Irritated Seborrheic Keratosis on the Upper Back Treated with Cryotherapy
A 60-year-old male presented to Village Dermatology in Katy and Houston, TX, with an irritated seborrheic keratosis on the upper back. Learn how cryotherapy was used to safely remove this benign but inflamed skin growth.
At Village Dermatology in Katy and Houston, Texas, we frequently treat patients with benign but bothersome skin growths such as seborrheic keratoses. While these lesions are noncancerous, they can become irritated, itchy, or inflamed, prompting treatment for comfort and cosmetic reasons. This case highlights a 60-year-old male with an irritated seborrheic keratosis successfully treated with liquid nitrogen.
Patient Presentation
A 60-year-old male presented as an established patient with a new lesion on the left upper back. The lesion had been present for one week, was moderate in severity, and caused irritation and itching. He reported no prior treatment.
He attended the visit accompanied by his wife.
Dermatologic Examination
A focused examination of the back was performed using a dermatoscope.
Findings included:
Irritated Seborrheic Keratosis: Inflamed, crusted papule located on the left superior medial upper back.
Associated pruritus and mild inflammation in the surrounding skin.
No suspicious or malignant lesions were noted.
Impression and Plan
Diagnosis: Irritated Seborrheic Keratosis (L82.0)
Seborrheic keratoses are common, benign, wart-like growths that may appear anywhere on the body. Although harmless, they can become symptomatic due to friction, trauma, or inflammation.
Treatment:
Cryotherapy with liquid nitrogen was performed on the symptomatic lesion.
One lesion was treated on the left medial upper back.
Consent obtained after reviewing risks including blistering, pigment changes, incomplete removal, and infection.
Counseling:
The patient was informed that irritated seborrheic keratoses can be effectively treated with cryotherapy.
Advised that mild crusting or redness is normal during healing.
Instructed to contact the office if the lesion fails to resolve or if there are concerning symptoms such as persistent tenderness or infection.
Key Takeaway
This case highlights the effectiveness of cryotherapy for treating irritated seborrheic keratoses. Even though these lesions are benign, treatment can provide relief from discomfort and improve skin appearance.
At Village Dermatology in Katy and Houston, TX, we offer expert evaluation and treatment for a variety of benign skin growths, including seborrheic keratoses, cherry angiomas, and lentigines.
Evaluation and Biopsy of a Pigmented Skin Lesion in a 38-Year-Old Female — Village Dermatology, Katy & Houston, Texas
A 38-year-old female patient underwent evaluation and biopsy of a new pigmented lesion under the arm at Village Dermatology in Katy and Houston, Texas, emphasizing early detection and sun protection counseling.
Patient Overview:
A 38-year-old established female patient presented to Village Dermatology in Katy, Texas for the evaluation of a new skin lesion on her left shoulder and right shoulder, as well as a mole under her left arm (axilla) that appeared three weeks prior. The patient reported that the lesion was not painful, bleeding, or changing in size or color, but wanted it evaluated for reassurance and appropriate care.
She also requested education and counseling regarding sun exposure and skin cancer prevention.
Clinical Examination
A comprehensive skin examination was performed, including the scalp, face, shoulders, and both axillae. The patient appeared well-developed, well-nourished, and in no acute distress.
Findings:
A darkly pigmented macule was identified in the left axillary vault.
No signs of ulceration, bleeding, or irritation were present.
A dermatoscopic evaluation revealed irregular pigmentation but no overtly malignant structures.
Differential Diagnosis
The primary considerations included:
Neoplasm of Unspecified Behavior
Dysplastic Nevus (Atypical Mole)
Lichenoid Keratosis
Because of the lesion’s new onset and pigmented appearance, a biopsy was recommended for definitive diagnosis.
Procedure: Shave Biopsy
After obtaining written informed consent, the area was prepped and anesthetized with 0.5% lidocaine with epinephrine.
A shave biopsy to the level of the dermis was performed using a Dermablade, and the specimen was sent for histopathologic evaluation (H&E staining).
Hemostasis was achieved with Drysol, and the site was dressed with petrolatum and a bandage.
The patient tolerated the procedure well without complications.
Post-Procedure Counseling
The patient was counseled on biopsy site care, including gentle cleansing and application of ointment to promote healing.
She was advised to contact the office if she does not receive biopsy results within two weeks.
In addition, sun protection education was provided, including:
Use of broad-spectrum SPF 30+ sunscreen daily
Avoidance of tanning beds
Regular self-skin checks and annual full-body skin exams
Clinical Insight
Pigmented lesions in sun-protected areas, such as the axilla, can represent a range of benign and atypical growths. While most are non-cancerous, early evaluation and biopsy are critical in distinguishing dysplastic nevi or melanoma from benign entities.
At Village Dermatology, we prioritize thorough skin cancer screening and patient education to promote early detection and lifelong skin health.
Follow-Up
The patient will be contacted once biopsy results are available. Depending on pathology, management may include simple observation, re-excision, or monitoring for recurrence.
Takeaway
This case highlights the importance of evaluating new or changing moles, even when they appear benign. Early dermatologic evaluation allows for accurate diagnosis and peace of mind.
At Village Dermatology in Katy and Houston, Texas, our board-certified dermatologists provide expert care for all skin lesions — from routine moles to complex skin cancers — with compassion and precision.
📞 Schedule your skin check today at Village Dermatology in Katy or Houston, TX, and take the first step toward proactive skin health.
Managing Acne Keloidalis Nuchae in a 31-Year-Old Male — Village Dermatology, Katy & Houston, Texas
A 31-year-old male with chronic Acne Keloidalis Nuchae was successfully managed at Village Dermatology in Katy and Houston, Texas, with oral doxycycline, topical clindamycin, and lifestyle counseling to reduce inflammation and scarring.
Patient Overview:
A 31-year-old male presented to Village Dermatology as a new patient for evaluation of skin lesions located on the posterior neck, posterior scalp, and hairline. The lesions were described as darkening, enlarging, and irregular in shape. They had been progressively worsening over several years, with more rapid change over the past month.
The patient denied prior treatment and sought a comprehensive dermatologic evaluation and management plan.
Clinical Examination
A focused skin examination was performed, including the scalp, posterior neck, face, and ears. The patient appeared well-developed and well-nourished, and was alert and oriented. A dermatoscope was used to closely inspect the lesions.
Findings revealed follicular-based papules and pustules coalescing into keloid-like plaques distributed along the mid-occipital scalp and posterior neck — findings consistent with Acne Keloidalis Nuchae (AKN), a chronic inflammatory scarring condition.
Diagnosis: Acne Keloidalis Nuchae (AKN)
Acne Keloidalis Nuchae is a chronic inflammatory disorder of the hair follicles, most commonly affecting men with curly or coarse hair. It typically presents as persistent papules, pustules, and firm scars on the back of the scalp and neck. AKN may worsen with shaving, tight collars, helmets, or other forms of mechanical irritation.
If left untreated, it can lead to permanent scarring alopecia and cosmetic disfigurement.
Treatment Plan
At Village Dermatology, the patient’s management plan focused on both inflammation control and prevention of further scarring.
1. Oral Doxycycline (100 mg, twice daily for 6 weeks):
To reduce inflammation and control bacterial colonization. The patient was counseled on potential side effects including gastrointestinal upset and sun sensitivity.
2. Topical Clindamycin 1% Solution (twice daily):
To reduce surface bacterial activity and inflammation in the affected areas.
3. Benzoyl Peroxide Wash:
Recommended as an adjunctive antibacterial wash to lower follicular bacterial load.
