Annual Skin Exam in Katy, Texas: Early Detection of Benign Lesions & Sun Damage in a 42-Year-Old Female

By: Dr. Ashley Baldree

At Village Dermatology in Katy and Houston, Texas, early detection of skin concerns remains a cornerstone of our commitment to long-term skin health. In this patient case, a 42-year-old female presented for a routine full-body skin exam — a vital preventive measure that plays a critical role in identifying both benign and potentially concerning skin lesions.

Patient Presentation

This new patient visited our Katy dermatology clinic for a full-body skin examination. While she reported no personal or family history of skin cancer, she sought ongoing monitoring due to a variety of skin lesions that had developed over the years. These lesions were spread across the body, and her primary concern was ensuring they remained non-cancerous.

Comprehensive Skin Exam Findings

A meticulous examination was performed, covering all areas of the body — from the scalp to the soles of the feet. A dermatoscope was used to enhance lesion visualization, allowing for in-depth assessment of pigmentation patterns and structural features.

Key dermatological findings included:

• Benign Nevi (moles) with uniform globular patterns:

  • 4mm nevus in the left inframammary crease

  • 7mm nevus on the left midfoot

  • 5mm nevus on the right buttock

• Lentigines (sun spots) were also observed, presenting as reticulated light tan macules across the trunk — consistent with cumulative sun damage.

• History of tanning bed use noted on the inferior thoracic spine, which increases long-term risk for melanoma and non-melanoma skin cancers.

Treatment & Preventive Counseling

Although all lesions were deemed non-malignant, this visit offered an excellent opportunity for preventive counseling:

• Sun Protection: The patient was educated on the use of broad-spectrum SPF 30+ sunscreen and encouraged to wear sun-protective clothing.

• Tanning Bed Risks: Counseling addressed the well-documented carcinogenic impact of tanning beds, emphasizing their role in skin aging and cancer development.

• Monthly Self-Skin Checks: The patient was advised to monitor her moles for any changes in size, shape, color, itching, or bleeding.

Next Steps

The patient was advised to return annually for full-body skin checks or sooner if changes are noticed. No biopsies were needed at this time, but her comprehensive screening ensures early intervention, should any lesion become suspicious in the future.

Persistent Neck Rash for Over 15 Years: Diagnosing a Complex Dermatologic Case in a 42-Year-Old Male

By: Dr. Caroline Vaughn

At Village Dermatology in Katy and Houston, we understand that chronic skin conditions can deeply impact quality of life. Today, we're sharing the story of a 42-year-old male patient who presented with a long-standing rash on his neck—an issue he has battled for over 15 years without relief.

Patient Background

This patient arrived as a new consult, seeking answers for an itchy, persistent rash localized on the right inferior posterior neck and extending to parts of the upper back and trunk. He had previously consulted multiple providers and been prescribed topical and oral steroids, with minimal to no improvement. The prolonged nature of his symptoms and failure to respond to prior treatment made this a particularly challenging dermatologic case.

He expressed frustration with the lack of clarity surrounding his diagnosis and proactively requested a biopsy to identify the exact cause before pursuing additional treatments.

Clinical Examination

A focused dermatologic examination was performed, including the:

• Neck and trunk

• Face, eyelids, and lips

Although a full body skin check was offered, the patient declined. The skin revealed chronic patches on the mid posterior neck and upper back with characteristics that suggested several possible conditions.

Using dermatoscopy, we noted the rash had a nonspecific appearance, raising a differential diagnosis of:

• Chronic Dermatitis (L30.9)

• Lichen Simplex Chronicus (LSC)

• Macular Amyloidosis

Next Steps: Punch Biopsy and Counseling

Given the chronicity and diagnostic uncertainty, a 4mm punch biopsy was performed on the mid posterior neck to obtain a tissue sample for histological examination. The area was numbed using local anesthesia and closed with 4-0 Nylon sutures.

During this visit, the patient received detailed counseling:

• Moisturizers and emollients were recommended for skin hydration

• We discussed phototherapy as a non-steroidal option pending biopsy results

• He deferred further steroid use until a definitive diagnosis is made

What This Case Highlights

This case is a perfect example of how long-term, unresolved rashes require a stepwise and evidence-based approach. Biopsy is a critical tool when first-line treatments fail or diagnosis is unclear. Conditions like macular amyloidosis or lichen simplex chronicus may appear similar clinically but differ significantly in treatment strategies.

At Village Dermatology, we provide thorough evaluations for patients across Katy and Houston, ensuring that even long-standing skin concerns are met with clarity and compassion.

Pediatric Dermatology Case: Treating Verruca Vulgaris on the Thumb of a Young Patient in Katy, TX

By: Dr. Ashley Baldree

Case Overview

At Village Dermatology, we routinely care for patients of all ages—especially children experiencing common dermatological concerns. One recent case involved a 4-year-old boy from the Katy and Houston, Texas area, who presented with a skin lesion on his left thumb. The lesion had been enlarging over several months, prompting concern from the family. This case highlights the importance of early intervention and education around pediatric viral skin conditions like verruca vulgaris (common warts).

Clinical Presentation

The young patient, otherwise healthy, had a moderate-sized wart on the distal radial side of the left thumb. His family reported the lesion had been present for months and was continuing to grow. There was no prior treatment history, and the child was brought in specifically for evaluation and potential management.

During the full physical exam, the dermatology team noted that the lesion had the classic cauliflower-like appearance typical of verruca vulgaris. A dermatoscope was used to confirm the diagnosis.

Diagnosis: Verruca Vulgaris

Verruca vulgaris, or the common wart, is a viral skin infection caused by the human papillomavirus (HPV). In children, warts are very common and often appear on the hands, fingers, and feet. They are contagious, can spread to other areas of the body or to others, and while benign, can cause discomfort, embarrassment, or functional limitation if left untreated.

Treatment Plan

To address the thumb lesion, the following steps were taken:

• Cryotherapy with Liquid Nitrogen: The wart was treated with 2 freeze-thaw cycles of liquid nitrogen, a standard and effective therapy for many pediatric patients. Consent was obtained from the family prior to the procedure.

• Salicylic Acid Topical Therapy: As part of ongoing home care, the patient was also prescribed topical salicylic acid, a proven adjunct therapy that helps soften and dissolve the wart over time.

• Parental Counseling: The dermatology team counseled the family on proper wart care, including:

  • Avoiding direct contact with the lesion to prevent spread

  • Applying topical treatments consistently

  • Monitoring for recurrence or changes in appearance

Follow-Up Recommendations

The patient and family were instructed to monitor the area for healing or new lesions, and to follow up if:

• The wart spreads to new locations

• It fails to improve after several weeks of treatment

• There is any change in color, size, or discomfort

Why Early Pediatric Wart Treatment Matters

While many warts in children can resolve on their own, professional evaluation ensures that no concerning features are missed, such as rapid growth, bleeding, or signs of other skin conditions. Early treatment also helps prevent spreading to other children—especially in shared environments like schools and playgrounds.

