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Medical Dermatology

As a full service dermatology medical group, Pacific Dermatology Institute limits our practice to diseases and conditions of the skin. We are truly experts in the care of your skin. Our practice welcomes virtually every possible skin condition you may have.

New, Changing or Worsening medical skin conditions can routinely be seen on the skin which can create emotional, physical and mental distress in our lives. Dermatologist are here to properly diagnosis your condition, present you with different treatment options and ultimately help resolve or improve your individual condition. Although not all skin conditions are curable our physicians will help you manage your specific condition.

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Abnormalities of Hair & Nails

The nails of the fingers and toes and the hair of the scalp and body can be affected by local disease and also by internal diseases. This is why a nail problem or a hair problem in and of itself is reason enough to see a dermatologist. Hair and nails are of high priority to us, but the body when in distress often let’s go of hair and nail production. In this way, thin nails and hair loss can tell the dermatologist that the body is under physical and emotional stress. Local disease is common such as fungus and bacterial infections, allergic reactions, and dermatitis related to dandruff. In summary, you should not put off a hair and nail problem because it may seem trivial to you.


When our natural skin oils build up in our pores, microorganism thrive and break down the oil. This leads to inflammation and the typical lesions most of us know like pimples, black- and white heads, nodules, cysts, and sometimes scars. There are different types of acne depending on what causes oil to build up under the skin and what microorganisms are breaking it down. The treatment usually involves an antibiotic to kill the bacteria, an exfoliating agent to unclog pores, anti-inflammatory medications to calm the skin and reduce swelling, and sometimes medications to change oil output. Diet can affect acne. So can some medications and products we use like moisturizers and makeup. Acne is not just one illness. When you come to PDI, our professionals will ask you several questions and examine your skin to determine what type you have so that it can be treated correctly.

Actinic Keratosis

Actinic Keratosis is a pre-skin cancerous condition affecting people who were exposed to a lot of sun in the past and with little natural protection from skin pigment or artificial protection from sunscreens. A significant portion of these rough, red, spike-like bumps usually found on sun-exposed skin may turn into squamous cell carcinomas and possibly, according to new data, also into basal cell carcinoma (linked article below) For that reason, dermatologists treat these lesions with either creams or destructive methods like freeze-burning with liquid nitrogen. Prevention is key in avoiding them in the first place. People with fair skin and people in sunny climates are best off using sunscreens regularly, avoid sunburns, and not underestimate the skin damage from tanning beds.

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Alopecia means hair loss, but it doesn’t specify the illness or diagnosis causing it. Conceptually, as long as the hair root is intact, the hair can grow back. If the illness destroys the hair root, it cannot grow back. In Alopecia areata, Tinea capitis and Telogen effluvium for example, you can lose a lot of hair, but the hair can grow back again. On the other hand, in Androgenetic Alopecia, Traction Alopecia, and Ciccatricial Alopecia due to Follicultis Decalvans, Lichen Planopilaris, or Lupus, the hair root is destroyed and replaced with scar tissue. Sometimes, only a biopsy can determine what type of illness is causing the hair loss, but often a dermatologist can make the diagnosis just by looking at the pattern of hair loss and the appearance of the skin of the scalp. Sometimes, a blood test is necessary, especially when hair isn’t growing because there is something missing to make it or some other illness is suppressing growth. Medications are a common cause of hairloss, but it’s not easy to determine the offending drug when a patient is on multiple medications.

The treatment of alopecia can be as easy as taking a supplement and as invasive as performing a hair transplant or injecting a medication under the skin. It can be as paradoxical as causing an allergic reaction to reset the immune system and as creative as wearing a wig or getting a covering tattoo. Alopecia is a complex subject in dermatology and the only way to sort it out is in consultation with a dermatologist.


Molluscum Contagiosum
Molluscum contagiosum is usually seen in children, sometimes also in adults. This is a harmless nuisance caused by a member of the pox virus family which is passed by skin-to-skin or skin-to-object contact. The virus only infects skin cells, does not enter the body, and poses no threat no people. Each lesion looks like a white to tan bump roughly the size of a pinhead and lesions often cluster from scratching. M.C. is often confused with warts, but is actually much easier to treat. Creams, blistering agents, freeze burning, and curettage (scraping with a sharp loop) are the common ways used in the dermatology clinic.



