Atypical Moles Described by Dermatologist Ronald Johnston, M.D.

Atypical or dysplastic moles are a type of mole that appear abnormal, but are benign, according to Florida dermatologist Dr. Ronald Johnston.

Mole, Atypical

Image of a Dyplastic or “Atypical” Mole.

A mole (or nevus) is a benign growth of cells that produce pigment in the skin called melanocytes. An atypical or dysplastic mole is one that often looks different clinically and, when biopsied, has atypical features under the microscope; hence it is called “atypical” due to the irregular or unusual features. However, an atypical mole is not cancerous, a pre-melanoma or melanoma; but rather, a benign mole with an atypical architecture and cellular appearance under the microscope.

Since it can be difficult to determine if a suspicious mole is simply atypical or a possible melanoma by only its appearance, your dermatologist may recommend the lesion is biopsied to ensure it is not a dangerous cancer.

If you have a history of atypical moles and possibly other risk factors, it is recommended to practice good sun-protection/sunscreen use daily, perform periodic self-skin exams and have periodic skin exams by your dermatologist.

Dr. Ronald Johnston Miramar Beach

Dr. Ronald Johnston, Florida Dermatologist

About Ronald Johnston, M.D. FAAD

Dr. Ronald Johnston received his medical degree (M.D.) and completed his dermatology residency at the University of South Florida (USF). He has been an Affiliate Assistant Professor in the Department of Dermatology and Cutaneous Surgery at the University of South Florida College of Medicine since 2011. He is a Fellow of the American Academy of Dermatology (AAD).

Dr. Johnston is in private practice at Advanced Dermatology & Skin Centre with locations in Miramar Beach, Niceville, and Panama City, Florida.

To make an appointment with Dr. Johnston, call Advanced Dermatology & Skin Centre at 1-855-MyDermDoc (855-693-3763).


Heart Health Kit – Patient Education Resources for Heart Disease

Vivacare’s new Heart Health Education Kit provides patient education handouts, videos and other educational references about heart disease for use on a doctor’s website. This delivers heart health information to patients from the source they trust most, their own doctor.

Heart Health Education

Heart Health Kit provides patient education resources regarding heart disease

Physicians enroll online at to create a free patient education account to access patient education resources regarding atrial fibrillation, congenital heart defects, coronary artery disease, heart failure, high cholesterol, hypertension, stroke and other cardiology topics. Vivacare makes it easy to display this content on the doctor’s own website, quickly transforming the website into a convenient and in-depth resource about heart disease.

Dr. Purushotham Kotha, M.D, FACC, a cardiologist in La Mesa, CA displays the Vivacare patient education content on his practice website to provide patients with access to information about anticoagulants, anti-hypertensives, statins and other treatment options. He has also used Vivacare to publish his medical expert opinion online regarding cholesterol level test results. “I am very impressed with the range and depth of the content and think its a tremendous resource for my patients,” said Dr. Kotha. “I recommend the Vivacare service to all of my colleagues.”

The heart health information includes videos, such as “Living with and Managing Coronary Artery Disease” and “Heart Attack Warning Symptoms”, and links to Spanish-language resources. The content also provides links to patient-oriented references from reputable organizations, such as the National Heart Lung and Blood Institute (NHLBI), the American Heart Association (AHA), and the American College of Cardiology (ACC).

See Press Release


Nonsurgical Treatment for Aging Facial Skin Reviewed by New York Dermatologist, Dr. Novick

Nelson Novick, M.D., a New York City Dermatologist, provides his professional perspective on a new treatment option for aging facial skin, the Nonsurgical 3D Vectoring Lift.

According to Dr. Novick, there has been a revolution over the last decade in our understanding of how our skin ages and in the development of new treatments for wrinkles and sagging skin.

NYC Dermatologist Novick

New York Dermatologist Nelson Novick, M.D. reviews an advanced approach to treating signs of sagging facial skin – Nonsurgical 3D Vectoring Lift

“Today, we can address many aging skin changes nonsurgically in a matter of minutes with little or no downtime,” according to Dr. Novick. For muscle overactivity, we have neuromodulators, such as Botox®, Dysport® and Xeomin®. For roughness, textural changes, skin dullness and mottled pigmentation, we have topical prescription medications, chemical peels, medical microneedling, etc. For fine wrinkles, we have fillers and for deeper furrows and volume loss, we have developed volumizing injectable fillers. And now, for sagging skin and apparent laxity, we have the *Nonsurgical 3D Vectoring Lift.