At Village Dermatology in Katy and Houston, TX, we specialize in compassionate, evidence-based pediatric dermatologic care that keeps families informed and involved.

When Chest Cysts Become Painful: A Dermatology Case Study in Katy & Houston, TX

By: Dr. Ashley Baldree

At Village Dermatology, we regularly treat patients experiencing complex skin conditions, including inflamed epidermal inclusion cysts. In this case report, we highlight a 65-year-old male patient from the greater Houston area who presented with a painful, enlarging cyst on his chest — a common but often underestimated condition.

Patient Background and Initial Concerns

The patient, a 65-year-old male, came to our clinic for evaluation of a persistent cyst located on the right medial superior chest. He reported that the lesion had been present for several months but had recently become painful, enlarged, and inflamed, prompting his visit. The patient had no history of treatment and initially hoped for conservative options like hot compresses.

Clinical Examination and Diagnosis

A focused dermatologic exam confirmed the presence of a painful, erythematous nodule, consistent with an inflamed epidermal inclusion cyst. These cysts often mimic infections when inflamed, displaying redness, swelling, and tenderness. Although non-cancerous, they can become acutely bothersome or infected if untreated.

Immediate Intervention: Incision and Drainage

Due to the severity of symptoms — including swelling, redness, and discomfort — a minor surgical procedure was indicated. The lesion was treated with an incision and drainage (I&D) procedure to relieve pressure and remove the contents of the cyst. Local anesthesia was administered, and the wound was carefully drained, cleaned, and dressed.

This procedure was medically necessary, as conservative measures had failed, and the condition presented signs of infection and significant discomfort.

Treatment and Medication

Following the I&D procedure, the patient was prescribed doxycycline monohydrate 100 mg to address potential underlying infection. He was counseled about:

• Photosensitivity precautions: Avoiding sun exposure and using sunscreen.

• Proper medication usage: Taking doxycycline with meals and avoiding lying flat for at least an hour after taking the pill.

The patient was advised to follow up in 4 weeks for potential cyst excision to prevent recurrence.

Educational Points for Patients in Katy & Houston, TX

Epidermal inclusion cysts are common in dermatology and are usually benign. However, when they become inflamed or infected, they require medical attention. Key takeaways include:

• Early evaluation can prevent worsening symptoms.

• Warm compresses may help initially, but infected or enlarging cysts often need intervention.

• Incision and drainage is a safe, effective procedure when performed in a medical setting.

• Follow-up care ensures resolution and helps prevent recurrence.

Dermatology Expertise Close to Home

At Village Dermatology, we provide expert dermatologic care to patients in Katy and Houston, Texas. If you or a loved one experiences any unusual skin growths, painful lumps, or cysts, contact our clinic for professional evaluation and treatment.

A Complex Case of Acne and Chronic Rash in a Young Adult Female: Village Dermatology Katy & Houston Case Study

By: Dr. Caroline Vaughn

Patient Background

A 20-year-old female from the Houston area presented to Village Dermatology for evaluation and treatment of two persistent dermatological conditions: moderate acne and a chronic, itchy rash on the legs and trunk. She had been using over-the-counter acne products with little relief and was currently applying a topical antifungal cream for her rash without significant improvement.

Clinical Findings

On physical examination, she had:

• Comedonal and inflammatory acne lesions across the face, arms, and trunk.

• Scaly, erythematous rash patches on the thighs, trunk, and sternum—especially itchy on the chest.

• Negative KOH prep for fungal elements, ruling out active tinea.

Her acne had been long-standing and resistant to standard topical treatments. Her rash, present for several months, appeared consistent with pityriasis rosea (PR) though other conditions such as contact dermatitis and nummular eczema were considered.

Diagnosis & Differentiation

• Severe acne (L70.0): The presence of scarring and lack of response to OTC treatments led to the decision to initiate isotretinoin (Accutane) therapy.

• Dermatitis (L30.9): Due to the non-specific nature and chronicity of the rash, the working diagnosis was dermatitis of unspecified cause, pending further response to treatment.

Treatment Plan

Acne:

• Isotretinoin (Accutane) initiation at 40mg/day following iPledge compliance procedures.

• Monthly lab monitoring (hepatic panel, triglycerides) and pregnancy tests.

• Aviane oral contraceptive prescribed for dual contraception during isotretinoin therapy.

• Thorough counseling on risks: dry skin, joint aches, photosensitivity, mood changes, and teratogenicity.

Dermatitis:

• Triamcinolone 0.1% cream applied twice daily for two weeks.

• Skin care instructions: regular moisturization, use of emollients, and avoiding application of steroids to the face and groin.

• Follow-up in 1 month to assess response.

Patient Education & Compliance

Detailed counseling was provided:

• The patient understood the long-term commitment and follow-up required for isotretinoin therapy.

• Education on the importance of sunscreen use, gentle cleansers, and avoiding triggers for dermatitis was emphasized.

Follow-Up Plan

• Monthly visits during isotretinoin therapy for acne management and monitoring.

• 1-month follow-up for reassessment of dermatitis response to triamcinolone.

Conclusion

This case highlights the importance of personalized dermatological care in managing complex skin conditions in young adults. At Village Dermatology, we provide expert acne treatment and rash evaluation in Katy and Houston, Texas, ensuring every patient receives tailored care that targets the root causes of their skin concerns.

Evaluation of Skin Lesions in a 53-Year-Old Female

By: Dr. Ashley Baldree

At Village Dermatology, we prioritize comprehensive skin evaluations, especially for patients with a personal or family history of skin abnormalities. This case highlights the importance of regular skin checks and timely biopsies in the early detection and management of potentially harmful lesions.

Patient Background

A 53-year-old established female patient presented to our clinic for evaluation of brown, moderate skin lesions. These lesions were located on the left hand, left forearm, and right zygoma. Her medical history was notable for dysplastic nevi, a condition that requires vigilant monitoring due to an increased risk of skin cancer.

Clinical Findings

On physical examination, the patient appeared well-nourished and in no acute distress. The evaluation, which included dermatoscopic inspection of the head, face, left forearm, and hand, identified multiple pigmented lesions.

1. Benign Nevi
   These pigmented nests of cells were observed across various body sites without any signs of malignancy. No immediate intervention was necessary.

2. Papule on the Left Dorsal Middle Finger
   A suspicious papule raised concern for a neoplasm of unspecified behavior. Differential diagnoses included cyst, dermatofibroma (DF), or blue nevus.

   • Procedure: A shave biopsy was performed under local anesthesia and sent for histopathological examination.