4. Safe Grooming Practices:
The patient was advised to avoid close shaving, tight clothing, or friction against the affected area.
If improvement is limited, intralesional Kenalog (ILK) injections will be considered at follow-up visits to further flatten hypertrophic lesions and decrease inflammation.
Patient Counseling
The patient was counseled that Acne Keloidalis Nuchae is a chronic and progressive condition, often requiring long-term maintenance to prevent recurrence. Regular dermatology follow-ups in our Katy and Houston, Texas offices were recommended to monitor progress and adjust therapy as needed.
Takeaway
This case underscores the importance of early diagnosis and intervention in Acne Keloidalis Nuchae to prevent scarring and improve quality of life. Through a combination of oral antibiotics, topical treatments, and lifestyle modifications, significant improvement can be achieved.
At Village Dermatology, our board-certified dermatologists in Katy, Texas and Houston, Texas specialize in treating complex scalp and skin conditions like Acne Keloidalis Nuchae with compassionate, evidence-based care.
If You’re Experiencing Similar Symptoms
If you notice bumps, scarring, or irritation on the back of your scalp or neck, it’s important to seek evaluation before permanent scarring develops.
Contact Village Dermatology today to schedule your appointment at our convenient Katy or Houston locations.
📞 Call us or book online today to begin your personalized treatment journey.
Allergic Contact Dermatitis from Poison Ivy in a 49-Year-Old Male Patient Presentation
A 49-year-old male from Katy, Texas developed an itchy red rash on his leg and groin after yard work. Diagnosed with allergic contact dermatitis from poison ivy, he was treated with a prednisone taper at Village Dermatology. Learn how Dr. Reena Jogi treats skin allergies in Houston and Katy, TX.
A 49-year-old male presented to our dermatology clinic in Katy, Texas, with a one-week history of a red, itchy rash on the right leg, groin, and left arm. The rash developed after spending time doing yard work, and the patient suspected possible contact with poison ivy. The rash was described as moderate in severity and had not improved with any over-the-counter treatments.
Clinical Examination
A focused dermatologic examination was performed, including inspection of the face, arms, legs, and genital area. The patient declined a full-body skin exam.
On examination, there were well-demarcated, geometric, eczematous patches distributed across the left arm, penis, and right leg, consistent with allergic contact dermatitis. No evidence of secondary infection or vesiculation was noted.
The patient was well-developed, well-nourished, alert, and oriented, and appeared in no acute distress. A dermatoscope was utilized during the evaluation for lesion assessment.
Diagnosis
Allergic Contact Dermatitis (L23.9) – secondary to likely exposure to poison ivy during yard work.
Treatment Plan
After confirming the clinical impression, the patient was counseled regarding appropriate skin care and environmental precautions to prevent recurrence.
Medications:
Prednisone 20 mg tablets – Tapering course:
Take 2 tablets (40 mg) once daily for 5 days
Then 1 tablet (20 mg) once daily for 5 days
Then 1 tablet (20 mg) every other day for 10 days
Total: 20 tablets
Counseling and Recommendations:
Skin Care:
Use gentle, fragrance-free, hypoallergenic cleansers.
Avoid scented soaps, detergents, and personal care products.
Apply fragrance-free moisturizers to support skin healing.
Environmental Precautions:
Avoid further exposure to poison ivy and wash all clothing or gear that may have contacted plant oils.
Clean tools and pets that may have come into contact with contaminated vegetation.
Prednisone Counseling:
The patient was counseled extensively on the risks and precautions associated with systemic corticosteroid use, including:
Short-term effects: increased appetite, mood changes, insomnia.
Long-term risks (with extended use): weight gain, osteoporosis, high blood pressure, and glucose elevation.
The patient verbalized full understanding of the tapering schedule and potential adverse effects.
Follow-up Plan:
Follow up as needed (PRN) if the rash fails to improve or recurs.
Consider patch testing in the future if recurrent or chronic allergic dermatitis is suspected.
Discussion
Allergic contact dermatitis (ACD) is a common inflammatory skin reaction caused by exposure to allergens such as poison ivy, nickel, fragrances, or topical products. The characteristic linear or geometric patterns are often diagnostic clues.
Poison ivy dermatitis results from contact with urushiol, an oil that triggers a delayed-type hypersensitivity reaction. Prompt washing with soap and water after exposure can minimize severity.
In moderate to severe cases involving widespread areas or sensitive regions like the genitalia, a prednisone taper is often required to control inflammation and prevent rebound flares.
At Village Dermatology in Katy and Houston, Texas, Dr. Reena Jogi and her team specialize in diagnosing and treating allergic skin conditions with tailored medical therapy, environmental guidance, and patient education.
Conclusion
This case illustrates a classic presentation of allergic contact dermatitis secondary to poison ivy exposure, successfully managed with a prednisone taper and detailed counseling on allergen avoidance and gentle skincare practices. With proper care, the patient’s rash is expected to resolve completely within several weeks.
Management of Toenail Fungus and Neck Skin Tags in a 43-Year-Old Male
A 43-year-old male from Katy, Texas presented with toenail fungus and neck skin tags. At Village Dermatology, fungal nail testing and skin tag removal were performed safely and effectively. Learn about advanced dermatologic treatments in Houston and Katy, TX.
Patient Presentation
A 43-year-old male presented to our dermatology clinic in Katy, Texas, with two main concerns:
Yellow, thickened toenails that had progressively worsened over the past 1–2 years.
Multiple skin tags on both sides of the neck that had become irritated by clothing and daily activities.
The patient was seeking evaluation, diagnosis, and treatment options for both conditions.
Clinical Examination
A comprehensive examination was performed, including inspection and palpation of the digits, toenails, and neck. The patient was alert, well-nourished, and in no acute distress. A dermatoscope was used for enhanced visualization.
Findings:
Toenails: Both great toenails showed yellow discoloration, thickening, and subungual debris, consistent with onychomycosis (fungal nail infection).
Neck: Several small, soft, pedunculated skin tags (acrochordons) were identified along the left and right anterior and lateral neck areas.
Diagnosis
Onychomycosis (B35.1) – fungal infection of the toenails, primarily affecting the right great toenail.
Acrochordons / Skin Tags (L91.8) – benign skin growths distributed bilaterally on the neck.
Treatment Plan
1. Onychomycosis
A nail clipping from the right great toenail was obtained and sent for PAS (Periodic Acid–Schiff) staining to confirm fungal involvement. Pending confirmation, the treatment plan includes initiating oral terbinafine—an effective systemic antifungal medication.
Because the patient reported a history of possible fatty liver disease, baseline liver function tests (LFTs) were ordered prior to starting therapy.
Patient Counseling:
Oral antifungal agents offer a higher cure rate than topical treatments, though recurrence is possible.
Possible side effects: liver toxicity, rash, and rare bone marrow suppression.
Instructions: Contact the office immediately if side effects such as nausea, fatigue, or jaundice develop.
Plan:
Await PAS results and lab confirmation.
Begin terbinafine therapy (typically 12-week course) upon clearance.
2. Skin Tag Removal
Given the patient’s cosmetic concern and mild irritation, in-office removal was performed during the visit.
Procedure Details:
Anesthesia: 3 cc of 1% lidocaine with epinephrine for local numbing.
Technique: Gentle gradle excision of five skin tags.
Locations: Left and right anterior and lateral neck.
Outcome: Minimal bleeding, no complications.
Post-procedure care:
Keep the area clean and dry for 24 hours.
