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Skin Doctor Day In The Life

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Dermatology is an amazing medical specialty with cosmetics, medicine, and surgery all in one day.

Good morning i’m dr. alexis stevens a board-certified dermatologist we’re gonna have a lot of fun we have surgery cosmetics and medical all mixed in today 32 patients on the schedule total hopefully they’ll let you come along so let’s go have some fun i just pulled in and there’s already three patients waiting let’s go see them all right so i always check beeping

My car does anybody else do that like literally beat their car five million times to make sure that it’s left through patients waiting once cosmetic so she’s numbing and then other to our medical believe hair loss and a fee so then i see them first patient is okay so book talks is a neurotoxin there is botox just poured new talks which social ministry both zeeman

They all act in the same way to actually paralyze the muscle so that when you’re moving down lines this expression lines i mean actually paralyzes the muscles that cause the movement and therefore the wrinkles for people and contractions that happen stop happening i just do it so it looks very nice and lateral and then you don’t have those lines you don’t know the

Frozen or like some people on television where they look a little scary and walking like this all day i’m not for that look she’s got so much botox in your face i don’t know if she’s ever gonna decompose so part of being in dermatology is keeping abreast with all the new drugs medications and treatments that are coming out today we have one of the representatives

From a new topical medication coming out for acne so let’s go meet him hi so today learn about gamzee today the first ever topical minocycline for acne i have two patients here right now for chemo treatment we were going to do kenalog injections for them in combination with silicone bandages and we’re also going to infuse hyaluronic acid into the scars this is

A keloid that’s responding very well to killowog injections a keloid is basically a scar that goes outside of the normal borders of where the original injury was making it more than a hypertrophic scar and we’re going to inject kenalog in here followed by aqua coat and we will use hyaluronic acid all right so now we’re about to do so i feel i mixed a bit some

Prp so we’re using this patterns whistling – whistling lift which is i have a hanif acid i love to do if i’m going to get acid because one if the patient doesn’t like it it can be immediately removed so that’s amazing it’s done something about hyaluronidase and – because it’s very safe i’m chance to do not have any foreign body reactions and it’s very malleable

Other thing that we’re using is prp so that sends for a platelet-rich plasma and the prp helps the body to naturally produce its own collagen over time it’s a more natural approach so think about prp as allowing the body to do what the filler immediately does prp can help that the body do that over time and the filler is more of that immediate effects a lot of

People come in and they want to see the results now that’s your filler when patients come in and they’re wanting more of a natural approach or something that’s going to be long lasting that would be prp i love to combine the two because when i give the immediate effect so people are happy and then brought that longevity of prp as well so this is the typical setup

For doing prp with fillers you have is your prp here on the target and spun down isolated and then i use a cannula as opposed to doing it with just a normal needle it’s just safer especially for around the eyes are just a very vascular and then if fillers which we already talked about and i do use wiesel gold which is a little device with 24-karat needles at the

End the needles are actually smaller than a hair follicle so it doesn’t hurt the patients and this is just an extra boost to give a little bit of extra room so very much okay so we are about to do a basal cell carcinoma excision it is nodular so we’re going down to the sub cutis areas of the fet as being removed and this patient has a pretty strong history of

Being vasovagal meaning that they faint often throughout anything even just like doing biopsies surgeries everything and past she’s had a lot of vasovagal experiences so we have the music going we’re going to be doing a lot of talk with iva during the time so that we can kind of distract her all right so let’s get to it do pathology that way we can confirm that

The margins are indeed clear and there are no more cancerous cells when you answer whether favorable spins or melanomas you actually want to mark the region so we call it 12 o’clock so we’ve marked at the top of this area here you can see the basal here in the middle and the 12 o’clock has been marked so that when the pathologist looks at it they can tell you if

There is a new positive margin exactly where it’s located so this is our marking here for the basal i usually do surgeries midday just to kind of help with the flow of the office just in case the surgery runs long what’s a squirter it’s attached to something we didn’t really plan or this way if it does run a little bit long it’s running into my lunch break versus

Making all of the rest of the patient for the day lates all right so we have a full house right now we have a bunch of full skin exams people do those four skin checks just in general to make sure everything is okay learning this and blowing nearby in general are benign and not troublesome somewhere on the scalp they can be a little bit more worrisome and if they’re

Growing we should definitely biopsy to make sure that there is no malignant is alopecia areata it’s a nice kind of circular oval she xanthelasma is eliminate cholesterol deposit half of patients with these have completely normal limits another half have a lipid disorder and the way that you can get rid of it is by doing something called cryo surgery or electric on

Occasion you can even surgically remove them so we have a patient that’s coming in with undiagnosed plaques that have been there for years right and she has them here on the elbows and then some plaques here she also has this what we’re calling a mole but it’s not a mole it’s actually a dramatic fibroma which is just fancy scar tissue name she was bit by a mosquito

At 16 in this developed so that’s how dermatophyte almost above and then this patch here she’s mentioned that she fell down kind of going upstairs and then this patch began so trauma in areas where patient has psoriasis is called communitisation so this is just a psoriatic patch and then the fact that it came after trauma is keeping her ization magellan’s is super

Controversial it’s in from lyme disease borrelia severe acute infection or is it truly delusions of parasitosis there’s a huge controversy around it and when i have patients who come in telling me that they’re having filaments come out of the body or feel like there’s things crawling out of their skin or they come in with a bag of what has come out of their skin

I do do a thorough workup and i die those based off of what i see under pathology when the pathologist brings back to me and clinically what we are seeing i think that everyone is owed due diligence and not just to be written off as delusions of parasitosis and so we did just have a patient come in and we worked her up thoroughly but we are now about to do laser

Hair removal on a family of three and they also don’t want to be filmed but i’m pretty sure that you guys have kind of seen the laser hair removal looks like so swelling and edema and erythema on the lower legs bilaterally so this is stasis dermatitis cellulitis does not occur bilaterally on the lower extremities okay guys so that’s it for the day it was a really

Amazing day i love dermatology so much and i hope that you got to have a long limbs into my world we did meds we did cosmetics we did surgery we were able to help a lot of people today and hopefully we were able to keep you entertained that’s how i like to break up my day to keep myself entertained and hopefully i was able to keep you guys entertained as well

Transcribed from video
Skin Doctor Day In The Life By Dr Alexis Stephens