3. Papule on the Left Ventral Proximal Forearm
   Another suspicious lesion was identified on the inner forearm. Differential considerations included congenital nevus or melanoma.

   • Procedure: A shave biopsy was also completed on this site under sterile conditions.

Dermatologic Interventions

Each biopsy was done using a Dermablade after administering lidocaine with epinephrine. Drysol was applied for hemostasis, and post-procedural care included Petrolatum and bandaging. The patient was thoroughly counseled on signs of complications and instructed to contact the clinic if results were not communicated within two weeks.

Patient Counseling & Prevention

• Monthly Self-Skin Exams were emphasized to help the patient monitor for changes in size, color, or shape of moles.

• Sun Protection: Use of a broad-spectrum SPF 30+ sunscreen was recommended daily.

• Skin Cancer Awareness: Education was provided on warning signs such as itching, bleeding, or rapid growth of lesions.

The patient plans to return in six months for a full-body skin screening, reinforcing the value of ongoing dermatologic surveillance.

Managing Moderate Atopic Dermatitis with Rinvoq | Village Dermatology Katy & Houston, TX

By: Dr. Caroline Vaughn
Introduction

Atopic dermatitis (eczema) can persist well into adulthood, impacting both comfort and confidence. At Village Dermatology, we offer advanced treatment options like Rinvoq (upadacitinib), a JAK inhibitor approved for moderate to severe eczema. This case highlights the progress of a 56-year-old woman after four months of Rinvoq therapy.

Case Overview

Patient: 56-year-old female
Condition: Moderate atopic dermatitis
Treatment Duration: 4 months on Rinvoq 30mg daily
History: Atopic dermatitis localized to scalp, with persistent patches on neck, face, shoulder, and forearm

Treatment Progress with Rinvoq

The patient reported:

• Significant symptom improvement

• No side effects from Rinvoq

• Ongoing use of topical medications only for small, resistant areas

📈 Breakthrough Symptoms:

• Mild itchy bumps on face and posterior neck

• Differential included breakthrough eczema vs. contact dermatitis

Updated Treatment Plan

To manage these residual symptoms and maintain control:

💊 Systemic Therapy (Continued):

• Rinvoq 30mg daily

  • Monitoring risks discussed: infections, cardiovascular events, shingles, malignancy

  • High-risk medication counseling emphasized

🧴 Topical & Supportive Therapies:

• Ketoconazole 2% shampoo – 2–3x/week for scalp and face

• Clobetasol shampoo – for flare-ups on scalp

• Hydrocortisone 2.5% cream – short-term use on face

🧼 Skin Care Counseling:

• Lukewarm water bathing

• Gentle cleansers (unscented)

• Moisturizing 2–3 times daily

• Avoiding scented detergents, handwashing, and scratching

Patient Education

We provided detailed counseling about:

• Rinvoq safety: infection risks, cardiovascular monitoring, and need for regular lab testing

• Flare-up triggers: stress, seasonal changes, irritants

• When to call: if symptoms worsen or signs of infection (e.g., crusting, yellow discharge) occur

Why This Matters in Katy & Houston, TX

Rinvoq is transforming the lives of patients with chronic eczema in areas like Houston and Katy, where humidity and heat often aggravate the condition. Our dermatologists provide comprehensive management, from high-risk medication monitoring to tailored topical therapy.

Follow-Up Plan

The patient will return in 6 months for a routine evaluation and medication monitoring.

Evaluating Bleeding Chest Lesions in Older Adults | Biopsy for Neoplasm of Uncertain Behavior

By: Dr. Caroline Vaughn

Introduction

Skin lesions that bleed, ulcerate, or change over time warrant thorough evaluation—especially in patients with a history of skin cancer. At Village Dermatology, we regularly assess suspicious growths using advanced tools and precise biopsy techniques. This case describes a 77-year-old woman presenting with chronic, bleeding papules on her chest and a past history of squamous cell carcinoma (SCC).

Case Presentation: Longstanding, Bleeding Chest Lesion

Patient: 77-year-old female
Chief Complaint: Bleeding, irritated lesion on the chest
Duration: Several years
Past Medical History: Squamous cell carcinoma
Concern: Potential recurrence or malignant transformation

Physical Exam Findings

On examination, an erythematous papule was noted on the right lateral superior chest. The lesion was:

• Moderately inflamed

• Chronically present

• Unresponsive to prior self-care

Given its bleeding nature and the patient’s SCC history, we considered the following differential diagnosis:

• Neoplasm of Uncertain Behavior

• Squamous Cell Carcinoma (SCC)

• Irritated Seborrheic Keratosis (ISK)

• Hypertrophic Actinic Keratosis (HAK)

Next Step: Shave Biopsy

To reach a definitive diagnosis, we performed a shave biopsy, which is a safe and minimally invasive technique for sampling superficial lesions.

🩺 Procedure Details:

• Location: Right lateral superior chest

• Technique: Shave biopsy to the dermis using a Dermablade

• Anesthesia: 0.5 cc of 1% lidocaine with epinephrine

• Hemostasis: Controlled with Drysol

• Post-procedure Care: Petrolatum and dressing applied

The sample was sent to pathology for H&E staining to confirm diagnosis.

Patient Counseling & Safety Measures

We discussed:

• Risks of biopsy: scarring, bleeding, infection, incomplete removal

• Importance of follow-up for pathology results

• When to call: If the lesion worsens or if results are not received within 2 weeks

Why This Matters in Katy & Houston, TX

As people age, the risk of skin cancer increases, particularly in sun-exposed areas like the chest and shoulders. This case underscores the need for early dermatologic evaluation—especially in patients with a cancer history or persistent, symptomatic lesions.

Treating Facial Melasma with Prescription Therapy | Village Dermatology Katy & Houston, TX

By: Dr. Ashley Baldree

Introduction

Melasma is a common skin condition that causes brown to gray-brown patches on the face, especially among women. At Village Dermatology, we understand that skin discoloration can be frustrating, especially when it's mistaken for other conditions like vitiligo. In this case, we helped a 42-year-old woman who had been struggling with light and dark patches on her face for over a year.

Case Summary: Facial Discoloration Concerns

Patient: 42-year-old female
Primary Concern: Discoloration on the face
Duration: 1 year
Distribution: Right cheek, left cheek, and forehead
Medical History: Family history of vitiligo (aunt); patient is a smoker

Clinical Findings & Diagnosis

We performed a comprehensive facial exam, including a Wood’s lamp test (used to differentiate pigmentation disorders). The lighter areas appeared to reflect the patient's natural baseline skin tone, while the darker, ill-defined hyperpigmented patches were consistent with melasma—not vitiligo.

