Dermatology

Dermatology and Podiatry

Our Dermatology Center of Excellence focuses on skin and nail issues related to the lower extremity.  We work with Dermatologists and Oncologists for comprehensive care. It is amazing how many skin issues the foot and ankle area produce.   By focusing on this, our Institute can better serve its patients in a comprehensive way to prevent small problems from becoming large.  We don’t have to suffer from skin cancer.  Having expertise in this field offers our patients added convenience and peace of mind.

Bowen’s Disease

This patient has Bowen’s disease or Squamous Cell Carcinoma in Situ. She had a skin lesion on the back of her heel and another doctor treated it as a wart but when we did the biopsy it came back as Squamous Cell Carcinoma in Situ. We were able to successfully remove the lesion and then advance a V-Y Flap in the excised lesions skin deficit to close the wound. She was able to walk out of the operating room and is recovering. This plastic surgical procedure is just one of many local random flaps we perform to close wounds for skin deficits. The sutures will dissolve and she will make a full recovery.

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We excised the lesion by making a 1.5 cm hole in the top of her foot, so we advanced a V-Y flap from proximal to distal to close the wound without tension.
Post op V-Y Advancement flap for malignant melanoma excision. Margins were clear and this saved the patient’s life.
You can see the incision site is healing well. The initial redness and swelling have subsided significantly, and the scar itself appears smooth and well-aligned.

Malignant Melanoma in Situ

This patient had a small black mole on the top of the foot and we biopsied it. It came back Malignant Melanoma in Situ. This is a very deadly skin cancer, and we caught it early. We excised the lesion by making a 1.5 cm hole in the top of her foot, so we advanced a V-Y flap from proximal to distal to close the wound without tension. We removed all of the cancer, and she will make a full recovery.

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Post op V-Y advancment flap after we excised the basal cell cancer. The patient had a full recovery and all margins were clear.
Basal Cell Carcinoma of the heel.

Basal Cell Carcinoma of the Heel

Basal cell cancers may appear as pearly white bumps or patches that may ooze or crust and look like an open sore. On the skin of the lower legs and feet, basal cell cancers often resemble non-cancerous skin tumors or benign ulcers.

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Gallery

Bowen’s disease or Squamous Cell Carcinoma in Situ. She had a skin lesion on the back of her heel and another doctor treated it as a wart but when we did the biopsy it came back as Squamous Cell Carcinoma in Situ. We were able to successfully remove the lesion and then advance a V-Y Flap in the excised lesions skin deficit to close the wound.
We excised the lesion by making a 1.5 cm hole in the top of her foot, so we advanced a V-Y flap from proximal to distal to close the wound without tension.
Post op V-Y Advancement flap for malignant melanoma excision. Margins were clear and this saved the patient’s life.
You can see the incision site is healing well. The initial redness and swelling have subsided significantly, and the scar itself appears smooth and well-aligned.
Basal Cell Carcinoma of the heel.
Post op V-Y advancment flap after we excised the basal cell cancer. The patient had a full recovery and all margins were clear.
The small brown dot next to styloid process of the fifth metatarsal (the bump in the middle of the picture) is malignant melanoma. We excised it and got clear margins so we resolved the problem for this patient.
This is what it looked like after we excised and closed the wound on the malignant melanoma. We sent this off to pathology and we got a clean margin all around thus saving this patient’s life.

Dr. Michaels Says:

“We use the most natural treatments available to this which means usually an external support of some kind.   There are numerous different devices we use but the most common recommendation is to wear good shoes and custom foot orthotics.  We have all of the best devices that get people back to doing what they love in house and most are covered by your insurance plan.”

Podiatric Dermatology Related Services

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