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.
Mohs is used primarily for the
treatment of head and neck basal and squamous cell skin cancers. It is
particularly useful for skin cancers in difficult areas such as nose, lips,
ears, and genitals.
It is also used on hands and feet where there is not a lot of extra tissue
for bigger surgical removals. Mohs is very effective for the treatment of
recurrent tumors (tumors that were previously removed and have regrown at the
same site). However, depending on the specific patient and tumor type, any area
of the body may be treated by Mohs surgery.
What are possible complications of Mohs?
As with any surgery or procedure,
Mohs is associated with possible risks and complications. While it is overall a
very safe and effective minor surgical treatment, there are some possible
uncommon complications. Since a scar usually forms anytime you cut the skin,
most patients understand and can expect some type of a scar after skin-cancer
removal.
Possible risks and complications of Mohs include (but are not limited to)
bleeding, bruising, wound infection, pain, unsightly scar, keloid (raised, thick
scar), cosmetic disfigurement, skin discoloration, nerve damage, allergic
reactions, pain, reaction to local anesthesia, widened or sunken in (depressed)
scar, wound opening (dehiscence) and splitting or retained stitches, cancer
recurrence, need for further surgery or treatment including radiation or plastic
surgery, and rarely death.
Minor, serious, or life-threatening reactions can occur with the use of
anesthetics or with medications given before, after, or during surgery. Nerves
controlling muscle movement, sensation, or other functions may be damaged. This
nerve damage may be permanent. Overall, most patients tolerate the minor surgery
very well without any complications.
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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