Apply petroleum jelly or antibiotic ointment to prevent crusting.
Avoid friction from jewelry or collars.
Discussion
This case highlights two common dermatologic conditions—onychomycosis and skin tags—frequently seen in adult patients.
Onychomycosis is a fungal infection that affects both the appearance and integrity of the nail plate. Oral antifungal therapy, such as terbinafine, remains the most effective treatment option, especially in long-standing or severe cases.
Skin tags are benign and often removed for cosmetic reasons or due to irritation. In-office excision is a quick and effective treatment with minimal downtime.
At Village Dermatology in Katy and Houston, Texas, Dr. Reena Jogi and her team combine advanced diagnostic tools and safe procedural care to address both medical and cosmetic skin concerns.
Conclusion
The patient underwent successful skin tag removal and is pending laboratory confirmation for toenail fungus before starting oral antifungal therapy. With proper follow-up and adherence to the care plan, excellent outcomes are anticipated for both conditions.
Hypertrophic Scar After Nose Piercing Treated with Intralesional Kenalog
A 31-year-old female developed a hypertrophic scar after a nose piercing. At Village Dermatology in Katy, Texas, the scar was treated with intralesional Kenalog and topical mupirocin. Learn how Dr. Reena Jogi manages facial scars, milia, and benign moles in Houston and Katy, TX.
Patient Presentation
A 31-year-old female presented to our dermatology clinic in Katy, Texas, with a raised scar on her left nasal sidewall following a recent nose piercing. The patient reported that the piercing was done approximately three months ago, and she had been instructed by her piercer not to remove the jewelry for six months. She was concerned about the thickened appearance around the site and sought treatment for the developing scar.
Clinical Examination
A detailed facial examination revealed a firm, raised, pink scar consistent with a hypertrophic scar located at the piercing site on the left nasal sidewall. The lesion was mildly thickened but not tender or pruritic.
The patient appeared well-developed, well-nourished, and in no acute distress. A dermatoscope was used to assess the lesion, confirming no signs of infection, ulceration, or keloidal overgrowth.
Additional Findings
Milia (L72.0): Small yellow-white cystic papules on the right malar cheek, benign and superficial.
Benign Nevi (D22.4): Multiple evenly pigmented moles scattered throughout the body.
Diagnosis
Hypertrophic Scar (L91.0) – Left nasal sidewall (post-piercing)
Milia (L72.0) – Right malar cheek
Benign Nevi (D22.4) – Diffuse
Treatment Plan
1. Hypertrophic Scar Management
The patient was counseled regarding the nature of hypertrophic scars and treatment options, including:
Intralesional corticosteroid injections (Kenalog)
Silicone gel or silicone sheets
Pulse dye laser for vascular improvement
After informed consent, Intralesional Kenalog (ILK) was administered:
Concentration: 5 mg/cc (diluted from 10 mg/mL)
Volume: 0.1 cc
Injection Sites: 1 (left nasal sidewall)
Administered by: AB
The risks of skin atrophy and pigment alteration were discussed, and the patient tolerated the procedure well.
To prevent infection, mupirocin 2% ointment was prescribed:
Sig: Apply to affected area once to twice daily until healed
Quantity: 15 grams, 1 refill
2. Milia
Counseling included reassurance that milia are benign keratin-filled cysts, often resolving spontaneously or with gentle exfoliation. Treatment options reviewed:
In-office extraction if persistent or bothersome
3. Benign Nevi
Patient education included monthly self-skin checks to monitor for any changes in size, color, or shape.
Recommendations included:
Regular dermatologic full-body exams every 6–12 months
Discussion
Hypertrophic scars commonly occur at sites of trauma, piercings, or surgical incisions and result from excessive collagen deposition during wound healing.
Intralesional corticosteroid therapy, particularly Kenalog (triamcinolone acetonide), is highly effective in flattening and softening hypertrophic scars. Combining ILK injections with silicone-based therapy often improves long-term outcomes.
At Village Dermatology in Katy and Houston, Texas, Dr. Reena Jogi and her team emphasize a personalized, evidence-based approach to treating scars, milia, and benign skin lesions. This ensures both cosmetic improvement and skin health maintenance.
Conclusion
The patient’s hypertrophic scar from a recent nose piercing was successfully treated with intralesional Kenalog and topical mupirocin. She was counseled on scar care and follow-up options, including silicone therapy and laser treatments for refinement. The patient will return in 6–8 weeks for reevaluation.
Management of Acne Rosacea in a 34-Year-Old Female with Doxycycline and Compounded Triple Rosacea Cream
A 34-year-old female from Katy, Texas, presented with chronic rosacea. Treatment with oral doxycycline and a compounded triple rosacea cream provided effective control of redness and pimples. Learn how Village Dermatology in Houston and Katy offers customized rosacea care.
Patient Presentation
A 34-year-old female presented to our dermatology clinic in Katy, Texas, with a chronic facial rash characterized by persistent pimples and redness. The patient reported that symptoms had been present for several years and were moderate in severity. She has a known history of rosacea, having previously undergone intense pulsed light (IPL) therapy, a course of isotretinoin (Accutane), and multiple topical treatments.
Clinical Examination
A focused facial examination revealed erythematous papules and pustules primarily distributed across the cheeks, nose, and chin—consistent with acne rosacea (L71.8).
The patient appeared well-developed, well-nourished, and in no acute distress. Dermatoscopic evaluation showed superficial telangiectasias and scattered inflammatory papules. No nodules or cystic lesions were observed.
Diagnosis
Acne Rosacea (L71.8) – distributed on the face and subxiphoid region.
The patient was counseled regarding the chronic nature of rosacea and the importance of trigger avoidance, sun protection, and consistent skincare.
Treatment Plan
After a detailed discussion of options, including laser therapy, topical agents, and oral medications, the patient elected to begin combination therapy consisting of oral doxycycline and a compounded triple rosacea cream.
Medication Regimen:
Morning Routine:
Wash with a gentle, non-irritating cleanser
Apply a broad-spectrum SPF 30+ moisturizer
Evening Routine:
Wash with a gentle cleanser
Apply the compounded triple rosacea cream (containing ivermectin, metronidazole, and azelaic acid)
Follow with a light moisturizer
Oral Therapy:
Doxycycline monohydrate 100 mg taken twice daily with food and a tall glass of water for 4 weeks
Counseling Provided:
Sun Protection: The patient was instructed to wear daily SPF and avoid direct sunlight to prevent photosensitivity associated with doxycycline.
Trigger Avoidance: Flare-ups can be provoked by alcohol, spicy foods, hot beverages, sun exposure, stress, and exercise.
Medication Effects:
Doxycycline: May cause sun sensitivity or gastrointestinal upset.
Ivermectin (Soolantra): Possible mild burning or stinging on application.
Metronidazole: May cause a metallic taste or transient redness.
Azelaic Acid (Finacea): Possible mild tingling or dryness.
The patient verbalized full understanding of the treatment plan and was scheduled for follow-up in six weeks to evaluate clinical response and tolerance.
Discussion
Rosacea is a chronic inflammatory skin condition that primarily affects the central face, often leading to persistent redness, papules, and visible blood vessels. Management focuses on controlling inflammation, reducing Demodex mite proliferation, and minimizing triggers that exacerbate symptoms.
At Village Dermatology in Katy and Houston, Texas, Dr. Reena Jogi utilizes a comprehensive treatment approach, combining oral anti-inflammatory therapy, custom-compounded topical formulations, and laser or light-based therapies when appropriate. This personalized care model helps patients achieve long-term remission and confidence in their skin health.
