Common Rashes of the Skin :Part 1- Hand Dermatitis

Also known as hand eczema, hand dermatitis is a common condition involving inflammation of the skin on the hands.  It occurs when the skin becomes irritated in response to a “trigger,” such as contact with harsh soaps, raw fruits/vegetables, and chemicals.  Environmental and genetic factors both play a role, although those with long term exposure to “wet work,” such as food handling, healthcare work, and hairdressing are at highest risk. Signs and symptoms include redness, itching, thickening of the skin, scaling, cracks, and even erosion and bleeding.   

In recent years, overuse of hand sanitizer has been associated with hand dermatitis, seen particularly in hospital workers.  Alcohol-based hand sanitizer can disturb the natural pH and barrier of the skin, leaving skin vulnerable to allergens which can penetrate beneath the surface and trigger an autoimmune reaction.  It is this reaction which causes reddening, itching, blisters, swelling, peeling, and cracking.  In severe cases, the condition can become persistent.  

Prevention of hand dermatitis involves avoidance of irritants, which varies between individuals but may include detergents & soaps, foods, metals, plants, cement, topical medications, gloves, cosmetics, as well as prolonged exposure to water.  Washing hands with lukewarm (not hot) water with a mild unscented soap, immediately followed by a heavy hand cream will help to keep hands moisturized and protected.  After washing, hands should be gently pat dry in order to not irritate the skin.  Additionally, gloves should always be worn (vinyl generally preferred over latex or rubber) before coming into contact with possible irritants.  If a patient is already experiencing hand dermatitis, corticosteroids may be prescribed to control the inflammation, followed by prevention strategies to avoid 

re-occurrence. 

This weeks blog written By Quynh-Dao Tonnu , PA Student from Nova Southeastern

Provider Spotlight: Shanah Cyr, Aesthetician

Shanah Cyr is one of our aestheticians. She provides aesthetic services to clients in our Cape Coral and Fort Myers offices. She is a licensed Facial Specialist who received her schooling at the Florida Academy of Massage and Skin Care.

What inspired you to pursue a career as an aesthetician?

When I started working for Florida Skin Center, I quickly saw how happy all the aesthetic patients were. They would talk about their skin and how much improvement they had seen. I knew I wanted to be able to bring about those results in patients.

What are some of the highlights of your career? 

The biggest highlight would be helping the patient. When I see the results of my work - their increased self-confidence because they are not afraid to show their skin - it makes me feel satisfied. I made a difference in their life for the better, and that brings me joy.

What are three things a patient can do to maintain healthy skin?

Cleanse, Exfoliate and Protect with SPF of 30 or more

What do you include in your own skin care regimen? 

I make sure I exfoliate regularly. As I get older, I see how quickly the texture of my skin changes if I don't regularly remove the dead skin.

What are the most common procedures you perform? What are the ones you most commonly recommend?   

The most common procedure performed as well as recommended would be Chemical Peels. They effectively help with such a wide range of concerns such as acne, fine lines, pore size, and uneven skin tone. If I have a patient with more specific needs, I may recommend microneedling or Exilis treatments.

What do you like to do for fun? 

I like to be with friends, or craft (always working on something new). But a good night in with my family is the best.

What do you like most about working at FSC? 

I enjoy the people the most. They are smart and funny and have a clear idea of who they are and where they want to be. This is a growing and successful business and I am grateful to be a part of that growth and success.

Provider Spotlight: Cindy Huang, PA-C

Cindy Huang is Florida Skin Center's physician assistant for the Lehigh Acres office. She is the newest provider to join our team. She received her B.A. in Psychology from Binghamton University, and her Masters in Medical Science from Arcadia University.

What inspired you to pursue a career as a physician assistant?

After college, I worked in behavioral cardiovascular research for several years, and interacted with subjects that would ask me a lot of medical questions that I could not answer. I have always had a desire to help people, and so I decided I wanted to become more directly involved in patient care. The physician assistant profession was appealing to me, because it allows one to provide care to patients but still have a life outside of work.

What are some of the highlights of your career? 

I would say working for Florida Skin Center is the highlight of my career. I worked for a few different practices in New York before moving here, and I have not come across a better organization to work for. Dr. Badia is an excellent and caring physician, and my colleagues are awesome. We work as a team to serve our patients, who are our #1 priority. It is always very rewarding to hear good feedback from patients that I have taken care of - those are usually highlights of my day/career! 