According to Dr. Novick, “the key difference between the outcomes of traditional surgical correction and nonsurgical 3D vectoring, both of which lift upwards and outwards, is the Nonsurgical 3D Vectoring Lift’s additional corrective dimension of ‘forward projection’. This 3D effect is the result of volumizing with the use of injectable agents designed for this purpose, such as Radiesse®, Voluma®, Restylane® SQ, and Stylage® XXL.

Although volumizing fillers are reabsorbed over time, they do promote new, native collagen synthesis, which may continue to provide structure, firmness and improved skin quality while continuing to lift tissues.

A typical Nonsurgical 3D Vectoring Lift of the face takes about fifteen minutes to perform. Bruising and swelling tend to be minimal, and most people can return to work or social activities immediately following treatment.

About Dr. Nelson Novick.

Nelson Lee Novick, M.D. is a Clinical Professor of Dermatology at Mount Sinai School of Medicine in New York City, an Attending Physician, and a former OPD Clinic Chief within the department of dermatology of the Medical Center. He is board certified both in internal medicine and dermatology and is a Fellow of the American Academy of Dermatology (FAAD) and a Fellow of the American Academy of Cosmetic Surgery (FAACS).

Appointments with Dr. Novick can be made at his New York City Office.

500 East 85th Street, Suite P-1
New York, New York, 10028

Tel: 212-772-9300  Fax: 212-772-0524


Limes and Sunshine Don’t Mix.

Did you know that lime juice can cause a profound rash to appear when the skin is exposed to sunlight? Apparently not many people do. When the rash below appeared on a 10-year old girl in Hawaii, none of the locals nor hotel staff had any idea what could have caused it. And hotel guests who caringly (or horrifyingly) asked what had happened stated that they had never heard of their being a problem with lime juice and sunshine.

Lime Rash Phytophodermatitis

Rash on the back of the legs from lime juice followed by sun exposure. (Formally referred to as “phytophotdermatitis”).

There are many case studies, and even more personal tales, of people developing severe rashes from “lime dermatitis”. This includes people in Mexico getting severe rashes on their chins as a result of drinking margaritas by the pool, or using slices of lime on their faces while sunbathing in an attempt to “cleanse toxins” from their skin.

My first encounter with this perplexing rash was with a friend’s daughter who had a terribly dark red rash on both arms after making Limeade on a Spring Vacation to visit grandparents in Los Angeles.

The skin condition is formally referred to by dermatologists as “phytophotodermatitis”. (“phyto” = plant, “photo” = light, and “dermatitis” = rash). Phytophotodermatitis can result following exposure to a variety of plant and plant substances, including celery, parsley and hogweed.

In the case shown here, the girl and her 3 friends had found limes growing in a garden and had fun squeezing the limes before wiping the juices onto the backs of their legs and heading onto a day at the beach. (See the telltale pattern of a hand on the back of the legs and the lines created by wiping the fingers.)

The rash started to appear on all 4 children the next day on their legs, arms, and or fingers with progressive worsening over the following 2 weeks. Those with the greatest exposure developed blisters.

The rash started off pink and progressed to a deep red. The dark color was remarkable and appeared like a bruise. Signs of the rash persisted for nearly 8 weeks, but eventually resolved with NO SCARS.

To avoid the rash, people should wash their hands after handling fruits and vegetables that may cause phytophotodermatitis. Once the rash has begun, treatment options are limited and the rash usually needs to run its course. Topical corticosteroids may reduce the risk of blistering and may lead to less darkening, though hydrocortisone that is available over-the-counter may not offer as much benefit as a prescription-strength formulation (clobetasol).

A rash that appears so starkly and suddenly can be very worrisome, especially when it appears on a child. However, patients and their parents should be reassured that the skin will eventually recover its normal appearance.

More awareness by those in the tourist industry, especially by those serving margaritas poolside to sunbathers, might help reduce the number of people who have their vacation (and skin) disrupted by this completely preventable rash.


Belotero Dermal Filler Reviewed by San Diego Dermatologist Dr. Atkin

San Diego Dermatologist Dr. Deborah Atkin is now offering the new dermal filler Belotero® at her private practice Dermatology & Laser of Del Mar, according to an October 23 press release.

Dr. Atkin

San Diego Dermatologist Dr. Atkin

According to Dr. Atkin, Belotero® is used to improve the appearance of fine lines and wrinkles and is similar to other hyaluronic acid dermal fillers such as Juvederm® and Restylane®, but offers added benefits that can help discreetly smooth out fine lines and wrinkles. She adds that one of the key differences between Belotero® and other dermal fillers is that it can be superficially injected to smooth out fine lines and wrinkles.

Dr. Atkin added that Belotero® may last longer than other dermal fillers because it is composed of similar moisturizing elements that occur naturally in the skin.