Conclusion
This case demonstrates effective management of chronic acne rosacea using a short course of oral doxycycline and a compounded triple rosacea cream. With adherence to skincare, trigger avoidance, and follow-up care, the patient is expected to experience a marked improvement in redness and inflammatory lesions.
Treatment of Verruca Vulgaris (Common Warts) with Cryotherapy in an 18-Year-Old Male
An 18-year-old male from Katy, Texas, was treated for multiple warts on his hand, elbow, and knee with cryotherapy. Learn how Village Dermatology in Houston and Katy effectively treats verruca vulgaris with liquid nitrogen and other advanced options.
By: Dr. Caroline Vaughn
Patient Presentation
An 18-year-old male presented as a new patient to our dermatology clinic in Katy, Texas, with multiple irregular skin lesions on his right hand and right elbow. The lesions had been present for several months and were moderately symptomatic, with intermittent itching and inflammation. He presented today for cryotherapy treatment.
Clinical Examination
A focused examination of the right forearm and hand revealed multiple verrucous papules consistent with verruca vulgaris (common warts). The lesions were distributed on the right elbow, right anterior distal thigh, right knee, right thenar eminence, and right radial palm.
The patient appeared well-developed and well-nourished, in no acute distress, and was alert and oriented. Dermatoscopic evaluation confirmed characteristic features of viral warts, including thrombosed capillaries and irregular surface texture.
Diagnosis
Verruca Vulgaris (B07.8)
Associated findings included mild pruritus and cutaneous inflammation at the affected sites.
Treatment Plan and Counseling
The diagnosis and treatment options were reviewed in detail. The patient was informed that resolution of viral warts may require three to four sessions of cryotherapy. Alternative treatment options such as topical salicylic acid, retinoids, Imiquimod (Aldara), Candida antigen injections, or Cantharidin were discussed for future consideration if cryotherapy proves insufficient.
Procedure: Liquid Nitrogen Cryotherapy
A total of 8 lesions were treated using liquid nitrogen, located on:
Right elbow
Right anterior distal thigh
Right knee
Right thenar eminence
The procedure was performed after informed consent, discussing potential risks including blistering, scarring, pigmentary changes, recurrence, incomplete removal, and infection. The patient tolerated the procedure well.
Post-Treatment Instructions:
Expect mild redness, swelling, or blistering for a few days.
Avoid picking or scratching the treated areas.
Apply a gentle moisturizer or petroleum jelly as needed.
Contact the office if lesions spread or become painful.
The patient was scheduled to follow up in one month for reassessment and potential retreatment.
Discussion
Verruca vulgaris is a benign but contagious viral infection caused by the human papillomavirus (HPV). It is commonly seen in teenagers and young adults, particularly on the hands, knees, and elbows due to frequent microtrauma and skin contact.
At Village Dermatology in Katy and Houston, Texas, cryotherapy remains a first-line, effective, and well-tolerated treatment for common warts. By freezing the lesion and destroying virally infected keratinocytes, cryotherapy can lead to clearance over several sessions while minimizing scarring.
Alternative treatments such as Candida antigen immunotherapy can be considered for resistant cases, leveraging the body’s immune response to clear both treated and distant warts.
Conclusion
This case highlights the successful initial management of verruca vulgaris using liquid nitrogen cryotherapy in an adolescent male. With consistent follow-up and adherence to post-treatment care, the patient’s prognosis for full resolution is excellent.
Evaluation and Management of a Suprapubic Cyst and Nasal Scar in a 34-Year-Old Female
A 34-year-old female from Katy, Texas presented with enlarging abdominal lesions and a nasal scar. Dermatologic evaluation revealed an epidermal inclusion cyst and residual nasal scar, both managed with intralesional Kenalog. Learn how Village Dermatology provides expert, customized care for cysts, scars, and acne in Houston and Katy, Texas.
Patient Presentation
A 34-year-old female presented to our dermatology clinic in Katy, Texas, for evaluation of enlarging, irregular skin lesions located on the abdomen. The lesions had been present for several weeks and were described as new and progressively enlarging. She also expressed ongoing cosmetic concerns regarding a previously treated scar on her nasal dorsum.
Clinical Examination
A focused dermatologic exam was performed, including evaluation of the abdomen and nasal region. The patient was well-developed, well-nourished, and in no acute distress. Using dermatoscopic assessment, two primary findings were noted:
Residual Nasal Scar (L90.5):
The patient has a history of prior intralesional Kenalog (ILK) and CO₂ laser therapy to the nasal dorsum for scarring, with significant improvement noted. However, she reported persistent mild discoloration and slight depression of the scar. No evidence of recurrence or abnormal pigmentation was observed.
Plan: The patient was counseled that scars naturally become less noticeable over time but remain permanent features of the skin. Follow-up with her cosmetic surgeon was advised to explore potential refinements for residual cosmetic concerns.Epidermal Inclusion Cyst (L72.8) – Left Suprapubic Skin:
On physical examination, a 1 × 1.8 cm firm, subcutaneous nodule was identified on the left suprapubic region. The lesion was consistent with an epidermal inclusion cyst. Management options—including observation, oral antibiotics, intralesional corticosteroid injection, and surgical excision—were discussed.
After reviewing the benefits and potential for post-procedural scarring, the patient elected to proceed with intralesional Kenalog (ILK) treatment.
Procedure:Lesions injected: 2
Medication: Kenalog 10 mg/mL diluted to 4 mg/cc
Total volume injected: 0.1 cc
The risks of cutaneous atrophy and pigment alteration were reviewed, and the patient tolerated the procedure well. She was advised to monitor for redness, tenderness, or rupture.
Acne Vulgaris (L70.0):
The patient also reported mild inflammatory and comedonal acne. She prefers to focus on non-pharmacologic management, including dietary modification and stress reduction. We discussed evidence-based skincare approaches, including:Gentle, non-comedogenic cleansers and moisturizers
Broad-spectrum sunscreen SPF 30+
Topical retinoids for long-term acne control
Consideration of hormonal therapy (spironolactone) or isotretinoin if future exacerbations occur.
The patient was advised that visible improvement may take up to 2–3 months and to return if symptoms persist or worsen.
Discussion
This case highlights a multidisciplinary dermatologic approach addressing both medical and cosmetic concerns—a common scenario seen in dermatology clinics across Houston and Katy, Texas. Intralesional Kenalog remains a versatile treatment option for both cystic lesions and scar modulation, offering effective results with minimal downtime. Ongoing patient education and individualized treatment planning remain essential for achieving optimal outcomes.
Conclusion
The patient’s cyst was effectively treated with intralesional corticosteroid injection, and her nasal scar continues to improve post-CO₂ laser therapy. With continued observation and adherence to a gentle skincare regimen, her prognosis remains excellent.
Pediatric Eczema and Hand-Foot-Mouth Disease in a 9-Year-Old Male | Village Dermatology Katy & Houston, TX
A 9-year-old male was treated at Village Dermatology in Katy & Houston, TX for chronic eczema and hand-foot-mouth disease. Learn about his treatment with tacrolimus ointment, moisturizers, and supportive care for viral rash.
By: Dr. Ashley Baldree
Introduction
Chronic skin irritation and viral rashes are common dermatologic concerns in children. Eczema (atopic dermatitis) and hand-foot-mouth disease (HFMD) may sometimes appear concurrently, particularly in pediatric patients with sensitive skin. This case describes a 9-year-old male who presented to Village Dermatology in Katy and Houston, Texas, with a chronic dry rash on his hands and arms, as well as recent vesicular lesions consistent with HFMD.
