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    Welcome and Let's Talk about Your Skin
    Susan Evans, MD posted:
    Hi everyone.I am Dr Susan Evans. I am pleased to introduce Myself to the webmd community. You may have seen my Good Morning America?s Health segment yesterday, where I worked with Cindy smith, wife of fireman, mother if two, rejuvenate under her eyes . We also helped Rob, a New York Business man, treat his razor bumps with Laser Hair removal.
  • While filming in NY, I was reminded of the extra steps required to keep your skin moist in harsh winters. I need your questions about Winter skin and I?ll add those answers to our page of Winter skin tips.

    Let's keep an open dialogue going! I want everyone's skin to look its healthy best. Look forward to hearing from you.
    Dr Evans
  • Take the Poll

    Have you taken any special precautions to protect your skin during the harsh winter months?
    • YES,I take all the necessary precautions.
    • sometimes I try when I remember.
    • Almost Never.
    View Poll Results
    santamyles responded:
    Hi Dr. Evans, I have a question that I hope you can help me with. Three days ago I noticed a rash or skin discoloration on my sons left upper arm. The discoloration is in the shape of a Band Aid but the last time he had a band aid on his shoulder was about 2 months ago when he had the H1N1 Vaccine. It is not raised, it is pink in the center(where the guaze would be) and white all around the outside (where the adhesive would be) in the shape of a band aid. It does not hurt him but I am concerned because it is not going away, it has not change, and it just showed up out of nowhere. Do you know what this can be?
    Susan Evans, MD replied to santamyles's response:
    I am very sorry to hear about your son.unfortunately ,without seeing your son's arm directly it would be very difficult to make a determination.I encourage you to visit your local pediatrician
    for an evaluation.Common things such as that can lead to skin eruptions are are allergic reactions,fungal infections,or contact dermatitis.
    An_207828 replied to Susan Evans, MD's response:
    Hi Dr. Evans, I am a 24-year-old healthy male. I am currently in a catch 22 situation.?

    ?I was dx with psoriasis when I was 18 and by the age of 21 I had moderate/severe psoriasis. I tried many topical medications with no relief. I was miserable. It was embarrassing. The redness, itching, and burning was symmetrical and all over my legs, arms, back, chest, and abdomen. I was prescribed Enbrel last year at the age of 23. I am now 99% clear and so happy with the results.?

    I had 2 warts on my left hand before?I started taking Enbrel and now I have 12. I have tried OTC solutions that contain salycylic acid such as Duofilm with no luck. I know the warts on my left hand were not caused by Enbrel and it doesn't seem logical that Enbrel would make the warts worse. However,?because Enbrel is an immuno-suppressant,?I am concerned that Enbrel could prevent my body from riding itself of the HPV virus. ?

    I have a few questions:

    Is HPV systemic or is the virus only located at the site of the warts on my left hand?

    If I keep using an immuno-suppressant medication and have long-term exposure to HPV am I at risk for penile cancer even though I have common warts and not genital warts?

    Should I stop using Enbrel and look for alternative ways of treating my psoriasis such as light therapy so that my immune system can fight off HPV?

    Or, should I stay on Enbrel since it is working so well and just get my warts removed with cryosurgery, laser surgery, or some other method in order to control the spread?

    Thank You Dr. Evans.
    An_207829 responded:
    Hey Dr. Evans. I have a very odd problem. I am a healthy 21 year old male I am about 165 lbs and am active and athletic. About 2 years ago I used to have something odd where there would be marks on my shoulder that looked like scratch marks that were about 3-4 inches long and it was almost identical looking on the other shoulder. It would run parallel with my collarbone on top of the shoulder. It went away and I kind of forgot about it but just the last couple days it has just recently come back and looks exactly the same as it used to. The weird thing is they look like decent scratch marks but they aren't scratches at all, they don't even break the skin it is just like red lines and you can't feel anything but look identical to scratches. Please if you have any answers or anything that seems applicable in this case...
    An_207830 responded:
    Hi Dr.Evans, I need help with my severly dry skin. It tiches, it hurts, it flakes off.. it's embarrassing! It looks and feels like dry leather. The sides of my stomach and chest look like spider webs. I don't use lotion on a daily basis, it takes to long to put it on and I have this thing about feeling or touching greasy things, so I don't like feeling greasy. I don't want my skin to be dry, but I don't want it to be greasy either. I take really hot showers because I'm always cold, and thats another thing that I won't change probably until the summer time; thats when I take cool showers. Well, are there any other ways to help with my dry skin, it's dry everywhere!! Any vitamins, or supplements.. anything?
    MarciaHiruo responded:
    Hello Dr. Evans,

    I have been treated for actinic keratosis with cryosurgery and once with electrosurgery. After cryosurgery the doctor usually uses the stick of a qtip to press on the site. What is he looking for? A change in the color of the skin? Is it normal to attempt two or three cryosurgery procedures before electrosurgery which yields tissue for a biopsy?
    Susan Evans, MD replied to An_207828's response:
    Dear Anon 4393:

    As you know, psoriasis is a life-long skin condition that while noncontagious, causes you a certain amount of suffering. It is a condition that is believed to be a dysfunction of the rate of development of your skin cells. With psoriasis, this rate is greatly accelerated, causing plaques to form on your skin, often becoming red and irritated.

