Dr. Rockoff received his undergraduate degree from Yeshiva College with the distinction of Summa Cum Laude. He received his medical degree from the Albert Einstein College of Medicine. His internship and two years of Pediatric residency were at the Bronx Municipal Hospital Center, followed by training in Dermatology at the combined residency program at Tufts and Boston Universities. Dr. Rockoff is certified by both the American Board of Dermatology and the American Board of Pediatrics.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Most of the time, doctors can diagnose an actinic keratosis just by examining
it. If the AK is especially large or thick, a biopsy may be advisable to make
sure that the spot in question is just a keratosis and has not become a skin
cancer.
There are other spots, called seborrheic keratoses, that are not caused by
sun exposure and have no relationship to skin cancers. These are raised brown
lesions that may appear on any area of the skin. They also often run in families.
How is an actinic keratosis treated?
The best treatment for an AK is prevention. For light-skinned individuals,
this means minimizing their sun exposure. By the time actinic keratoses develop,
however, the relevant ultraviolet radiation is often so far in the past that prudent
preventive measures play a relatively small role. Fortunately, treatment methods
are usually simple and straightforward:
Cryosurgery: Freezing AKs
with liquid nitrogen often causes them to slough off and go away.
Other forms of surgery: Doctors sometimes cut away or burn off AKs.
5-fluorouracil (5-FU): Creams
containing this medication cause AKs to become red and inflamed before they
fall off. Although effective, this method often produces unsightly and
uncomfortable skin for a period of weeks, thus making it impractical for many
patients. This method is best for patients who have a great deal of sun damage and many AKs. Once the skin heals, it often looks much smoother and even-toned, in addition to having fewer actinic keratoses.
Imiquimod (Aldara): This immune stimulator is similar in its indications and effects to 5-FU.
Photodynamic therapy (PDT): This therapy involves applying a dye (aminolevulinic acid [Levulan] or ALA) that sensitizes the skin to light, leaving it on for about one hour, and then exposing the skin to light that activates the dye. This light can come from a laser or other light source. Like 5-FU and imiquimod, photodynamic
therapy works best for patients with many AKs. Patients need to avoid exposure to sun or intense fluorescent light for two days after treatment to prevent ongoing peeling.
Diclofenac (Solaraze): This cream is an nonsteroidal antiinflammatory drug (NSAID), an agent related to ibuprofen [Advil, Children's Advil/Motrin, Medipren, Motrin, Nuprin, PediaCare Fever], a popular medication for headaches). Diclofenac is gentler than 5-FU or
imiquimod, causing less inflammation, but must be applied for a longer period of about two months to achieve benefits.
The word "rash" means an outbreak of red bumps on the body. The way people use this term, "a rash" can refer to many different skin conditions. The most common of these are scaly patches of skin and red, itchy bumps or patches all over the place.
Psoriasis is a long-term skin condition that may cause large plaques of red, raised skin, flakes of dry skin, and skin scales. There are several types of psoriasis, including psoriasis vulgaris, guttate psoriasis, inverse psoriasis, and pustular psoriasis. Symptoms vary depending on the type of psoriasis the patient has. Treatment of psoriasis may include creams, lotions, oral medications, injections and infusions of biologics, and light therapy. There is no cure for psoriasis.
Skin cancer is the most common form of cancer
in humans. There are three main types of skin cancer; basal cell carcinoma and
squamous cell carcinoma (the nonmelanoma skin cancers), and melanoma.
Sunburn is caused by overexposure to UV radiation from the sun. UV rays can also damage the eyes. Repeated overexposure to UV rays also increases the risk for scarring, freckles, wrinkles, and dry skin. Symptoms of sunburn include painful, red, tender, and hot skin. The skin may blister, swell, and peel. Sun poisoning (severe sunburn) include nausea, fever, chills, rapid pulse, dizziness and more. Treatment for sunburn depends upon the severity. Sun protection and sunscreen for an individual's skin type is recommended to decrease the chance of sunburn.
Wrinkles, whether they be fine line or deep furrows, typically appear on areas of the body that receive a high amount of exposure to the sun. Smoking, light skin type, hairstyle, the way you dress, your occupational and recreational habits, and heredity are all factors that promote wrinkling. Medical treatments for wrinkles include antioxidants, moisturizers, alpha-hydroxy acids, and vitamin A acid. Cosmetic procedures that treat wrinkles include dermabrasion, microdermabrasion, glycolic acid peels, laser resurfacing, Botox, and fillers.
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