Patient Presentation
A 9-year-old male presented for evaluation of a painful, dry rash affecting the hands and arms for approximately two years.
The rash was lighter than the surrounding skin, itchy, and worsened during cold, dry weather.
Recently, he also developed small vesicles and erosions on both palms.
No prior prescription treatments had been used—only over-the-counter moisturizers.
Examination
A focused dermatologic exam included the hands, wrists, and feet.
Findings included:
Hypopigmented, dry patches on the dorsal hands and wrists, consistent with eczema.
Vesicular and erosive lesions on the right and left ulnar palms, consistent with hand-foot-mouth disease.
The rest of the exam was unremarkable.
The patient appeared well developed, alert, and in no acute distress.
Diagnosis
Dermatitis, Unspecified (L30.9) – consistent with eczema flare related to environmental triggers.
Hand-Foot-Mouth Disease (B08.4) – viral vesicular eruption of the hands and feet.
Management Plan
1. Eczema
The likely diagnosis of eczema was discussed in detail with the patient’s mother, including the chronic nature of the condition and environmental factors such as cold, dry air and frequent hand washing.
Treatment Plan:
Topical tacrolimus 0.1% ointment, applied twice daily to affected areas.
Continue liberal use of emollients 2–3 times daily, particularly after bathing.
Avoid scented soaps, detergents, and fabric softeners.
Recommended lukewarm bathing and use of gentle cleansers.
Discussed use of KattaMD resources for eczema-friendly nutrition and lifestyle guidance.
Counseling:
Reviewed the side effects and proper use of topical steroids and non-steroidal alternatives like tacrolimus.
Advised follow-up in 3 months to assess progress.
2. Hand-Foot-Mouth Disease
Findings: Vesicles and erosions on both palms.
Plan:
Explained that HFMD is a self-limited viral infection that typically resolves within 7–10 days.
Recommended supportive care, including topical anesthetics for any painful lesions.
Advised good hand hygiene and avoidance of close contact with others until lesions crust over.
Discussion
This case illustrates the overlap of chronic eczema and acute viral infection in a pediatric patient. Children with eczema are prone to increased skin sensitivity and may experience flares triggered by viral illnesses or environmental factors. Management focuses on restoring the skin barrier, controlling inflammation, and preventing secondary infections.
Conclusion
At Village Dermatology in Katy and Houston, TX, pediatric patients with chronic rashes receive comprehensive evaluation and care. This case highlights the importance of identifying both chronic conditions like eczema and acute viral infections such as hand-foot-mouth disease, and providing gentle, evidence-based treatment tailored to each child’s needs.
Managing Chronic Rash, Nail Discoloration, and Psoriasis in a 49-Year-Old Female
A 49-year-old female presented to Village Dermatology in Katy, Texas, with chronic rash, nail discoloration, and plaques on the elbows. Diagnosed with onychomycosis, tinea pedis, and psoriasis, she began topical antifungal and steroid therapy with close follow-up planned for optimal results.
At Village Dermatology in Katy and Houston, Texas, we recently evaluated a 49-year-old female who presented as a new patient with a one-year history of itchy, hardened skin on her fingers. The rash was moderate in severity and had not responded to over-the-counter treatments. A comprehensive skin, nail, and hand examination was performed, including dermatoscopic evaluation.
Clinical Findings
The patient exhibited several dermatologic conditions affecting the skin and nails:
Onychomycosis (Nail Fungus) – The right toenail showed discoloration, onycholysis (nail lifting), and subungual debris, classic findings consistent with a fungal nail infection.
Tinea Pedis (Athlete’s Foot) – Fungal infection was also noted on the feet, with scaling and itching between the toes.
Plaque Psoriasis – The patient had erythematous, well-demarcated plaques with silvery scale on both elbows, consistent with chronic plaque psoriasis.
Diagnosis
Onychomycosis (B35.1)
Tinea Pedis (B35.3)
Plaque Psoriasis (L40.0)
Treatment Plan
1. Fungal Infections (Onychomycosis and Tinea Pedis)
The patient was counseled that onychomycosis often fails to respond to topical agents and that oral antifungal therapy, while more effective, carries potential risks such as liver toxicity.
To minimize systemic risks, the patient was started on topical antifungal therapy with:
Ketoconazole 2% cream, applied twice daily to the toenail, feet, and affected hand areas for two weeks, then continued for one additional week after clearing.
She was advised that fungal infections tend to recur, particularly in humid climates such as Houston and Katy, Texas, and should report any side effects immediately.
2. Psoriasis Management
For the plaque psoriasis on her elbows, the patient was counseled on the chronic nature of psoriasis, potential triggers (such as stress, cold weather, and infections), and the importance of consistent skincare.
Treatment was initiated with:
Triamcinolone acetonide 0.1% cream, applied twice daily for 2 weeks, then as needed for flares (not exceeding 14 days per month).
Emollient moisturizers and gentle cleansing routines to support the skin barrier.
The patient was encouraged to use tar-based or zinc pyrithione shampoos, get moderate natural sunlight exposure, and maintain regular follow-ups for flare management.
Patient Counseling and Education
The patient was counseled extensively on:
The chronic and relapsing nature of psoriasis and fungal infections.
The importance of adherence to topical therapies for best outcomes.
Lifestyle factors, such as keeping feet dry, avoiding skin trauma, and reducing stress.
Follow-up was scheduled in 6 weeks to assess the response to therapy and adjust treatment as necessary.
Dermatology Insight
This case highlights how multiple overlapping dermatologic conditions—such as psoriasis and fungal infections—can complicate diagnosis and management. At Village Dermatology, our specialists in Katy and Houston take a comprehensive, individualized approach to skin and nail disorders, emphasizing both medical efficacy and patient education to prevent recurrence and improve quality of life.
Case Report: Dermatographic Urticaria in a 67-Year-Old Female | Village Dermatology Katy & Houston, TX
A 67-year-old female with itchy, red rashes on the arm and leg was diagnosed with dermatographic urticaria at Village Dermatology in Katy & Houston, TX. Learn about her treatment with antihistamines, topical steroids, and follow-up care.
Introduction
Dermatographic urticaria, also known as “skin writing,” is a form of physical urticaria where light scratching or pressure on the skin causes red, raised, itchy welts. While often benign and self-limiting, the condition can be bothersome and impact quality of life. At Village Dermatology in Katy and Houston, Texas, we evaluate and manage urticaria with individualized care plans to reduce discomfort and improve skin health.
Patient Presentation
A 67-year-old female presented with:
An itchy, red rash on the right arm and right leg
Moderate severity, ongoing for several months
Rash appears intermittently and typically resolves within 30 minutes
Past treatment included oral prednisone with limited improvement
Examination
A focused dermatologic exam revealed:
Erythematous, linear, edematous plaques induced by scratching
Findings consistent with acute urticaria with dermatographism
No other concerning lesions identified
The patient was otherwise well-nourished, alert, and in no acute distress.
