Dr. Alai is an actively practicing medical and surgical dermatologist in south Orange County, California. She has been a professor of dermatology and family medicine at the University of California, Irvine since 2000. She is U.S. board-certified in dermatology, a 10-year-certified fellow of the American Academy of Dermatology, and Fellow of the American Society of Mohs Surgery.
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.
Yes, Mohs is a widely used method of
surgically removing the most common types of skin cancers, including basal cell
carcinoma and squamous cell carcinoma. It is currently not used to remove
noncancerous growths. Less frequently, Mohs may also be used for other
malignant tumors. In special cases, Mohs may be used to surgically treat
malignant melanoma, lentigo maligna, dermatofirosarcoma protuberans, merkel cell
tumor, microcystic adnexal carcinoma, malignant trichoepithelioma, angiosarcoma,
atypical fibroxanthoma, and other cancerous tumors. However, most Mohs surgeons
treat primarily basal and squamous cell cancers by this technique.
Am I a good candidate for Mohs surgery?
You
may not be a good candidate for Mohs if you are unable to tolerate local
anesthesia, have extreme anxiety, have a surgical phobia, or are in very poor
health.
Your decision on the best treatment choice may depend on different factors
such as the location and type of skin cancer, your past treatments, your overall
health, and level of comfort. Your physician can help you sort through the
different treatments and assist in your shared decision-making process. However,
the right decision for you is always yours and your doctor's to make.
What if I have artificial joints or other health issues?
Your Mohs surgeon
needs to know of any underlying medical conditions that may affect your surgery
or wound healing. You would want to be certain to tell your surgeon beforehand
if you have any artificial parts (implants) like knees or hips, a pacemaker or
defibrillator, or need to take antibiotics before dental procedures because of a
heart condition or murmur.
Your Mohs surgeon needs to know if you have had a history of "Staph" or other
skin infections in the recent past. You may be asked to wash with a special
antibiotic soap or wash like Hibiclens (chlorhexidine) the night or morning
before surgery to help reduce the number of bacteria on your skin.
Patients need to also advise their surgeon of any drug allergies to
anesthetics like lidocaine (Xylocaine), epinephrine, or novocaine. Additionally,
the surgeon may need to know of any bleeding or bruising tendencies, hepatitis,
HIV/AIDS, or pregnancy.
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.
Melanoma is a type of skin cancer which begins in skin cells called melanocytes and affects more than 53,600 people in the United States each year. These melanocytes can grow together to form benign moles which, after a change in size, shape, or color can be a sign of melanoma. Caused by sun exposure, early detection becomes extremely important to avoid a spread to other areas of the body. Diagnosis is confirmed through a biopsy of the abnormal skin and treatment depends on the extent and characteristics of the patient.
A keloid is a scar that doesn't know when to stop. When the cells keep on reproducing, the result is an overgrown (hypertrophic) scar or a keloid. A keloid looks shiny and is often dome-shaped, ranging in color from slightly pink to red. It feels hard and thick and is always raised above the surrounding skin.
Cancer is a disease caused by an abnormal growth of cells, also called malignancy. It is a group of 100 different diseases, and is not contagious. Cancer can be treated through chemotherapy, a treatment of drugs that destroy cancer cells.
Signs and symptoms of penile cancer include a lump on the penis and redness, irritation, or a sore on the penis. Risk of penis cancer is higher in uncircumcised men, due to a higher risk of HPV infection. Other risk factors include being over 60, having phimosis, having poor hygiene, using tobacco products, and having many sex partners. Prognosis and treatment depend upon the tumor's location and size, the stage of the cancer, and whether the cancer was recently diagnosed or if it recurred.
Scar formation is a natural part of the healing process after injury. The depth and size of the wound incision and the location of the injury impact the scar's characteristics, but your age, heredity and even sex or ethnicity will affect how your skin reacts.
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.
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