    Being on Enbrel does help to minimize your psoriasis condition. Because it is an oral medication, it can affect you systemically. There are some other treatments that are more localized that you may want to discuss with your dermatologist. Laser treatments use a dose of UVB rays directly on the psoriatic patch. In this way it targets the abnormal cells and does not affect your healthy cells at all. Not everyone is able to tolerate laser therapy, so ask your doctor.

    You mention the HPV warts, and this is a very different problem from the psoriasis. Again, talk with your dermatologist about the best way to handle your situation. It is necessary for your doctor to see you in order to determine if you have only one condition or multiple conditions that need to be treated separately.

    Best wishes,

    Dr. Evans
    Susan Evans, MD replied to An_207829's response:
    Dear Anon 5015:

    Without actually being able to see these marks on your skin it is difficult to determine their cause. Most of the time these types of marks can be due to contact dermatitis. You might want to consider if you have recently changed your washing detergent, or even the soap you use in the shower. From time to time fungal infections can contribute to unusual skin markings, sometimes acquired in communal showers, or from using gym equipment that has been infected by a previous patron. Try to evaluate what you may be doing differently that could be causing these marks. It is always best to see your doctor so that a direct observation can be made of such marks.

    Best wishes,

    Dr. Evans
    Susan Evans, MD replied to An_207830's response:
    Dear Anon 6767:

    I'm so sorry to hear about your severely dry skin. Being comfortable in your skin is important. There are a number of causes of dry and irritated skin.

    You mention that you like to take very hot showers, and while this might make you feel more comfortable in the wintertime, it can rob your skin of natural moisturizing oils. Consider moderating the temperature of your shower and see if that might help.

    Such skin irritation could also be due to other conditions that would need to be evaluated by your doctor. Some other causes could include eczema or psoriasis. Eczema is a chronic inflammatory condition of the skin that leaves the sufferer with intensely itchy and irritated skin. Psoriasis is a condition where certain patches of your skin regenerate skin cells at a greatly accelerated rate, leaving patches of scaly patches of inflamed skin.

    In order to address your problem, talk with your doctor and make sure that there is no underlying problem that should be addressed. In addition to that, making sure that you are adequately hydrated is a good healthy approach.

    Best wishes,

    Dr. Evans
    Susan Evans, MD replied to MarciaHiruo's response:
    Dear Marcia:

    Actinic keratoses are slow-growing localized precancerous tumors. Most of the time these are caught in the very early stages and are most commonly treated with cryotherapy (or freezing therapy).

    Other methods of handling AKs include electrocautery or laser therapy.

    For patients whose lesions persist after treatment your doctor will likely consider taking a biopsy in order to get more information about the lesion.

    If you are at risk of developing such precancerous AKs, make sure you are fully aware of what I call the ABCDs of skin lesions:

    A - Asymmetry: If two halves of what looks like a mole do not match, keep an eye on this.

    B - Border: Uneven borders of a skin lesion can be a sign of skin cancer. Look for jagged or scalloped edges.

    C - Color: Moles that are multiple colors are a danger sign. Benign moles are typically a solid color.

    D - Diameter: Most squamous cell cancers will grow larger than 1/4 of an inch, or the size of a pencil eraser. Melanomas can be deadly even when they are smaller than 1/4 inch.

    For any questionable skin lesion, get in to see your dermatologist immediately. A dermatologist can usually tell very quickly if your questionable mole is anything to worry about. The sooner a skin cancer is treated, the better the results.


    Dr. Evans
    charban replied to Susan Evans, MD's response:
    Hi Dr. Evans,

    I have a dandruff condition that just keeps getting worse. It occurs towards the front of my hairline and it looks as if my scalp is peeling away. The flakes are pretty large and thing and Ive tried everything to get rid of them. I took a shorter shower just yesterday with cooler water and scrubbed my scalp as well as I could without hurting it. This morning I went to look at my hair, and i noticed that there were so many flakes! I was looking through a few other posts and noticed that someone mentioned it started after using Duac for his/her skin. I started using Duac the last couple months of December, and was wondering if this may be a side effect. Do you have any solutions to my horribly embarrassing dandruff? Should I stop using Duac (even though its been helping my skin a lot)?
    Dakm1 responded:
    Dr. Evans:
    I have a cyst about 1/16 of an inch from my lower left eyelid. My question is with it being so close to the eye, should I see a dermatologist or an opthamologist. Thank you.
    Annie_WebMD_Staff replied to Dakm1's response:

    Please post your questions to the doctor as a new discussion thread. Posting replies to old existing threads makes it difficult to find those questions. Simply mouse over the orange "Post Now" button and click on the Discussion link (not the Tip or Resource link) to start a new discussion thread.

    Thank you!

    - Annie
    Susan Evans, MD replied to Dakm1's response:
    Dear Dakm1,

    I would suggest that you see your dermatologist, as a cyst is part of your dermis. Let your dermatologist determine if you should see your ophthalmologist instead.


    Dr. Evans

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