Diagnosis
Dermatographic Urticaria (L50.3)
Management Plan
Medications
Zyrtec (cetirizine): Patient was already taking 10 mg twice daily; dose increased to 20 mg twice daily as tolerated
Triamcinolone acetonide 0.1% cream: Prescribed for application twice daily to affected areas for 2 weeks, with instructions to use as needed for flares
Counseling & Education
The patient was counseled on:
Skin care: Use bland emollients to reduce scratching and maintain skin barrier health
Expectations: Dermatographism affects 2–5% of the population and is often idiopathic; most cases are benign
When to contact office: If symptoms worsen, fail to improve, or become more symptomatic
Follow-Up
Return in 2 weeks for reassessment
If symptoms persist beyond 6 weeks, initiation of Xolair (omalizumab) may be considered
Conclusion
This case illustrates the clinical presentation and management of dermatographic urticaria in an older female patient. At Village Dermatology in Katy and Houston, TX, we provide both immediate symptom relief with antihistamines and long-term strategies, including advanced therapies like Xolair, when needed.
Full Body Skin Exam in a 73-Year-Old Female: Benign Findings and Sun Protection Counseling
A 73-year-old woman underwent a full body skin exam at Village Dermatology in Katy and Houston, TX. Findings included benign moles, sun spots, seborrheic keratoses, and cherry angiomas. Learn why yearly skin checks are essential for prevention and peace of mind.
At Village Dermatology in Katy and Houston, Texas, we encourage patients of all ages to schedule routine full body skin exams. These comprehensive evaluations are an essential way to monitor for skin cancer, track changes in moles, and identify other skin conditions. This case highlights a 73-year-old female who presented for a preventive exam.
Patient Presentation
A 73-year-old female came to our clinic as a new patient for a full body skin examination. She reported new but stable lesions on the right and left upper back. The lesions had been present for several months, were moderate in severity, and had not changed recently.
She had no history of skin cancer but wanted reassurance and preventive counseling.
Dermatologic Examination
A head-to-toe exam was performed, including the scalp, face, trunk, extremities, nails, and mucosal surfaces. A dermatoscope was used to assess pigmented lesions.
Findings included:
Benign Nevi (Moles): Symmetrical, evenly colored macules and papules throughout.
Seborrheic Keratoses: Flat, waxy pigmented growths, common with aging.
Lentigines (Sun Spots): Light tan macules in sun-exposed areas, consistent with sun damage.
Cherry Angiomas: Bright red vascular papules scattered across the skin.
No suspicious or malignant lesions were detected during the exam.
Impression and Plan
Benign Nevi
Stable, non-worrisome moles.
Counseling: Monthly self-skin checks recommended.
When to call the office: Any mole that changes in size, shape, or color, or begins to itch, burn, or bleed.
Seborrheic Keratoses
Benign age-related growths.
Counseling: No treatment necessary unless irritated or for cosmetic reasons.
Lentigines (Sun Spots)
Result of chronic sun exposure and damage.
Treatment options discussed: sunscreen, bleaching creams, retinoids, chemical peels, and laser therapy.
Daily regimen recommended:
Broad spectrum SPF 30+ sunscreen
Vitamin C serum in the morning for added antioxidant protection
Lip balm with SPF
Wide-brimmed hats and sun-protective clothing for long outdoor exposure
Cherry Angiomas
Small, benign blood vessel growths.
Counseling: Treatment not required, but removal possible with laser or electrodesiccation if cosmetically desired.
Key Takeaway
This case demonstrates the importance of full body skin exams for older adults, even when lesions appear stable or benign. Routine evaluations provide reassurance, early detection of skin cancers, and personalized skin care guidance.
At Village Dermatology in Katy and Houston, TX, we specialize in comprehensive skin exams, mole evaluations, and preventive sun care counseling.
Case Report: Oral Minoxidil and PRP Therapy for Androgenetic Alopecia in a 41-Year-Old Male | Village Dermatology Katy & Houston, TX
A 41-year-old male with androgenetic alopecia was treated at Village Dermatology in Katy & Houston, TX with oral minoxidil and platelet-rich plasma (PRP) therapy. Learn about his treatment plan and follow-up strategy.
by: Caroline Vaughn
Introduction
Androgenetic alopecia (AGA), also known as male pattern hair loss, is the most common cause of progressive hair thinning in men. Many patients initially try over-the-counter treatments like topical minoxidil without success. At Village Dermatology in Katy and Houston, Texas, we offer advanced therapies such as oral minoxidil and platelet-rich plasma (PRP) therapy to help slow progression and stimulate regrowth. This case highlights a 41-year-old male with longstanding hair loss.
Patient Presentation
The patient, a 41-year-old male, presented with:
Generalized hair thinning on the scalp
Symptoms present for 2 years, gradually worsening
Prior trial of over-the-counter topical minoxidil, without significant improvement
He sought evaluation and treatment options for hair restoration.
Examination
A focused scalp examination revealed:
Patterned thinning at the vertex and mid-occipital scalp
No scarring or evidence of inflammatory alopecia
Dermatoscopic findings consistent with androgenetic alopecia
The patient was otherwise well developed, alert, and in no acute distress.
Diagnosis
Androgenetic Alopecia (L64.8)
Management Plan
Diagnostic Approach
A punch biopsy was recommended to confirm the diagnosis and rule out other causes of hair loss.
Treatment Options Discussed
The patient was counseled extensively on treatment choices:
Medical therapies: oral minoxidil, oral finasteride, topical minoxidil, spironolactone
Adjuncts: low-level laser therapy, nutritional supplements, hair transplantation
Procedural options: platelet-rich plasma (PRP) injections and Alma TED therapy (cosmetic, not insurance-covered)
Risks, benefits, and expectations of each were reviewed in detail.
Treatment Chosen
The patient elected to start:
Oral minoxidil 2.5 mg daily (with monitoring for low blood pressure)
PRP therapy, initiated during the visit, with additional sessions planned
Follow-Up
4–6 months for reassessment of response
Baseline photos taken to document progress
AGA handout and PRP pricing reviewed with the patient
Conclusion
This case highlights a comprehensive approach to male pattern hair loss, combining oral minoxidil with PRP therapy. At Village Dermatology in Katy and Houston, TX, we tailor treatment plans to each patient’s goals, offering both medical and procedural options for optimal hair restoration outcomes.
Full Body Skin Exam in a 56-Year-Old Male: Benign Findings, Actinic Keratosis, and Lipoma
A 56-year-old male underwent a full body skin exam at Village Dermatology in Katy and Houston, TX. Findings included benign moles, lentigines, cherry angiomas, a lipoma, and actinic keratosis treated with cryotherapy.
by: Ashley Baldree
At Village Dermatology in Katy and Houston, Texas, annual full body skin exams are a cornerstone of preventive care. These visits allow for the monitoring of existing lesions and early detection of skin cancer or precancerous growths. This case highlights a 56-year-old male with multiple skin findings, including benign nevi, actinic keratosis, lentigines, cherry angiomas, and a lipoma.
Patient Presentation
A 56-year-old male presented for a full body skin examination as a new patient. He reported longstanding lesions on the right upper back and chest, which had been present for years and remained asymptomatic. His primary concern was preventive screening and reassurance.
The patient declined genital examination but agreed to a full inspection of all other body areas.
Dermatologic Examination
A comprehensive skin exam was performed, including dermatoscope evaluation. Findings included:
Benign Nevi: Symmetrical, evenly pigmented macules and papules with no concerning features.
Actinic Keratosis (AK): One precancerous lesion located on the left forehead.
Lentigines (Sun Spots): Light tan macules in sun-exposed areas.
Cherry Angiomas: Bright red vascular papules scattered on the trunk and extremities.
Lipoma: A soft, 6 cm mass on the left posterior shoulder, consistent with a benign fatty tumor.
Impression and Plan
Benign Nevi
Plan: Observation only.