About Deborah H. Atkin, M.D.

Dr. Deborah Atkin is a board-certified dermatologist and a member of the American Academy of Dermatology (AAD), the American Society for Dermatologic Surgery (ASDS), the American Society for Laser Medicine and Surgery (ASLMS), and the American Dietetic Association (ADA).

Dr Atkin is experienced in performing a variety of cosmetic dermatology procedures, including Ulthera® , Botox® , Thermage® and Coolsculpting®.

Dr. Atkin practices at Dermatology & Laser of Del Mar at 12865 Pointe Del Mar Way, Suite 160 in Del Mar, CA. Dr. Atkin and her team can be reached at (858) 350-7546.


Tanorexia – Indoor Tanning Addiction Explained by Miami Dermatologist Dr. Marta Rendon

Boca Raton dermatologist Marta Rendon, M.D., FAAD reviews the addiction that some people have for indoor tanning, despite its risks, which she describes as “Tanorexia“.

Dr. Marta Rendon, M.D. Boca Raton Dermatologist

Boca Raton Dermatologist Dr. Marta Rendon

Dr. Rendon uses the term tanorexia to describe people who suffer from the need to over-tan. The bad news is that just like cigarettes and smoking, there is no safe amount of tanning that can be done. The dangers of tanning beds are in their exposure to harmful ultraviolet rays.

“The popular TV show Jersey Shore introduced the world to a way of living known as “GTL” — gym, tan, laundry. While we can’t argue against the virtues of maintaining your figure or keeping your clothes clean, we do take issue with tanning on a daily basis.”

While the tanning bed industry would like you to think that only the “safe” ultraviolet rays are used, this just isn’t the case. Ultraviolet A, which is predominately found in tanning beds, penetrates more deeply into the skin than ultraviolet B. This leads not only to skin cancer, but is also a major cause of early wrinkling and leathery skin. ”

About Marta Rendon, M.D., FAAD

Dr. Marta Rendon, M.D. is in private practice at the Dermatology and Aesthetic Center in Boca Raton, Florida.

To make an appointment to see Dr. Rendon, call 561-750-0544, or visit Dr. Rendon’s website at the Dermatology and Aesthetic Center.


Cosmeceuticals – Dr. F. Victor Rueckl Advises Getting Them From Your Doctor

Consumers who are seeking the highest quality skin care products or cosmeceuticals are advised by dermatologist Dr. F. Victor Rueckl to obtain them from their own doctor’s office.

Victor Rueckl, M.D.

Las Vegas Dermatologist Dr. Victor Rueckl provides advice on skin care products

Las Vegas Dermatologist, F. Victor Rueckl M.D. of Lakes Dermatology, wants to make sure that his patients know what they are getting when they purchase non-prescription skin care products by providing his perspective online at “Be Careful Using Over The Counter Products Versus Medically Tested and Prescribed Products.

According to Dr. Rueckl, the effectiveness of skincare products depends in part on the active ingredient and other elements, such as those that provide stability. “I prefer medically tested products – the proof that the work has been done on human skin, not lab animals.”, said Dr. Rueckl. He added that medical grade products have better stability. “Products like SkinCeuticals are stabilized so that they maintain their effectiveness from the first drop, to the last, and they have a shelf-life of years!”

Dr. Rueckl reviewed some common ingredients that may result in more improvement in skin tone, texture, discoloration, and wrinkles.

  • Vitamin C. Vitamin C antioxidants neutralize factors that lead to premature aging, loss of elasticity, and hyperpigmentation. Vitamin C makes sunscreens more effective too.  (Vitamin C, in order to be stabilized, must also contain L-ascorbic acid.)
  • Retinol. Retinol, the first antioxidant to be widely used in nonprescription wrinkle creams, neutralizes free radicals that break down skin cells and cause wrinkles. Retinol is less potent than the topical retinoid tretinoin that is available only by prescription.
  • Hydroxy acids. Alpha hydroxy acids, beta hydroxy acids and poly hydroxy acids are are exfoliants that remove the upper layer of old, dead skin and stimulate the growth of smooth, evenly pigmented new skin.
  • Coenzyme Q10.  Some studies have shown reduction fine of wrinkles around when Coenzyme Q10 is used around the eyes. This ingredient is available in some skincare products, but it can be more effective when taken as an oral supplement.
  • Copper peptides. Copper peptides enhance wound healing and may also stimulate production of collagen and enhance the action of antioxidants.
  • Kinetin. Kinetin is a plant growth factor that may improve the appearance of wrinkles and uneven pigmentation with minimal irritation and may be a potent antioxidant. Kinetin is an active ingredient of Kinerase® and ProTherapy® are using it in many of their skincare products now.
  • Tea extracts. Green, black and oolong tea contain compounds with antioxidant and anti-inflammatory properties. Green tea extracts are the ones most commonly found in wrinkle creams.