Diagnosis: Melasma (L81.1)
Distribution: Periorbital and malar regions (under eyes and cheeks)

Treatment Plan for Melasma

Melasma can be challenging to treat, especially with long-term sun exposure or hormonal triggers. We created a treatment plan combining prescription therapy and sun protection:

🧴 1. Tri-Luma Cream (Hydroquinone + Tretinoin + Fluocinolone)

• Application: At bedtime for 3 months, then paused for 1 month

• Purpose: Targets pigmentation at the cellular level

• Counseling: Discussed risk of irritation, dryness, and rare side effect of pseudoochronosis (bluish skin discoloration)

💊 2. Oral Tranexamic Acid (650mg)

• Dose: Half a tablet twice daily

• Purpose: Reduces melanin production via hormonal pathways

• Counseling: Avoid smoking and hormonal contraceptives; discussed small risk of blood clots

☀️ 3. Daily Tinted Broad-Spectrum Sunscreen (SPF 30+)

• Essential for preventing recurrence and protecting sensitive skin during treatment

Lifestyle Guidance & Expectations

• Triggers of Melasma: Sun exposure, heat, pregnancy, and birth control pills

• Skin Care Recommendations: Non-irritating cleansers, sun avoidance, and daily SPF use

• Patient Education: Counseling provided on medication risks, expectations for gradual improvement, and the importance of treatment breaks

Photos were taken to monitor progress, and the patient will return in 3 months for a skin check and evaluation of treatment efficacy.

Why This Matters in Katy & Houston, TX

Sun exposure in Houston and Katy's warm climate can worsen melasma, especially for individuals with medium-to-darker skin tones. Our team at Village Dermatology provides evidence-based treatments with personalized education to help patients manage pigmentation safely and effectively.

Treating Tinea Corporis (Ringworm) in Older Adults | Village Dermatology Katy & Houston, TX

By: Dr. Ashley Baldree

Introduction

At Village Dermatology, we see patients across all age groups with chronic, undiagnosed rashes. In this case, a 65-year-old man presented with a 6-month history of a red, persistent rash on his upper thigh and leg. The lesion was ultimately diagnosed as Tinea Corporis, a common fungal infection of the body, also known as "ringworm."

Patient Presentation

Patient: 65-year-old male
Primary Complaint: Rash on the left proximal thigh and leg
Symptoms: Red, persistent, non-healing rash
Duration: 6 months
Previous Treatment: None

Clinical Examination & Diagnostic Approach

A full skin exam was performed, with close evaluation of the left anterior lateral thigh and leg. Though the KOH prep (a diagnostic test for fungal infection) was equivocal, the clinical presentation—scaly red patches in a ring-like configuration—strongly suggested Tinea Corporis.

Diagnosis: Tinea Corporis (Ringworm)

Tinea Corporis is a fungal skin infection caused by dermatophytes. Despite its name, it is not a worm but a superficial fungal infection often transmitted from pets, communal showers, or contaminated clothing. It is common in warm, humid climates like Houston and Katy, Texas.

Treatment Plan

We initiated empiric antifungal treatment with:

• Topical Ketoconazole 2% Cream

  • Instructions: Apply to the affected area twice daily

  • Duration: Continue for 1 week beyond resolution of symptoms

  • Counseling: Explained potential for irritation; use less frequently if needed

Patient Education & Lifestyle Counseling

We also educated the patient on:

• Avoiding moisture buildup (tight clothing, excessive sweating)

• Using breathable fabrics to prevent recurrence

• Washing towels and bedding frequently

• Avoiding skin-to-skin contact or shared clothing during treatment

Despite excellent cure rates, recurrence is common, especially in older patients with thinner skin or immune system challenges.

Why It Matters in Katy & Houston

The warm, humid Gulf Coast climate creates a perfect breeding ground for fungal infections. Delayed or incorrect diagnoses can allow fungal rashes to persist for months. At Village Dermatology, we use a combination of clinical expertise, diagnostic testing, and patient education to treat conditions like Tinea Corporis quickly and effectively.

Follow-Up Plan

The patient is scheduled to return in 4 weeks for reevaluation. If the rash persists, oral antifungal therapy (e.g., terbinafine or griseofulvin) may be considered.

Full-Body Skin Exam Reveals Benign Lesions in a 23-Year-Old | Village Dermatology Katy & Houston, TX

By: Dr Caroline Vaughn

Introduction

At Village Dermatology in Katy and Houston, Texas, we encourage annual full-body skin exams to help identify skin cancer early and educate patients about skin health. This case describes a 23-year-old woman’s first comprehensive skin check. Though her lesions were benign, this visit offered a valuable opportunity for prevention, education, and reassurance.

Case Overview

Patient: 23-year-old female
Concerns: Long-standing, asymptomatic skin lesions and evaluation for skin cancer risk
History: No personal or family history of melanoma or non-melanoma skin cancer

The patient had moderate tanning and presented with numerous pigmented lesions across the body. She was especially interested in learning how to protect her skin, identify suspicious growths, and understand what was normal.

Comprehensive Skin Exam

A detailed skin examination was conducted using a dermatoscope, covering:

• Scalp, face, and ears

• Chest, back, arms, and legs

• Fingers, toes, and nails

• Trunk, breasts, buttocks, and groin (patient declined underwear removal)

Despite the widespread nature of her nevi, all lesions evaluated were benign and showed no signs of atypia or malignancy.

Key Diagnoses & Counseling

✅ 1. Benign Nevi (Moles)

• Locations: Right and left upper back, left upper arm

• Appearance: Symmetric, evenly pigmented, no irregular borders

• Education:

  • Monthly self-skin checks

  • Warning signs: change in size, shape, color, or symptoms like itching or bleeding

  • Sunscreen and sun-avoidance emphasized

✅ 2. Solar Lentigines ("Sun Spots")

• Location: Left anterior thigh

• Cause: Chronic sun exposure

• Treatment Options Discussed:

  • Topical retinoids or brightening creams

  • Chemical peels or laser therapy

  • Daily broad-spectrum SPF 30+ sunscreen

✅ 3. Cherry Angiomas

• Location: Right abdomen

• Characteristics: Bright red, dome-shaped vascular papules

• Notes:

  • Harmless and common

  • Removable with laser or electrodesiccation if desired

Preventive Education for Young Adults

Even in your 20s, early skin evaluations provide peace of mind and education for lifelong skin health. This patient was advised on:

• Daily broad-spectrum sunscreen use

• Wearing protective clothing outdoors

• Avoiding tanning beds

• Monitoring moles monthly using the ABCDE criteria (Asymmetry, Border, Color, Diameter, Evolution)

Follow-Up Plan: Annual full-body skin check unless new symptoms arise

Why This Matters in Katy & Houston, TX

With sunny climates and year-round UV exposure, early skin cancer screenings are essential—even for young adults with no personal or family history. Village Dermatology offers comprehensive full-body skin exams, personalized education, and treatment for everything from sunspots to suspicious lesions.