Counseling: Monthly self-skin checks recommended. Patient educated on the ABCDEs of melanoma (Asymmetry, Border, Color, Diameter, Evolution).
Actinic Keratosis
Treatment: One lesion treated with liquid nitrogen cryotherapy.
Risks explained: Crusting, blistering, pigment changes, incomplete removal, recurrence, and infection.
Counseling: AKs are precancerous and should be treated promptly to prevent progression to squamous cell carcinoma.
Lentigines
Plan: Sun protection counseling.
Recommendations: Daily broad spectrum SPF 30+ sunscreen, reapplied every 2 hours during sun exposure. Suggested options included mineral sunscreens and lip balm with SPF.
Optional treatments discussed: bleaching creams, retinoids, chemical peels, and laser.
Cherry Angiomas
Plan: Observation only.
Counseling: Removal with laser or electrodesiccation is optional if desired for cosmetic reasons.
Lipoma
Findings: 6 cm soft tissue mass on left posterior shoulder.
Plan: Referral to plastic surgeon Dr. Rodger Brown for surgical excision due to size and location.
Counseling: Lipomas are benign and often stable, but removal can be considered for comfort or cosmetic reasons.
Key Takeaway
This case demonstrates the value of comprehensive annual skin exams. Even when lesions appear stable or benign, dermatology visits provide reassurance, allow for the treatment of precancerous conditions like actinic keratoses, and guide patients on cosmetic or surgical options for benign growths.
At Village Dermatology in Katy and Houston, TX, we provide expert full body skin checks, mole monitoring, cryotherapy, and referrals for surgical removal of large benign growths.
Case Report: Molluscum Contagiosum and Verruca Vulgaris in a 7-Year-Old Female | Village Dermatology Katy & Houston, TX
A 7-year-old girl was treated at Village Dermatology in Katy & Houston, TX for molluscum contagiosum and warts on the knee and buttocks using cantharidin therapy. Learn about her diagnosis, treatment, and follow-up care.
Introduction
Skin infections caused by viruses are common in children, with molluscum contagiosum and warts (verruca vulgaris) among the most frequent. These lesions may persist for years, spread to other areas, and cause parental concern. At Village Dermatology in Katy and Houston, Texas, we offer safe and effective treatments, including cantharidin therapy, to help children achieve clear skin.
Patient Presentation
The patient, a 7-year-old female, presented with:
Growing warts on the right knee, present for years
Shiny bumps on the abdomen and buttocks, suspected to be molluscum contagiosum
She had not received prior treatment for these lesions.
Examination
A focused dermatologic exam revealed:
Verruca vulgaris (common warts): cauliflower-like papules on the right knee
Molluscum contagiosum: pink, shiny, dome-shaped papules with central umbilication on the abdomen, right buttock, and left buttock
The patient was otherwise well-nourished, alert, and in no acute distress. A dermatoscope was used to confirm clinical features.
Diagnosis
Molluscum Contagiosum (B08.1)
Verruca Vulgaris (B07.8) with associated cutaneous inflammation
Treatment Plan
Molluscum Contagiosum
Diagnosis discussed with the patient’s mother
Cantharidin (Cantharone) applied to 2 enlarging lesions on the buttocks
Counseling provided:
Lesions may blister before resolving
Spread occurs via direct contact or swimming pools
If lesions spread rapidly or cause a rash, return to clinic
Verruca Vulgaris (Common Warts)
Cantharidin therapy applied to 3 inflamed warts on the right knee
Counseling provided:
Warts are caused by human papillomavirus (HPV)
Can spread via direct contact
Other treatment options include salicylic acid, retinoids, Aldara cream, or cryotherapy
Warts may recur despite treatment
Post-Treatment Instructions
Leave Cantharone on for 6–8 hours, then wash off thoroughly with soap and water
Watch for possible side effects: blistering, scabbing, or pigmentary changes
Follow-up as needed if lesions persist, spread, or recur
Conclusion
This case demonstrates the effective use of cantharidin therapy for treating molluscum contagiosum and warts in pediatric patients. At Village Dermatology in Katy and Houston, TX, we provide comprehensive and child-friendly dermatologic care for viral skin infections, helping families manage both the medical and cosmetic aspects of these conditions.
Guttate Psoriasis in a 32-Year-Old Male: Case Study and Treatment with Light Therapy
A 32-year-old male was diagnosed with guttate psoriasis at Village Dermatology in Katy and Houston, TX. Learn how phototherapy and topical treatments can help manage red, flaky, itchy lesions covering 20% of the body.
by: Ashley Baldree
At Village Dermatology in Katy and Houston, Texas, we treat a wide range of skin conditions, including psoriasis. This case highlights a 32-year-old male with guttate psoriasis, a form of psoriasis that often appears suddenly and can be triggered by infections such as strep throat.
Patient Presentation
A 32-year-old male presented for evaluation of red, flaky, itchy skin lesions. The psoriasis had been present for several months and was distributed across multiple areas of the body.
He reported no family history of psoriasis and had not previously tried biologic therapies or other systemic treatments. At presentation, he was using only a prescription topical steroid (triamcinolone cream).
Dermatologic Examination
A comprehensive skin exam was performed, including use of a dermatoscope.
Findings included:
Guttate psoriasis: Multiple small, red, scaly papules scattered across the body.
Body Surface Area (BSA) Involvement: Estimated at 20%.
Skin type: IV (moderate brown skin).
No other significant abnormalities were detected.
Impression and Plan
Diagnosis: Guttate Psoriasis (L40.4)
This type of psoriasis is typically associated with an immune response, often following strep throat infections. It presents with numerous small, red, scaly spots resembling “raindrops” on the skin.
Treatment Plan
Continue topical triamcinolone cream as needed.
Initiate light therapy (phototherapy) to reduce inflammation, slow down excessive skin cell turnover, and promote clearance of lesions.
Patient agreed to proceed with treatment.
Counseling
Guttate psoriasis often resolves with treatment of the triggering infection.
Other options include topical steroids, UV therapy, and systemic therapies (reserved for severe or persistent cases).
Patients with a history of guttate psoriasis have an increased risk of developing chronic plaque psoriasis later in life.
Advised to return if symptoms worsen or fail to improve after several months of treatment.
Key Takeaway
This case illustrates the importance of early recognition and treatment of guttate psoriasis. With proper dermatologic care, patients can achieve significant improvement through therapies such as topical treatments and phototherapy.
At Village Dermatology in Katy and Houston, TX, we provide comprehensive evaluation and treatment for psoriasis and other chronic skin conditions.
Case Report: Full Body Skin Examination in a 52-Year-Old Female with Multiple Benign Lesions | Village Dermatology Katy & Houston, TX
A 52-year-old female presented for a full body skin exam at Village Dermatology in Katy & Houston, TX. Findings included benign nevi, lentigines, cherry angiomas, seborrheic keratoses, and dermatofibromas. Learn about her counseling, cryotherapy treatment, and prevention plan.
by: Caroline Vaughn
Introduction
Full body skin examinations are a vital part of preventive dermatology, particularly for patients with a history of tanning bed use or multiple skin lesions. At Village Dermatology in Katy and Houston, Texas, our dermatologists carefully evaluate the skin for concerning growths while providing patient education about sun safety and skin cancer prevention. This case highlights a 52-year-old female who presented for her annual skin examination.
Patient Presentation
The patient, a 52-year-old female, presented for a routine full body skin exam. She reported skin lesions on the chest that had been present for several months. They were asymptomatic and of moderate severity. She has a history of tanning bed use, which increases her risk of skin cancer.