What are three things a patient can do to maintain healthy skin?

Moisturize your skin daily, wear a broad-spectrum sunscreen of at least SPF 30 (and reapply at least every 2 hours), and get regular full-body skin checks.

What do you include in your own skin care regimen? 

I use Skin Medica's Retinol Complex and TNS Eye Repair to help keep my skin looking more youthful by reducing the look of fine lines and dark circles. I also like Skin Medica's HA5 Hydrator, which makes my skin feel very soft and smooth almost instantly. I use Colorescience's Sunforgettable in the morning, which is a powder mineral sunscreen. It's very quick to apply, which is crucial because I'm always in a rush in the morning!

What are the most common procedures you perform? What are the ones you most commonly recommend?   

Being a dermatology physician assistant is great because we get to do both cosmetic and medical procedures. The most common medical procedures I perform are skin biopsies; they are also the most common medical procedure I recommend, because a large percentage of patients coming in for their full-body skin checks are not aware of some of the abnormal moles or growths on their body that need to be tested. On the cosmetic side, it depends on what the patient is looking to improve. One of the many great things about Florida Skin Center is that we offer a full array of cosmetic/aesthetic (and medical) services, so we have many options to treat the signs of aging, from fillers and Botox to laser to chemical peels to microneedling.

What do you like to do for fun? 

I love to try new restaurants, play sports, and do DIY projects. I also love spending time with my 2 cute nephews.

What do you like most about working at FSC? 

The FSC culture, which emphasizes teamwork and growth. I enjoy coming in to work every morning and knowing that I'm part of a team that cares about each other, both personally and professionally. 

What is the last book you read? 
Harry Potter and the Cursed Child, although I'm still working on it!

Provider Spotlight: Brooke Drew, PA-C

Brooke Drew is Florida Skin Center's physician assistant for the Cape Coral office. She has been with Florida Skin Center for 3 years. She received her B.S. in Biomedical Science from the University of South Florida, and her Masters in Medical Science from Nova Southeastern University.

What inspired you to pursue a career as a physician assistant?

Science was my favorite subject in school, and I have always had a desire to help people. I chose to become a Physician Assistant to help others, while also having time to be with and take care of my family.  I had some of my own experiences with skin conditions at a young age, and that is what made me want to pursue a career in Dermatology.

What are some of the highlights of your career? 

I can say that I am in my dream career. Dr Badia is a wonderful physician to work with and my colleagues are top notch. I am proud to have the Cape Coral location open to serve patients’ needs for everything from routine skin checks, to surgeries, lasers, and cosmetic procedures on a daily basis. I love when patients come back and tell me their condition is better, and knowing that I can potentially change their life by taking care of their skin.

What are three things a patient can do to maintain healthy skin?

Cleansing, Moisturizing, and Sunscreen (a yearly skin check of course goes along with the sunscreen).

What do you include in your own skin care regimen? 

To keep my skin clear and youthful, I use Skin Medica's AHA/BHA wash. It gives me the right balance of clean and also helps to exfoliate away dead skin. I also use retinol and TNS Essential Serum daily. These products help to exfoliate and improve collagen to keep my skin looking refreshed. I finish my daily routine with Skin Medica's Tinted Total Defense and Repair. It gives me protection (SPF 30) and color for the day.

What are the most common procedures you perform? What are the ones you most commonly recommend?   

One thing I love about my career as a Dermatology Physician Assistant is that I do a little of everything. Routine biopsies are the most common procedures I do, but I really enjoy surgery.

What do you like to do for fun? 

I am married and a mother of 2 busy girls, ages 2 and 4. We have family in the area and spend a lot of time with them. We also like to go on the boat (of course with sunscreen and protective clothing ;) )

What do you like most about working at FSC? 

Relationships and the ability to grow. We are a close family here at FSC, and we all care for each other. We are encouraged to grow and take on new tasks, responsibilities, and are always learning.

What is the last book you read? 

I am studying to recertify for my Physician Assistant National Boards this year, so I have been doing a lot of reading and taking courses to prepare.

Provider Spotlight: Shirisha Vallarapu, PA-C

Shirisha Vallarapu is Florida Skin Center's senior physician assistant. She received her B.S. in Microbiology from Miami University in Oxford, Ohio, and her Masters in Medical Science and B.S. in Physician Assistant Studies from Nova Southeastern University. If you are a patient of our Fort Myers office, you most likely have met her!

What inspired you to pursue a career as a physician assistant? 