Annual Full-Body Skin Exam Identifies Early Precancerous Lesions in 71-Year-Old Female | Village Dermatology in Katy & Houston, TX

By: Dr. Caroline Vaughn

Regular full-body skin exams are a cornerstone of skin cancer prevention and early detection, particularly in older adults with a history of sun exposure and family history of skin cancer. This case highlights a 71-year-old female patient from the Houston area who visited Village Dermatology for her annual comprehensive skin evaluation.

📋 Chief Complaint: Routine Full Body Skin Exam

The patient, a well-nourished, alert, and oriented 71-year-old woman, presented without current skin symptoms but with a history of non-melanoma skin cancers and multiple past Mohs surgeries. Her motivation for care was preventive, driven by both personal and family history.

🔬 Clinical Findings:

During her full-body dermatological evaluation, the following key findings were noted:

• Benign Nevi: Evenly pigmented, symmetrical macules and papules on the right upper back. No signs of malignancy.

• Seborrheic Keratoses: Common age-related, benign lesions seen on the forehead, epigastric area, and upper back.

• Lentigines: Reticulated light brown macules distributed on sun-exposed skin of the trunk, consistent with UV damage.

• Actinic Keratoses (AKs): Nine precancerous lesions treated with liquid nitrogen cryotherapy, located on the forearms, hands, and face.

• Cherry Angioma: A benign red papule on the right cheek, discussed but not treated.

• Neoplasm of Uncertain Behavior: A suspicious papule on the upper back underwent shave biopsy for histopathologic diagnosis.

💬 Patient Counseling and Management

Our board-certified dermatologist provided in-depth counseling on:

• Sun protection: SPF 30+ sunscreen, reapplication every 2 hours, sun-protective clothing, and lip balm with SPF.

• Self-skin exams: Monthly checks for changes in moles or the appearance of new lesions.

• Treatment strategy:

  • Immediate cryotherapy for AKs.

  • Scheduled shave biopsy for the suspicious neoplasm.

  • Monitoring benign nevi and seborrheic keratoses without intervention.

🧴 Prevention Tips for Houston-Area Residents

Given the intense sun exposure in Katy and Houston, Texas, we strongly advise:

• Daily application of broad-spectrum sunscreen.

• Avoidance of tanning beds.

• Wearing UPF clothing and wide-brimmed hats.

• Scheduling annual full-body skin exams, especially for those over 60 or with a family history of skin cancer.

✅ Outcome

The patient tolerated all procedures well, including the cryotherapy and shave biopsy. A follow-up appointment was scheduled in 6 months for monitoring and continuity of care.

📍 Why This Matters for Residents in Katy and Houston, TX

This case emphasizes the importance of routine dermatologic care and early identification of precancerous and cancerous skin changes. At Village Dermatology, we’re committed to delivering expert skin cancer screening and treatment for our community in Katy and Houston.

Managing Adult Female Acne – A Hormonal & Aesthetic Approach in Katy & Houston, TX

By: Dr. Caroline Vaughn

Introduction

At Village Dermatology, we understand that acne isn’t just a teenage concern. Many women in their 30s and 40s struggle with persistent breakouts driven by hormonal shifts, stress, and skincare routines. In this case, we highlight the experience of a 39-year-old woman from the Houston area who presented with chronic adult acne—primarily on her chin and jawline—and how we developed a personalized treatment plan to address both active acne and long-term skin health.

Patient Profile & Symptoms

Patient: 39-year-old female
Primary Concern: Moderate acne on the lower face
Duration: Several years
Symptoms: Blackheads, whiteheads, and inflammatory pimples
Skin Type: Oily and dry combination skin
Previous Treatment: None effective; online prescriptions not helpful

Diagnosis: Hormonal Acne

Her acne pattern—localized to the chin and jawline, with onset in her mid-20s—suggested a hormonal component. A thorough physical exam using a dermatoscope confirmed comedonal and inflammatory acne lesions on the cheeks and chin.

Customized Treatment Plan

Our goal was to treat both active breakouts and post-inflammatory hyperpigmentation. We developed a three-pronged regimen that includes:

💊 1. Oral Spironolactone (50mg twice daily)

• Helps regulate hormone-induced oil production

• Side effects discussed: breast tenderness, menstrual changes, rare electrolyte imbalance

• Lab monitoring for potassium and kidney function if needed

🌙 2. Topical Tretinoin 0.025% Cream

• Used at bedtime, gradually increased in frequency

• Addresses clogged pores and improves pigmentation and skin texture

• Patient advised on side effects and slow introduction to minimize irritation

💉 3. Optional Microneedling with PRP

• Discussed as a procedure to boost collagen, minimize scarring, and improve overall texture

• Non-invasive, aesthetic option offered to accelerate results

Skincare & Lifestyle Education

We provided detailed counseling on:

• Gentle cleansers: CeraVe, Cetaphil, La Roche Posay

• Non-comedogenic moisturizers & SPF 30+

• Daily AM/PM routine tailored for acne-prone, sensitive skin

• Realistic expectations: 60–80% improvement expected in 2–3 months

Sun protection, product layering, and gradual adaptation to tretinoin were emphasized, and the patient was given written handouts and visual instructions for use.

Why This Matters in Katy & Houston

Women in their 30s and 40s often face unique skincare challenges. Whether due to hormonal fluctuations, stress, or incorrect products, adult female acne can affect both appearance and self-esteem. At Village Dermatology, we offer a clinical and cosmetic hybrid approach—combining evidence-based prescriptions with aesthetic treatments tailored to your skin goals.

Follow-Up Plan

We will reassess in 6 weeks with a full-body skin exam and adjust treatment based on acne improvement, medication tolerance, and interest in aesthetic procedures.

A Mysterious Rash Uncovered – Managing Dermatitis, Scabies & Nerve-Related Itching in Katy & Houston, TX

By: Dr. Ashley Baldree

Introduction

Skin rashes can have a variety of causes—from allergies and infections to nerve-related issues. At Village Dermatology, we pride ourselves on delivering a thorough and patient-centered approach to diagnosis and treatment. In this case, we saw a 70-year-old woman from the Houston area with an itchy, red rash across her legs and trunk—which evolved into a multidimensional diagnosis and treatment plan.

Case Overview: Itchy Rash of Unclear Origin

Patient: 70-year-old female
Symptoms: Itchy, red rash for 2 weeks, primarily on the legs and trunk
Initial Treatment: OTC topical steroids (clobetasol and hydrocortisone)

Despite prior treatment, the patient’s rash had not improved. Upon clinical evaluation, we identified multiple overlapping causes contributing to her symptoms.