Examination
A comprehensive full body skin exam was performed, including the scalp, face, trunk, extremities, nails, and groin (patient declined underwear removal). A dermatoscope was used for detailed mole evaluation.
Findings included:
Benign nevi: Regular, symmetrical moles without concerning features
Lentigines: Sun-induced pigmented lesions (sunspots)
Cherry angiomas: Small vascular growths
Seborrheic keratoses: Benign, warty growths
Dermatofibromas: Firm nodules on right calf and left buttock
Rash on right ear: Possible dermatitis, differential includes seborrheic dermatitis vs. eczema
Neoplasm of uncertain behavior: Courtesy liquid nitrogen (LN2) treatment performed
The patient was otherwise well-appearing, alert, and in no acute distress.
Counseling & Management
1. History of Tanning Bed Use
Counseling on increased melanoma, basal cell carcinoma, and squamous cell carcinoma risk
Emphasized sun avoidance, sunscreen SPF 30+, and protective clothing
2. Benign Nevi (D22.9)
No treatment required
Patient educated on monthly self-skin checks and to return for changes in size, color, or symptoms
3. Lentigines (L81.4)
Benign, but may be treated with sunscreen, retinoids, chemical peels, or laser if desired
Counseling on consistent broad spectrum SPF 30+ use
4. Cherry Angiomas (D18.01)
Benign vascular lesions, no treatment required
May be removed with laser or electrodesiccation if cosmetic concerns arise
5. Seborrheic Keratoses (L82.1)
Common, benign growths that increase with age
No treatment needed
6. Dermatofibromas (D23.71, D23.5)
Benign scar-like nodules
Stable, but may be surgically removed if symptomatic or enlarging
7. Dermatitis, Unspecified (L30.9)
Rash on right ear treated with over-the-counter hydrocortisone cream
Patient advised to return if not improving
8. Neoplasm of Uncertain Behavior
Treated with liquid nitrogen cryotherapy today
Monitored for resolution; follow-up in 1 year
Conclusion
This case demonstrates the importance of comprehensive annual skin exams, especially in patients with risk factors such as tanning bed history. At Village Dermatology in Katy and Houston, TX, we provide thorough evaluations, identify both benign and concerning lesions, and counsel patients on skin cancer prevention and sun safety.
Case Study: Pilar Cyst, Benign Nevi, and Sun Damage in a 37-Year-Old Female
A 37-year-old female underwent a full body skin exam at Village Dermatology in Katy and Houston, TX. Findings included a pilar cyst, benign moles, lentigines (sun spots), and seborrheic keratosis. Learn why regular skin exams and sun protection are essential.
by: Ashley Baldree
At Village Dermatology in Katy and Houston, Texas, we routinely evaluate patients for skin lesions to identify both benign and potentially concerning findings. This case highlights a 37-year-old female presenting for a comprehensive skin exam, with findings including a pilar cyst, benign moles, lentigines (sun spots), and seborrheic keratosis.
Patient Presentation
A 37-year-old female presented as a new patient for evaluation of brown skin lesions present throughout the body. The lesions had been present for years, were moderate in severity, and had not been treated in the past. She reported no personal history of skin cancer.
Dermatologic Examination
A full-body skin exam was performed with a dermatoscope. Key findings included:
Pilar Cyst: A firm, subcutaneous cyst located on the mid-occipital scalp.
Benign Nevi (Moles): Symmetrical, evenly pigmented macules and papules throughout, including a 4 mm mole on the left midback, documented for monitoring.
Lentigines (Sun Spots): Reticulated, light tan macules distributed in sun-exposed areas.
Seborrheic Keratosis: A pigmented, waxy papule and flat lesion on the right leg.
No evidence of skin cancer was noted.
Impression and Plan
Pilar Cyst
Counseling: Pilar cysts are benign keratin-filled sacs that often run in families.
Plan: No treatment required unless cyst becomes painful, red, or ruptures.
Benign Nevi
Plan: Observation, with a 6-month recheck of the mole on the back.
Counseling: Monthly self-skin checks recommended; patient advised to report any changes in size, shape, or color.
Lentigines (Sun Spots)
Plan: Emphasis on sun protection with broad spectrum SPF 30+ sunscreen.
Treatment options: Topical bleaching creams, retinoids, chemical peels, or laser for cosmetic improvement.
Seborrheic Keratosis
Counseling: Benign, age-related growths that require no treatment unless irritated or cosmetically undesired.
Key Takeaway
This case illustrates the importance of regular skin exams for early detection and reassurance. While all findings were benign, the patient received counseling on sun safety, mole monitoring, and when to seek medical attention.
At Village Dermatology in Katy and Houston, TX, we specialize in comprehensive skin exams, mole monitoring, sun protection counseling, and cosmetic dermatology for both prevention and peace of mind.
Case Report: Atopic Dermatitis and Folliculitis in a 28-Year-Old Patient | Village Dermatology Katy & Houston, TX
A 28-year-old patient with itchy rashes and acne-like bumps was diagnosed with atopic dermatitis and folliculitis at Village Dermatology in Katy & Houston, TX. Learn about their treatment plan with topical steroids, clindamycin, and skin care counseling.
Introduction
Chronic skin conditions like atopic dermatitis (eczema) and folliculitis can significantly affect quality of life if not properly treated. At Village Dermatology in Katy and Houston, Texas, our dermatologists specialize in evaluating persistent rashes, providing targeted treatment, and educating patients on long-term skin care strategies. This case highlights a 28-year-old patient presenting with eczema flare-ups and folliculitis.
Patient Presentation
The patient, a 28-year-old, presented with:
Itchy, red rash on arms and left hand, present for several months
History of childhood eczema
New acne-like bumps on the buttocks, especially after wearing tight clothing
The patient was not on any treatment prior to evaluation.
Examination
A dermatologic examination revealed:
Eczema patches: well-demarcated, eczematous, inflamed patches on the arms and hands
Folliculitis: follicular-based pustules on the buttocks
The patient appeared well-nourished, alert, and in no acute distress.
Impressions & Treatment Plan
1. Atopic Dermatitis (Eczema, L20.89)
History of flares since childhood
Prescribed triamcinolone acetonide 0.1% cream, applied BID during flares for up to 14 days/month
Advised on proper skin care:
Use lukewarm water with mild cleansers
Apply emollients (CeraVe, Cetaphil, Vanicream) 2–3 times daily
Avoid scented detergents and fabric softeners
Moisturize immediately after bathing
Counseling on triggers: stress, scented soaps, detergents, dry skin, weather changes, and scratching
Education on side effects of long-term steroid use, including skin thinning and hypopigmentation
2. Folliculitis
Likely exacerbated by tight-fitting clothing and friction
Patient already using benzoyl peroxide wash (Panoxyl bar)
Prescribed clindamycin 1% gel, applied once to twice daily for prevention and treatment
Counseled that post-inflammatory hyperpigmentation (brown spots) may remain temporarily but fade with time
If resistant, future treatment may include oral doxycycline
Counseling & Education
The patient was instructed to:
Continue moisturizers daily for eczema
Use benzoyl peroxide wash and clindamycin for folliculitis
Avoid overuse of topical steroids to minimize side effects
Return for follow-up in 2 months or sooner if symptoms worsen
Conclusion
This case highlights the importance of personalized dermatologic care for patients with both eczema and folliculitis. At Village Dermatology in Katy and Houston, TX, our team provides tailored treatment plans combining medications, lifestyle guidance, and preventive care to ensure healthy skin and improved quality of life.