I knew I always wanted a career in healthcare from a young age. I also wanted a career that would give me an opportunity to have a good work life balance and raise a family. My career as a PA has been very rewarding. I love having my own schedule and seeing patients daily while also getting to do a mix of procedures while  having plenty of family time.

What are some of the highlights of your career? 

Florida Skin Center was my very first job straight out of school. I have been working with Dr. Badia for over 13 years. I think the highlight of my career has been seeing the growth within myself and Florida Skin Center as we continue to grow and expand. I also love how I have built great relationships with our patients over the years. And see them out when I am out in the community.

What are three things a patient can do to maintain healthy skin? 

Sunscreen is vital to maintaining healthy skin especially here in SW FL and I recommend we wear it daily. Developing a good skin regimen at an early age for prevention, that includes retinol and antioxidants because although we all age, we can do it gracefully; and getting annual skin checks. We don’t know what we can’t see.

What are the most common procedures you perform? What are the ones you most commonly recommend?  

What I love about working at Florida Skin Center is that I get the opportunity to do medical and cosmetic procedures.  On the medical side, I perform biopsies to rule out skin cancers and other conditions, as well as surgeries to remove skin cancers.  I also love doing cosmetics for patients because it’s amazing to see how much better we feel about ourselves by doing simple non-invasive procedures like fillers, Botox and lasers.

What do you like to do for fun?

I have been married for 10 years and have two little boys, 2 and 7, who keep me on my toes. We love going to Disney and Lakes Park and doing all things boy.

What do you like most about working at FSC?

The culture. It is such a great work environment. The ladies I work with are all wonderful and are like a second family to me. We all genuinely care for each other and want the best for each other and our patients.

What is the last book you read?

I like a good suspense novel. The last book I read was : A Girl on a Train. Would love suggestions!

Common Pediatric Dermatology Conditions Series: Week 4 -Pityriasis Rosea

Pityriasis Rosea is a rash commonly seen in children and adults. The rash classically starts with a larger spot called a “herald patch.” This first patch is often red, raised, and slightly scaly.  A few days after the patch appears, many smaller spots will begin to appear, often in the shape of a Christmas tree. Although the rash may look concerning, it is not contagious and will go away within 4-10 weeks. Other symptoms can include headache, tiredness, fever, sore throat before the rash appears, but many people are asymptomatic.  Although the exact cause of pityriasis rosea is unknown, it is thought to be caused by certain viruses.

Many times the rash is asymptomatic, but in some the rash can be quite itchy and cause discomfort.  If the rash itches or continues for longer than 10 weeks, it is best to see a doctor so they can ensure the rash is properly diagnosed and prescribe medications to help with itching.  Treatments for itch include steroids, and antihistamines. There is no cure for pityriasis rosea, and treatment is symptomatic. Pityriasis rosea doesn’t cause scarring, and usually does not recur.

This weeks blog written by guest blogger: Abby Leboza, PA Student from Nova Southeastern 

Common Pediatric Dermatology Conditions Series: Week 3- Acne

    Acne is a very common skin condition of children and teenagers in which the pores on the face, neck, chest, back, or shoulders become plugged with bacteria, oil and dead skin cells. When this occurs, the plugged pores can begin to look red and inflamed.  Acne in part is caused by a bacterium called Propionibacterium acnes. These particular bacteria thrive in the oily environment of the skin . P. acne produced the redness and inflammation that are the hallmarks of acne lesions. Without treatment, this inflammation can cause scarring.  There are various types of acne including whiteheads, blackheads, and deeper cystic acne.  It is common for children and teenagers to have multiple types of acne at one time.

Acne is best treated early to decrease the risk of scarring. Often, people will try to treat acne with over the counter cleansers, moisturizers, and topicals. If over the counter products are not working on their own, it is time to see a dermatologist who can prescribe other medications.  These can include topical medications, and/or oral medications. A provider can also sometimes make recommendations for alternative or adjunct treatments such as chemical peels, facials, steroid injections, laser, and light therapy that can help with acne and acne scarring. Other factors that can help with acne breakouts are to minimize stress, and high-diary/high-carb diets. Break-outs can also be worsened due to hormones and certain medications. Moisturizing the skin of the face is imperative to help tolerate acne medications, and also reduce oil production. When your skin is overly dry, it will produce more oil and can lead to more inflammation and acne breakouts.

This weeks blog written by guest blogger: Abby Leboza, PA Student from Nova Southeastern