Differential Diagnoses Considered

1. Urticaria (Hives) – Red, raised spots consistent with allergy or histamine response

2. Allergic Contact Dermatitis (ACD) – Possible reaction to recent change in laundry detergent

3. Scabies – Due to rash distribution and clinical suspicion, despite a negative KOH scraping

4. Notalgia Paresthetica – Nerve-related itching due to a history of spinal disc issues and recent back surgery

Step-by-Step Management Approach

✅ 1. Dermatitis/Urticaria Treatment

• Topical: Triamcinolone 0.1% cream applied twice daily

• Oral: Hydroxyzine 25mg tablets as needed for itch

• Lifestyle: Switch detergent to All Free & Clear

• Counseling: Advised against prolonged steroid use and explained risk of skin thinning and hypopigmentation

✅ 2. Scabies Treatment (Empiric)

• Despite a negative KOH skin scraping, treatment was initiated due to the possibility of early or atypical scabies.

• Prescription: Ivermectin 3mg (two doses, one week apart)

• Topical: Permethrin cream applied from neck to toes for 8 hours, repeated in 1 week

• Hygiene Education:

  • Isolate bedding and clothing for 72 hours

  • Wash items on high heat

  • Treat household contacts

✅ 3. Notalgia Paresthetica Relief

• Topical OTC: CeraVe or Sarna Anti-Itch Cream

• Education: Provided a handout on the nerve-related cause of itching

• Monitoring: Recommended further work-up if symptoms persist or worsen

Why This Case Matters in Katy & Houston, TX

With overlapping skin conditions and histories of nerve problems or allergy exposure, a single diagnosis isn’t always enough. This case highlights how Village Dermatology delivers thorough evaluations, considers all possible causes, and tailors treatment to each patient’s history and lifestyle.

Whether you’re dealing with rash, itching, or chronic skin issues, our dermatology team in Katy and Houston is equipped to help—from diagnostics to comprehensive care.

From Viral Rash to Nail Fungus – Treating Molluscum and Onychomycosis in Katy & Houston, TX

By: Dr. Ashley Baldree

Introduction

At Village Dermatology, we see a wide variety of skin conditions, from viral rashes to fungal nail infections. In this case, a 42-year-old man from Katy, Texas presented with two common dermatologic concerns: a bumpy rash in the underarm area and a chronic fungal nail infection. This blog post shares how our team accurately diagnosed and effectively treated both conditions using evidence-based, patient-focused care.

Case Overview

Patient: 42-year-old male
Complaints:

1. Rash in the axilla (underarm area) for 2 weeks

2. Toenail infection for over 1 year

He was not on any prescription medications, though he had attempted to self-treat the nail issue using over-the-counter antifungal products with limited success.

Diagnosis 1: Molluscum Contagiosum

The underarm rash was diagnosed as Molluscum Contagiosum, a viral skin infection caused by a poxvirus. It presents as pink, umbilicated (dimpled) bumps, often spread through skin-to-skin contact or shared water sources like pools. In this case, the patient’s children also had molluscum, supporting a diagnosis of household transmission.

Affected areas:

• Left axilla

• Rib cage

• Posterior axilla

• Lateral chest

Treatment: Liquid Nitrogen Cryotherapy

The patient chose cryotherapy with liquid nitrogen (LN2)—a quick and effective method to destroy molluscum lesions. We treated 57 lesions in total using two freeze-thaw cycles per site.

Post-treatment counseling included:

• Possible side effects: blistering, pigment changes, recurrence

• Hygiene and skin care tips

• What to do if lesions worsen or spread

Follow-up: Scheduled in 4 weeks to monitor progress and consider topical tretinoin if needed.

Diagnosis 2: Onychomycosis (Toenail Fungus)

The second complaint involved a discolored, dystrophic left toenail, which began after trauma during a softball tournament. Clinical exam revealed superficial onychomycosis, a common fungal nail infection.

Treatment Plan: Topical Tolcylen

Given the superficial nature of the infection, the patient was prescribed Tolcylen, a medical-grade topical antifungal that penetrates the nail plate. Oral medications offer higher cure rates but carry risks such as liver toxicity and bone marrow suppression.

Key patient education:

• Topicals often require prolonged use and may not always cure the infection

• Oral antifungals are more effective but not without potential serious side effects

• 50% of patients experience recurrence even after successful treatment

Follow-up: 4 weeks for reassessment of nail and skin conditions

Why This Matters in Katy & Houston, Texas

Common dermatologic issues like molluscum contagiosum and toenail fungus can easily be misdiagnosed or undertreated. At Village Dermatology, we provide accurate diagnostics, thorough patient education, and personalized care plans—from pediatric infections to adult fungal conditions.

Treating Squamous Cell Carcinoma with ED&C – A Dermatology Case in Katy & Houston, TX

Introduction

At Village Dermatology, we routinely diagnose and treat skin cancers in patients across Katy and Houston, Texas. This case highlights our care of a 76-year-old man with squamous cell carcinoma (SCC) on his lower leg. We’ll walk through his biopsy, diagnosis, and treatment using electrodesiccation and curettage (ED&C)—a non-surgical option for low-risk skin cancers.

Case Presentation: From Biopsy to Treatment

Patient: 76-year-old male
Location: Left distal pretibial region (front of the lower leg)
Chief Complaint: Follow-up for lesion diagnosed as a well-differentiated squamous cell carcinoma (SCC)

The patient initially visited us in April 2025 for a suspicious lesion on his lower leg. A shave biopsy confirmed the presence of well-differentiated SCC, a common but potentially invasive form of skin cancer caused by long-term sun exposure, radiation, or immune suppression.

Why ED&C?

For superficial, well-differentiated SCCs on the trunk or extremities, ED&C (electrodesiccation and curettage) offers a highly effective and minimally invasive treatment. While surgical excision or Mohs surgery remains the gold standard for many skin cancers, ED&C is an appropriate choice for:

• Low-risk or superficial SCC

• Patients with contraindications to surgery

• Those preferring faster recovery and lower costs

Procedure Details

On his return visit, the patient underwent the ED&C procedure at our Katy clinic. Here's how it was performed:

• Anesthesia: 2 cc of 1% lidocaine with epinephrine was injected locally.

• Technique: The tumor was removed using a curette (a surgical scraping instrument), followed by electrodesiccation to destroy residual cancer cells.

• Cycles: Two full cycles were performed to ensure complete removal of visible cancer.

• Final lesion size: 1.3 cm.

• Post-procedure: A pressure dressing was applied, and detailed wound care instructions were provided.

Counseling & Education

We always ensure patients understand their condition and options. This patient was educated on:

• Risk Factors: Sun exposure, radiation, immunosuppression, and HPV.

• Recurrence: ED&C has slightly higher recurrence rates compared to surgical excision but is still effective for specific low-risk cases.

• Warning Signs: To contact us immediately if new lesions appear, especially those that bleed, ulcerate, or fail to heal.

