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Dermatology Practice Today

Examining the Scalp
May 13, 2013 3:00 PM by Amy Gouley
(Pictured above and below) A 54-year-old male presents with two bald patches on the scalp. He complains that the bald patches itch. Diagnosis: Alopecia Areata (Pictured below) A one-year-old presents with a lesion on her scalp since birth. Diagnosis: Read More...
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Help Your Dermatologist Help You
May 3, 2013 1:33 PM by Raymond Shulstad
More dermatological procedures, such as biopsies and excisions, are being done in primary care settings than ever before. With this in mind I want to give everyone some food for thought as to how they can more accurately read the pathology. As clinicians Read More...
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I’ve Got Bugs
April 15, 2013 12:50 PM by Raymond Shulstad
There are several presentations for patients who have or believe they have "bugs" in or on their skin. There are the haves, have nots and the "I know I have it and I brought proof but have nots." The haves are easy to diagnose. The most common of these Read More...
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Neurodermatitis
April 4, 2013 4:25 PM by Amy Gouley
This was a 71-year-old female who reported a rash for 7 months. Her primary physician thought she needed a dermatologist evaluation. At the beginning of taking her history, she was pointing to lentigines scattered on her face, arms and legs that she "disliked." Read More...
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The Use of Dermatoscopes
March 28, 2013 9:04 AM by Raymond Shulstad
I had a student ask me recently if I had a dermatoscope and if I could show her how to use it. The answer was simple enough. No, I don't need one. This of course led to the logical question...Why? This blog post was inspired by this exchange. The simplest Read More...
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Spring Breakers Beware
March 11, 2013 3:36 PM by Raymond Shulstad
As the universities and secondary schools are preparing for spring break, it is important that we are educated and educate our young patients on the dangers of ultraviolet exposure. I am going to focus this blog more specifically towards the use of tanning Read More...
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A Rapid Case of Metastatic Melanoma
March 1, 2013 2:47 PM by Amy Gouley
Above, a 75-year-old patient with stage 4 metastatic melanoma. He came to us after a staged excision and graft. The black dots are new satellite nodal mets. Above, metastatic satellite lesions on the scalp of the same patient. He had the original scalp Read More...
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A Case of the Creeping Crud
February 21, 2013 1:30 PM by Raymond Shulstad
If you have been around medicine long enough and seen enough patients with rashes then you have probably heard the term "creeping crud." It is often used by older patients to describe a rash that appears to be spreading or moving to other areas of the Read More...
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For the Love of Derm
February 14, 2013 1:40 PM by Amy Gouley
(Above) Heart-shaped pigmented Basal Cell Carcinoma on the back of a 71-year-old male. (Above) Heart-shaped Actintic Keratosis on the left forearm of an 88-year-old male. (Above) Heart-shaped squamous cell carcinoma on the lower leg of a 73-year-old male Read More...
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Cellulitis, Melanoma and Acne Granulomatous
February 7, 2013 10:10 AM by Amy Gouley
Malignant Melanoma on a 69-year-old female Breslow Thickness: 0.9mm Clark Level 3/Early 4 Mitotic Index: 2 dermal mitosis Referred for Lymph node mapping and treatment Cellulitis on the lower leg. Cellulitis on the lower leg 2 days later, following Predinsone Read More...
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Treating Stasis Dermatitis
January 31, 2013 3:06 PM by Raymond Shulstad
As this is my first attempt at blogging I will start by introducing myself. My name is Raymond Shulstad, DNP, ARNP-C, BC, DCNP. I have been practicing dermatology for the past 11 years in the Tampa Bay area. I completed my DNP in December of 2009 at the Read More...
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Diagnosing Carcinoma and Melanoma
January 25, 2013 1:04 PM by Amy Gouley
This patient had perfectly symmetrical basal cell carcinomas on both forearms. The patient even remembers getting horribly sun burned on both arms twenty years ago! This 72 year old patient presented for a total body exam. The patient reported a pencil Read More...
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Rashes, Bumps and Burns, Oh My!
December 13, 2012 9:41 AM by Amy Gouley
1. 61 y/o M new patient presents for rapidly growing bump on right cheek. Shave biopsy proven Invasive Squamous Cell Carcinoma and scheduled for MOHS. 2. 56 y/o F spilled hot water on her ankles on Thanksgiving. Patient is complaining of soreness and Read More...
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Three Derm Diagnoses
November 30, 2012 9:27 AM by Amy Gouley
1. A patient presented to my clinic for a rash on his hands. After a plan was developed, he stood up and I said, "How about I take a quick look at your back since it's difficult to see our own backs." He raised his shirt and here this was, a large 3cm Read More...
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My Four Favorite Derm Cases
November 15, 2012 9:26 AM by Amy Gouley
1. A patient presents with a new spot on the nose for 3 months. No history of skin cancer. I believe it's a BCC and path proves it's a SCC, WOW! 2. Ceruloderma, a drug-induced pigmentation secondary to Lupus medication. 3. "Show and Tell:" I love a zip Read More...
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