after being diagnosed or after having a dermatitis for greater than six months, then it's referred to a chronic dermatitis, such as an eczema.

So eczema might not be the exact medical term that we use, but there are different forms of eczema, whether it be allergic or non-allergic which is some contact dermatitises more related to irritants. So, definitely getting into figure out, this can be an auto-immune disease. It might not be an autoimmune disease depending on the type of dermatitis it is.

And depending on the type, well, like I said, the type of. It is an inflammation of the skin regardless. Potentially the first layer, maybe even the second later, if it is like a psoriasis that goes into a different type of skin illness or disease. But dermatitis specifically can turn into an auto-immune disease and affect other things, or it can be a symptom of the autoimmune disease.

So number one, if you have something that keeps on staying over six months or keeps on returning, it is a good idea to have that checked on so that you can find out if maybe, you know, you have a disease going on that could affect your joints, affect your healing. And reevaluate your immune system.

But recognizing that our skin, most of the time is a symptom of other things. And so definitely the basics of skincare with good moisturizing, drink, drinking enough water and you know, really treating a problem or a scaly area fast so that you can try to get it under control. So, it doesn't snowball into other issues.

Host: Do you like any particular moisturizers? Cetaphil, Aquaphor? Do you like any of those?

Krista: I love all of those. I like anything that may not be the perfumed lotions that we have that can really irritate the skin. So, I like Cetaphil, CeraVe, Vanicream Aquaphor, Eucerin, all of those are great products. Some, whether you, it comes in an ointtment form or a cream form has really, you know, depending on the location and what you have going on, it may absorb and not feel as oily and gross.

And I like going back to the basics of really identifying a lotion, such as CeraVe that has some ceramides in it, which are proteins in the skin that can really bulk up the skin and hydrate the skin and therefore make the skin way stronger and less risk of injury.

Host: Wow, what great information. I swear. You are such an awesome guest Krista. So, now tell us a little bit about some of the other things that we briefly mentioned, like psoriasis. Or you even mentioned dermatitis, and we've talked a little bit about different types of that, but what else do you see in your practice that you think is important? And you want listeners to know what you guys can do for them and maybe some home remedies.

Krista: Yes. Great. There are a lot of skin diseases out there, and I seem to be seeing a ton of psoriasis. It's an inflammation of the second layer of skin and it can lead to, or even be, people can have psoriatic arthritis. Psoriatic arthritis can really affect the joints and it can really decrease their mobility long-term. So identifying this super early, whether it be through their skin or through their joints. The difficult thing is we don't currently, we don't have a blood test that's real easy to identify it in the joints at this point. But they are working on it and hopefully we will have that in the near future.

Usually you can tell by presentation. But you know, a lot of people will ignore these areas and we do have lasers. We have different, you know, topical regimens, which are products that can really calm it down. And then if that doesn't work a step approach to maybe UVB, which is we have an extract laser that really has targeted UVB into the specific area of inflammation to reduce that inflammation and therefore resolve the problem. The skin is an organ that is overall, if it's having a problem, if you can get it under control fast, you'll have less problem, overall. There's several types of psoriasis.

There's several types of dermatitis. Definitely dealing with that inflammation and getting it under control is key. And then even the lasers. We do have new biologics. We have lots of biologics out there that if this is an auto-immune disease we could evaluate, you know, because overall, if it's an auto-immune disease, then it's going to impair the rest of your I guess immune system.

And so if you can get that under control and really help someone, so it doesn't progress into other issues, then that's why these medications are out there and they can really be so wonderful for so many people that have, that have struggled forever with psoriatic arthritis or psoriasis itself. And we have a biologic now that is approved for a atopic dermatitis.

So really getting in to see, you know, I have a lot of people that will find that their psoriasis is in embarrassing locations that really can make them uncomfortable, always, every second of the day. Think about an inch that bugs you, you know, just because it's hidden, doesn't mean it isn't on their mind constantly. And how difficult that would be to deal with. If maybe we can just treat it super fast and get it gone, it'd be worth coming in for.

Host: Well, I think a lot of these are worth coming in for and what great information. Now you have about 30 seconds here to wrap up and give us maybe a minute, your best skin advice. You've you're a great guest. You have a wealth of knowledge and incredible expertise. Tell us your best skin advice for people whose kids are suffering from some of these things, who adults may be having some of these things and when you feel it's important that we come to see you.

Krista: Yeah. So, if you have a lot of moles, then definitely starting full skin exams to evaluate those moles and sizes and really get the education you need to know what can progress and what can get worse is key. So coming in at any age, if you want a skin exam and want evaluated, and then number two, even the slow growing skin cancers, the squamous cells, the basal cells we are seeing in a younger generation.

So, you know, knowing early on what's a problem. And if it gets dealt with fast, it can really cause, it can really improve the long-term complications. Same with these skin diseases. If we take care of our skin through eating right, exercising, drinking enough water. That can be first the basics along with moisturizing well, once a day, when you get out of the shower within three minutes an intensive moisturizer, head to toe is so important and key to really reduce further skin issues. And then once you do have a problem, get in right away to get it taken care of, to reduce complications.

Host: Rock on. That is excellent information. And Krista, thank you so much again, what a great guest you are. And that concludes this episode of Say Yes To Good Health with Memorial Hospital. To make an appointment with Krista, you can call 217-357-6560 for the new location at 630 Locust Street in Carthage, Illinois.

For more health tips, you can always visit our website at mhtlc.org to get connected with any of our providers. We'd like to thank our audience and invite you to download subscribe, rate, and review on Apple podcasts, Spotify and Google podcast. Share these shows with friends and family, because boy, we are sure learning a lot from the experts at Memorial Hospital. I'm Melanie Cole.

Disclaimer: The medical health information provided during this program is for general information and educational purposes only, and is not a substitute for professional advice. None of the given information is for the purpose of diagnosis or treatment. Neither does this program serve as approval for any health product or brand.

This program aims to enhance your personal health and wellness through the adoption of healthy lifestyles and your prompt presentation to the health professional whenever you suspect that you are ill. For treatment and professional advice ensure you consult your physician.