Why Early Treatment Matters in Katy & Houston

As Houston’s sun exposure and aging population contribute to rising skin cancer rates, early detection and treatment are essential. At Village Dermatology, we combine evidence-based procedures with personalized counseling to ensure optimal outcomes and peace of mind.

Follow-Up Care

The patient is scheduled for a follow-up visit in one month to evaluate healing and confirm no signs of recurrence. Ongoing monitoring will help ensure long-term success and skin health.

From Mystery Bump to Diagnosis – A Young Woman’s Dermatology Journey in Katy & Houston, Texas

By Dr. Caroline Vaughn

Introduction

At Village Dermatology in Katy and Houston, Texas, we frequently see patients concerned about new or changing skin lesions. While many skin bumps are benign, proper evaluation is crucial to ensure accurate diagnosis and treatment. In this case report, we highlight a 23-year-old woman’s experience with a persistent chest lesion and an unexpected facial rash—showcasing our patient-centered approach and expertise in general and medical dermatology.

Case Overview: Chest Lesion Evaluation

Chief Complaint: A brown lesion on the chest, present for six months, recently inflamed.

A healthy 23-year-old woman came to our clinic in Katy for a first-time dermatologic consultation. Her main concern was a moderately pigmented bump on her lower sternum that had started showing signs of inflammation within the past week. She had never received prior treatment and was understandably anxious about the sudden change in the lesion’s appearance.

Expert Examination & Diagnosis

Our board-certified dermatologists conducted a comprehensive skin exam, using a dermatoscope for close evaluation. Based on the lesion's location, features, and recent inflammation, two potential diagnoses were considered:

• Epidermal Inclusion Cyst (EIC): A benign sac filled with keratin that can become inflamed or rupture.

• Inflammatory Papule: A more general term for a raised, inflamed lesion.

After discussing treatment options and risks with the patient, including the possibility of surgical excision or anti-inflammatory therapy, she opted for a Kenalog (ILK) injection—a minimally invasive solution with minimal downtime.

Treatment Administered:

• Intralesional Kenalog (ILK) Injection: 4.0 mg/cc (0.1 cc total volume).

• Counseling: Education on lesion care, potential outcomes, and signs that warrant follow-up.

Unexpected Diagnosis: Perioral Dermatitis

During her visit, the patient also mentioned a facial rash she had been managing on her own. Our exam revealed redness and inflammation around the mouth and cheeks, characteristic of Perioral Dermatitis—a chronic inflammatory skin condition.

Treatment Plan:

• Topical Metronidazole 0.75% Cream: To be applied nightly.

• Lifestyle Modifications: Avoiding cosmetic products, using non-comedogenic skincare, and protecting the skin from wind and sun exposure.

• Patient Education: Triggers such as steroid creams, certain toothpastes, and environmental factors were discussed.

Follow-Up & Outcomes

We scheduled follow-ups at:

• 4–6 weeks for the chest lesion post-ILK.

• 6 months for reassessment of Perioral Dermatitis, with a backup plan for doxycycline therapy if needed.

This dual-case highlights the importance of seeing a qualified dermatologist—even for what seems like a “simple bump.” Accurate diagnosis, patient education, and personalized treatment are pillars of dermatologic care at Village Dermatology, serving Katy and Houston, TX.

Why This Matters in Katy & Houston, Texas

In growing urban and suburban communities like Katy and Houston, patients often delay seeing a specialist. This case underscores how early evaluation by an experienced dermatologist can save time, reduce anxiety, and lead to effective, tailored treatment plans. Whether you're dealing with a puzzling bump, persistent rash, or just want peace of mind, our team at Village Dermatology is here to help.

Comprehensive Skin Check Uncovers Common Skin Concerns in a 68-Year-Old Patient: A Case Report from Village Dermatology

By Dr. Caroline Vaughn

At Village Dermatology, serving Katy, Texas and Houston, Texas, we are committed to proactive skin health.
Today, we share the case of a 68-year-old woman who visited us for a full-body skin exam and evaluation of several long-standing skin lesions. Her history, including a personal diagnosis of basal cell carcinoma and a family history of melanoma, underscores the importance of annual skin checks — especially for patients at higher risk.

Patient Background

This new patient presented with brown lesions located on her upper back and left breast. These lesions had been present for years, but she had never sought treatment before. Her medical history was significant for:

• Basal cell skin cancer (previously treated)

• Family history of melanoma (mother)

• Family history of non-melanoma skin cancer (father)

In addition to evaluating her lesions, she sought education about sun exposure and advice on monitoring her existing moles.

Examination Findings

Using both clinical inspection and a dermatoscope, a thorough examination of her skin, scalp, nails, and mucosa was performed. Key findings included:

• Benign Nevi: Regularly shaped, evenly colored moles with no signs of malignancy.

• Lentigines: Light tan macules, common signs of sun damage, scattered throughout sun-exposed areas.

• Cherry Angiomas: Benign vascular growths across the body.

• Seborrheic Keratoses: Benign "warty" growths on the back and shoulders.

• Actinic Keratoses: Precancerous lesions on the forehead.

• Irritated Seborrheic Keratosis: Inflamed, crusted lesion behind the left ear.

Treatment Plan

The patient underwent cryotherapy (liquid nitrogen treatment) for:

• 9 seborrheic keratoses (upper back and shoulders)

• 2 actinic keratoses (right forehead)

• 1 irritated seborrheic keratosis (postauricular skin)

She was counseled extensively on:

• Sun protection: Regular use of broad-spectrum SPF 30+ sunscreen, sun-protective clothing, and lip balm with SPF.

• Self-exams: Monthly self-skin checks for any new or changing lesions or moles.

• Follow-up care: Importance of annual full-body skin exams.

The patient was advised that lentigines, cherry angiomas, and seborrheic keratoses are benign and treatment is optional unless they become symptomatic.

The Importance of Regular Skin Exams

This case highlights the need for yearly skin checks, especially for individuals with:

• A personal or family history of skin cancer

• Chronic sun exposure

• A history of precancerous lesions such as actinic keratoses

Early detection and preventive treatment can greatly reduce the risk of progression to squamous cell carcinoma or melanoma.

At Village Dermatology, we pride ourselves on thorough, compassionate care for every patient — whether addressing cosmetic concerns, precancerous changes, or skin cancers.

✅ If you live in Katy, Texas, or Houston, Texas, and you are due for your annual skin check or have noticed new or changing moles, we invite you to schedule an appointment with our expert dermatology team today!
Prioritize your skin health — early detection saves lives.

Treating Actinic Keratosis and Squamous Cell Carcinoma in Older Adults: A Real Patient Story from Houston and Katy

Article by Dr. Ashley Baldree

At Village Dermatology, we often see patients in their later years with skin changes due to sun exposure over a lifetime. One recent patient, an 88-year-old man, came to us with darkening, enlarging lesions on his scalp that had become irregular over time. These skin changes were concerning not just because of how they looked—but because they could be signs of precancerous or cancerous skin growths.