Biologics for Psoriasis Reviewed by New Orleans Dermatologist Dr. Jeffrey Poole

Biologics are a class of medications that have become an important treatment option for psoriasis.

Jeff Poole, M.D.

Dr. Jeffrey C. Poole, New Orleans Dermatologist

Dr. Jeffrey C. Poole, New Orleans area dermatologist, provides his clinical perspective regarding the use of biologics.

There are currently four biologics approved for psoriasis:

Biologics inhibit the immune system, reduce inflammation and inhibit the excessive skin cell growth. Different biologic medications target different portions of the immune system. Some biologic medications reduce an inflammatory signal called tumor necrosis factor (TNF). Others control the activity of an immune signal called interleukin.

According to Dr. Poole, “Biologics are the most recent advances in the treatment of psoriasis, though they have been in use in the U.S. for nearly 14 years. Biologics were initially considered 2nd line agents, but can now be considered 1st line therapy for severe, diffuse or resistant cases of psoriasis.”

Dr. Poole pointed out that “biologics should be considered when someone has psoriasis that is limiting their daily life in terms of function or psychosocially. Some examples of this include the following:

  1. When psoriasis covers large areas of the body so that applying a topical medication to all of the affected areas is impractical. In such cases, using a “whole body” therapy, such as biologics, might be considered.
  2. When psoriasis is especially severe, even if the affected area is limited. Examples include severe/resistant hand psoriasis in a surgeon or pianist, facial psoriasis in an actress or newscaster, or foot psoriasis in an athlete.
  3. Psoriasis that requires “whole body” therapy, but has failed other, non-biologic treatments, such as UV phototherapy, methotrexate, and acitretin to name a few.

When considering which biologic medication to recommend to a particular psoriasis patients, Dr. Poole pointed out that “each case of psoriasis has unique characteristics and each individual has a unique health history and lifestyle. These variables may make one medication a better fit for a particular patient than another.”

“In general, I find etanercept (Enbrel®) and adalimumab (Humira®) are my first agents– both have a long track record of safety with excellent effectiveness, and are quite similar in their mode of action. Ustekinumab (Stelara®) is the newer kid on the block, and for this reason, I generally reserve it if someones fails or does not respond sufficiently to my first options. Because ustekinumab works by a different mechanism of action, there are some patients in which it may be my first line agent.

About Dr. Jeffrey Poole, M.D., FAAD

Jeffrey Poole, M.D. is a board-certified dermatologist who earned his medical degree from Tulane University School of Medicine, and completed an internship and residency in Pediatrics at Keesler AFB Regional Medical Center. Dr. Poole then performed a residency in Dermatology at the LSU School of Medicine in New Orleans, during which he was selected to be Chief Resident.

Dr. Poole is a Fellow of the American Academy of Dermatology, the American Society of Dermatologic Surgery, the American Society of Laser Medicine and Surgery and the Society for Pediatric Dermatology. He is a member of the Louisiana Dermatologic Society and the Greater New Orleans Pediatric Society, and was recently elected President of the Louisiana Dermatologic Society for 2008.

Appointments with Dr. Poole can be made at Poole Dermatology in Metairie, Louisiana. Phone: 504-838-8225.


Dermatologists Remind Patients About the Benefits of Sunscreen

Before you slip over to the beach to catch up on your tan this summer, don’t forget to slop on the sunscreen.

The American Academy of Dermatology (AAD) and its member dermatologists want to remind American consumers that sunscreen remains a safe and effective form of sun protection. Remember that protecting yourself from sun exposure is the best way to prevent skin cancer and premature aging of the skin, such as unwanted wrinkles and age spots.

NYC Dermatologist Dr. Daniel Siegel, MD

AAD President Dr. Daniel M. Siegel, M.D. recommends routine sunscreen for good skin health

Dr. Daniel Siegel, MD, President of the American Academy of Dermatology (AAD), has a few helpful suggestions for how to reduce sun exposure.  He recommends “generously applying a water-resistant, broad-spectrum sunscreen— that protects against both types of ultraviolet radiation (UVA and UVB) — with an SPF 30 or higher, in conjunction with other sun-safe practices such as limiting sun exposure, seeking shade, and wearing sun-protective clothing, hats and sunglasses.”