Psoriasis often first presents in young adulthood or old age. This leads people to wonder if it was caused by an infection, however, it is a genetic disease which nevertheless needs a trigger to show. That trigger could be stress, a sore throat, a medication, or a sun burn, for example. Psoriasis is usually only a skin disease, but sometimes the joint get inflamed too. The best way to understand why the skin is generating the rash lesions seen in psoriasis is that a gene needed for turning on and off the wound healing mechanism in the skin doesn’t work properly and can’t be turned off as easily after the skin gets injured. This explains why psoriasis often shows in areas subject to repeated trauma from friction, burns, infections, cuts, and scratches. Even though the tendency to develop psoriasis lesions is life-long and can not yet be cured, there are many great medications to treat the condition. Most patients with proper treatment can completely clear their psoriatic lesions and stay clear for long periods of time. This makes it worth to make a trip to a dermatologist even if you have heard there is no cure.

Seborrheic Keratosis

One of the most common reason for a visit to the dermatology office are growths called Seborrheic Keratosis abbreviated S.K., Seb. Ker. by most dermatologists. An S.K. is neither cancerous nor per-cancerous. S.K’s are often confused with moles. They can occur on the scalp, face, chest, abdomen, groin, back, and the extremities, in other words, anywhere on the body. Occasionally, S.K’s itch. There are several theories why they occur. Sun damage, a skin virus analogous to the wart virus, and a gene mutation. There are rare cases of cancer triggering a large number of S.K.’s suddenly appearing on the body. The treatment is medically not required even though many patients want them treated. Unfortunately, insurance companies do not usually cover the treatment unless there is a medical necessity for removal. Treatment can be performed with liquid nitrogen, curettage, electro-dessication, and topically applied acids, even the OTC wart treatment may help.

Skin Biopsy

A skin biopsy is performed to help diagnose skin conditions due to growths or eruptions. A biopsy is not a therapeutic procedure even if, at times, it happens to also resolve the condition like an irregular mole. The method used to biopsy a skin lesion depends on the size and depth of the sample lesion. The different methods are shave, punch, and excisional biopsy. Each has advantages and disadvantages, ie benefits and risks. The benefit of a larger sample is a better chance for the dermato-pathologist to make a correct diagnosis. The risk of a larger sample size is that the bigger or deeper the biopsy, the greater the chance of a permanently visible scar, pigmentation change, or infection after the procedure. This is why we ask you to carefully consider the benefits and risks of a biopsy before you give us consent to perform it.

Skin Cancer

Skin cancer means that one of the many different types of cells which make up the skin not only divides out of control, but also break through normal barriers which separate one skin structure from another. So the two malignant features of skin cancer are unchecked growth and invasive behavior. Benign skin growths tend to stop growing at some point and do not invade other skin structures. Consequently, there is no such thing as a benign skin cancer. However, by far the majority of skin cancers do not kill people, even if they can locally destroy the skin due to their malignant behavior. The most common types of skin cancer are Basal Cell Carcinoma (BCC), Squamous Cell Carcinoma (SCC), and Malignant Melanoma (MM). For every one patient with Melanoma in the US, there are roughly 4 patients with SCC and 20 patients with BCC. Merkel Cell Carcinoma is rare but often lethal if found too late. Melanoma is the biggest killer of people originating in the skin and, among young people, one of the most common causes of death. The cause of Melanoma is both genetic and environmental. The cause of BCC and SCC is mostly environmental due to the high energy ultraviolet rays of the sun which damage the genetic code of skin cells and change them into pre-cancerous cells first, then cancerous cells. To counter-act this damage, protection from the sun and a healthy diet help because less damage occurs and whatever damage does occur can be better and faster repaired if certain nutrients like anti-oxidants are present. Skin cancer can happen to all ethnic groups, no one is really totally safe in the sun. The most important prevention means to look at your own skin on a regular basis to scan for new or changing growths and spots, and to be screened for skin cancer by a dermatologist. Even a Melanoma is curable, if detected early.

Skin Tags

These are out-pouching’s of loose skin in the folds. They grow when the skin is exposed to too much insulin in turn seen in people on diets too rich in sugars and starches. There is no other medical significance to skin tags. Removing them is usually not covered by insurance. The removal can be done with sharp scissors, electro-desiccation, or cryo-therapy.

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