In this blog, I’ll share how we evaluated and managed his condition, and what this case can teach us about actinic keratosis (AK) and squamous cell carcinoma (SCC) in older adults.

The Patient's Visit: Evaluation and Diagnosis

This gentleman had multiple lesions on his scalp and cheek that had changed in size and color. These are classic warning signs for sun-related skin damage. During his exam, we noticed scaly, red patches and thickened nodules—findings that led us to diagnose both actinic keratoses and biopsy-proven squamous cell carcinomas.

We used a dermatoscope, a special magnifying tool, to closely inspect the lesions. His overall health was good, and he was fully alert and oriented—key factors when planning treatment in older adults.

What Are Actinic Keratoses?

Actinic keratoses (AKs) are precancerous skin lesions caused by chronic sun exposure. They often appear as rough, red or pink patches and are common on the scalp, face, ears, and hands—especially in fair-skinned individuals.

These spots can turn into squamous cell carcinoma if left untreated, though not all do. That’s why it’s important to treat AKs early. For this patient, we treated 10 AKs using cryotherapy, where liquid nitrogen freezes the lesions, causing them to crust and fall off naturally over a few weeks.

We also counseled him on:

• Wearing broad-spectrum sunscreen SPF 30+ daily

• Using sun protective clothing

• Regular follow-ups to check for new or changing lesions

Learn more about AKs and skin cancer at Village Dermatology's Skin Cancer Education Page.

Diagnosing and Managing Squamous Cell Carcinoma (SCC)

This patient also had two areas on his scalp that were confirmed by biopsy to be well-differentiated squamous cell carcinomas. SCC is a common type of non-melanoma skin cancer and can become more serious if not addressed.

We discussed treatment options including:

• Mohs surgery (a highly precise surgical technique)

• Surgical excision

• Radiation therapy (XRT)

Although Mohs surgery is our standard for high-risk areas like the scalp (due to precision and low recurrence rates), the patient declined surgery and opted for radiation therapy instead. We coordinated with his primary care provider for referral to a radiation oncologist.

This type of shared care ensures that the patient gets treatment tailored to his preferences and health status while also addressing the seriousness of his diagnosis.

Learn more about SCC and treatment choices on our site:
Basal and Squamous Cell Carcinoma Treatments

Key Takeaways from This Case

✅ Sun damage is cumulative—what we did decades ago can show up now.
✅ Actinic keratoses are warning signs and should be taken seriously.
✅ Squamous cell carcinoma is treatable, especially when caught early.
✅ Radiation therapy can be an option for patients who can’t or prefer not to undergo surgery.
✅ Personalized care matters, especially in older adults with specific health goals.

At Village Dermatology in Katy and Houston, we’re committed to delivering expert, compassionate care for every age. If you have changing skin lesions or a history of sun exposure, schedule a skin cancer screening with us.

Early Detection, Expert Treatment: Managing Basal Cell Carcinoma on the Forehead

Blog Article by Dr. Caroline Vaughn

At Village Dermatology Houston, we understand that skin cancer screenings can be anxiety-provoking—but early detection paired with precise treatment can make all the difference. In this article, I want to share the case of a 68-year-old patient we first saw in March 2025, whose story highlights the value of thorough skin exams, patient education, and personalized care.

Initial Visit: A Concern for Suspicious Lesions

Our patient, a vibrant 68-year-old woman, came to our clinic as a new patient seeking evaluation for suspicious skin lesions on her right upper back and chest, as well as overall surveillance for skin cancer. She also wanted counseling on sun protection and help monitoring existing moles.

During her full-body skin exam, which included the use of a dermatoscope, we identified two areas of concern:

• A papule on her left dorsal forearm, which we suspected could be a seborrheic keratosis, squamous cell carcinoma, or a neoplasm of uncertain behavior.

• A darkly pigmented macule on the left forehead, which had features raising concern for basal cell carcinoma (BCC).

To evaluate these lesions further, shave biopsies were performed on both. The forehead lesion was later confirmed to be a nodular basal cell carcinoma, the most common—and fortunately, one of the most treatable—types of skin cancer.

Learn more about BCC in our Village Dermatology skin cancer overview and basal cell carcinoma guide.

Why Basal Cell Carcinoma Needs Prompt Attention

Basal cell carcinoma (BCC) is a slow-growing skin cancer that often appears in sun-exposed areas like the forehead, nose, and ears. Although BCC rarely spreads to other parts of the body, it can grow deep into the skin and cause significant tissue damage if left untreated.

The forehead is considered a high-risk area (Area M) for cosmetic and functional reasons. Given the tumor’s location and size (1.1 x 1 cm), Mohs micrographic surgery was the recommended and most appropriate treatment.

April 2025: Mohs Surgery & Complex Repair

Mohs surgery was performed in April 2025, with excellent results. The cancer was fully removed in just one stage, and no residual tumor cells were detected on frozen section analysis. The final defect measured 1.4 x 1.7 cm, extending into the adipose (fat) layer.

Due to the location and lack of surrounding skin laxity, we performed a complex layered repair with a Burow’s graft to ensure the wound was closed properly and healed with minimal scarring.

What is a Burow’s graft?
A Burow’s graft uses nearby healthy skin, shaped and repositioned to fill in the surgical defect. In this case, tissue from the adjacent forehead was used to create a natural closure with good cosmetic outcomes.

What to Expect After Mohs Surgery

Mohs surgery is a meticulous technique that removes skin cancer while preserving as much healthy tissue as possible. It’s especially valuable in cosmetically sensitive areas like the face.

Our patient experienced no complications, and the wound was closed with both deep sutures and a running epidermal stitch. She returned for a suture removal and wound check one week later.

Skin Cancer Prevention Tips

Our patient came to us not only for treatment but also to learn how to prevent future skin cancers. Here's what we recommend for all our patients, especially those in sunny areas like Katy and Houston:

• Apply broad-spectrum SPF 30+ sunscreen every day, even on cloudy days.

• Wear a wide-brimmed hat and protective clothing when outdoors.

• Schedule yearly full-body skin exams with a board-certified dermatologist.

• Check your skin monthly at home for new or changing moles or growths.

Final Thoughts

This case is a great example of why early detection and personalized treatment planning matter so much. Because our patient came in early and we were able to act quickly, her basal cell carcinoma was treated successfully with minimal tissue loss and an excellent cosmetic result.

If you’re in Katy or Houston and concerned about a skin lesion—or just want peace of mind through regular skin checks—schedule a visit with Village Dermatology Houston today. Whether it’s a new mole, a non-healing spot, or a general skin concern, we’re here to help you protect your skin and your health.