But what about vitamin D? Many people worry that sunscreen will block vitalizing vitamin D from being absorbed. Even though sun exposure stimulates the production of vitamin D in the skin, there are many other, safer ways to get the vitamin without putting yourself in harm’s way. Dr. Siegel recommends that individuals who are concerned about their vitamin D intake “should discuss obtaining sufficient vitamin D from foods and/or vitamin supplements with their doctor.”

Dr. Siegel provided his expert opinion about sunscreen ingredients, particuarly those that have received attention in the press.

1) Oxybenzone  is one of the few FDA-approved ingredients that provides effective broad-spectrum protection from UV radiation. Although there has been some concern mentioned in the press about possible long-term side effects from using sunscreens with oxybenzone, Dr. Siegel pointed out that “peer-reviewed scientific literature (available to date) and regulatory assessments from national and international bodies do not support a link between oxybenzone in sunscreen and hormonal alterations, or other significant health issues in humans. He added that “the FDA has approved oxybenzone in sunscreen for use on children older than 6 months.”

2) Retinyl palmitate, a form of vitamin A (retinol), is used as an ingredient in some sunscreens as an antioxidant to prevent degradation of the product and maintain efficacy. There has been recent attention about possible side effects from retinyl as a result of in vitro (test tube) studies and one unpublished report using mice. However, Dr. Siegel stated that“there is no published evidence to suggest either increase the risk of skin cancer in these patients. In fact, oral retinoids are used to prevent skin cancers in high-risk patients.”

3) Nanotechnology is being explored as a means to give sunscreen greater broad spectrum protection from UVA and UVB rays. Titanium dioxide and zinc oxide tend to leave a white residue on the skin when used in a regular formulation that contains large particles. When these ingredients are converted into  smaller molecules, nanoparticles, they appear to vanish on the skin, do not leave a residue, and retain and enhance their ability to block UVA and UVB light. “Considerable research on the use of nanoparticles on healthy, undamaged skin has shown that the stratum corneum — the outermost layer of the skin — is an effective barrier to preventing the entry of nanoparticles into the deeper layers of the skin.  Titanium dioxide and zinc oxide have a long history of safe use in sunscreens and offer good options for broad-spectrum UV protection.”

Everyone wants to have a fun and safe summer. By adding sunscreen to your daily routine, like brushing your teeth and washing your hands, the small step can have a big payoff and add years to your life down the line.

About Dr. Daniel M. Seigel

Daniel Mark Siegel, M.D. is a board-certified dermatologist, Mohs surgeon and President of the American Academy of Dermatology.

Dr. Daniel M. Siegel also serves as Clinical Professor of Dermatology at the State University of New York (SUNY) at Downstate School of Medicine, directs the American College of Graduate Medical Education (ACGME) approved Procedural Dermatology Fellowship and the American College of Mohs Surgery training program.

Dr. Siegel is an author of two books and over two dozen referenced medical publications and is co-editor of The Physician’s Internet Review for Dermatologists. In addition, he is on various editorial boards in the field of dermatology and is a contributing editor to the Dermatologic Surgery journal.


Erivedge Skin Cancer Medication for Treatment of Basal Cell Nevus Syndrome

In recent years, doctors have begun to discover the genetic basis of several types of cancer. Basal Cell Skin CancerThese cancers are caused by rare DNA mutations that are present at birth, rather than environmental hazards or DNA damage throughout one’s lifetime.  Although skin cancer is most commonly caused by excessive sun exposure, in rare cases it is caused by a genetic disorder called basal cell nevus syndrome.

Basal cell nevus syndrome is a rare genetic condition that causes basal cell skin cancer to develop around puberty. Many skin cancer experts treat basal cell cancer with topical creams, such as imiquimod, but until recently there has been no effective way to prevent skin cancer from developing in basal cell nevus syndrome patients.

Fortunately for these patients, a recent study published in the June 7 issue of the New England Journal of Medicine found that a new medication can prevent skin cancer from developing in the first place. The researchers found that Erivedge®, an oral medication used to treat basal cell cancer, can prevent skin cancer in patients who are genetically predisposed for developing it.

Erivedge® works by blocking a signal called the “Hedgehog” signal that causes basal cells to grow uncontrollably. The recent study was unique because it demonstrated that Erivedge® can prevent, as well as treat, basal cell skin cancer. The next step, researchers say, is to develop it into a topical cream with fewer side effects than the oral medication.

Side effects from present dosage of oral Erivedge® can be debilitating and lead to over 1/2 of participating patients to discontinue treatment.  Side effects include weight loss, fatigue, muscle cramps, hair loss, and changes in taste perception. In order to reduce the risk of developing adverse effects, researchers are testing whether prescribing the medication intermittently (2 months on, followed by 2 months off), or reduced dosages will reduce the symptoms while still being at least 90% as effective.