Treating Pediatric Keloids: A Case Study of an 11-Year-Old Girl with a Right Ear Scar

By: Dr. Caroline Vaughn

Keloid scars are notoriously challenging to manage—especially in pediatric patients. At Village Dermatology, we provide individualized care for children and adolescents dealing with scarring issues that affect both physical comfort and self-esteem. In this blog post, we explore the case of an 11-year-old girl from Katy, Texas who came to us for treatment of a recurrent keloid scar on her right ear.

Patient Overview

This young patient was seen in our dermatology clinic as a new patient, accompanied by her guardian. Her chief complaint was a scar on the back of the right earlobe, previously identified and treated as a keloid. It had been surgically removed once before and treated with intralesional Kenalog (ILK) injections, but the keloid had returned.

What Is a Keloid?

A keloid is a type of raised scar that grows beyond the boundaries of the original wound due to an overactive healing response. Keloids can occur after ear piercings, surgical procedures, acne, or even minor injuries—especially in individuals with a genetic predisposition.

In this case:

• Location: Right posterior earlobe

• Severity: Moderate and visibly enlarging

• Symptoms: Currently asymptomatic but concerning due to recurrence

Treatment Plan

After a careful examination using a dermatoscope and discussion with the family, we proceeded with intralesional steroid treatment to reduce the keloid’s size and prevent further growth.

✅ Intralesional Kenalog Injection (ILK)

• Medication: 40 mg/cc of Kenalog

• Volume Injected: 0.1 cc

• Injection Site: Right posterior earlobe

• Goal: Flatten the scar and reduce inflammation

Patient Counseling Included:

• The risks of skin atrophy from steroid injections

• A clear explanation of follow-up plans and options if the scar does not respond, including surgical revision with post-op ILK or radiation therapy (XRT)

What Happens Next?

The patient was instructed to return in 1 month for reevaluation. If the keloid does not improve with intralesional steroid treatment, we will consider surgical excision followed by adjunct therapy to minimize recurrence.

Expert Pediatric Dermatology in Katy and Houston, Texas

At Village Dermatology, we take a compassionate and comprehensive approach to pediatric skin concerns, from common rashes to complex scarring. Keloid scars in children can be both physically and emotionally distressing, and we’re here to offer safe, evidence-based treatments that work.

📍 Now accepting new patients in Katy and Houston, TX
📞 Call us today to schedule an evaluation for pediatric scars or skin lesions

Annual Skin Examination in a 19-Year-Old Female with a Family History of Melanoma

by: Ashley Baldree

At Village Dermatology, serving Katy, Texas and Houston, Texas, we know the importance of early detection in preventing serious skin conditions. This case highlights a 19-year-old female patient who visited our clinic for her annual full-body skin examination due to a family history of malignant melanoma.

Patient Background

The patient’s grandmother was diagnosed with melanoma, placing her in a higher-risk category. While she reported no symptoms, she wanted to ensure her skin remained healthy through regular monitoring.

She also requested a thorough mole check, which is especially important for individuals with a first-degree relative diagnosed with melanoma.

Clinical Examination

A complete dermatologic exam was performed, including the scalp, face, neck, chest, abdomen, back, arms, legs, groin, buttocks, nails, and digits. The patient was healthy, alert, and in no distress. A dermatoscope was used to examine any pigmented lesions in greater detail.

Key findings included:

• Benign Nevi – Regular, symmetrical, evenly colored moles scattered across the body.

• Lentigines – Light tan macules in sun-exposed areas, consistent with sun damage.

• No suspicious lesions requiring biopsy were detected during this visit.

Risk Factors for Melanoma

The patient’s family history is the most significant risk factor. Individuals with a parent, sibling, or child who has had melanoma have a higher likelihood of developing it themselves. UV exposure and a high number of moles are additional contributing factors.

Counseling & Prevention Plan

During the visit, we provided comprehensive counseling on sun protection and self-skin examinations, including:

• Applying broad-spectrum sunscreen SPF 30+ daily, even on cloudy days.

• Wearing sun-protective clothing and wide-brimmed hats when outdoors.

• Performing monthly self-skin checks to monitor for moles that change in size, shape, or color, or that itch, burn, or bleed.

• Seeking prompt evaluation for any new or changing skin lesions.

We also discussed cosmetic options for lentigines, such as topical lightening creams, chemical peels, and laser treatments for patients seeking aesthetic improvement.

Follow-Up

The patient was advised to return in 12 months for her next annual skin examination, or sooner if she notices any concerning changes.

Why Annual Skin Exams Matter

In Katy and Houston, our sunny climate increases the risk of sun-induced skin damage and skin cancer. Annual dermatology visits are one of the most effective ways to catch skin cancers early—when they are most treatable.

If you have a family history of melanoma, or simply want peace of mind, Village Dermatology is here to provide expert skin checks and personalized care.

Chronic Itchy Rash on Scalp and Beard: Managing Seborrheic Dermatitis in a 38-Year-Old Male

At Village Dermatology, we often see patients dealing with persistent skin conditions that come and go over time. One common example is seborrheic dermatitis, a chronic inflammatory condition that typically affects areas of the body with high oil production—such as the scalp, face, and neck. In this case, we evaluated and treated a 38-year-old male from the Katy and Houston, Texas area who had been struggling with flares of a scaly, itchy rash for years.

Patient Case Overview

This new patient presented with a rash affecting multiple areas:

• Right side of the lip

• Left lip

• Neck

• Scalp

He described the rash as moderately severe, itchy, and flaky, and reported that the symptoms would flare periodically. Despite washing his hair daily and trying over-the-counter shampoos, the condition persisted.

Clinical Examination

During the comprehensive skin examination—including use of a dermatoscope—we noted pink to orange, scaly plaques on the:

• Left superior parietal scalp

• Philtrum (area between the nose and upper lip)

• Right chin and beard area

The patient was alert, oriented, and in no acute distress, with otherwise healthy appearance. Based on clinical findings, we diagnosed him with seborrheic dermatitis.

Understanding Seborrheic Dermatitis

Seborrheic dermatitis is a chronic skin condition characterized by inflammation in areas with abundant oil glands. While the exact cause is unknown, it is believed to involve a combination of genetic, environmental, and yeast (Malassezia) factors. Stress and weather changes can also trigger flare-ups.

Treatment Plan and Counseling

Because the patient had already tried non-prescription shampoos without relief, we developed a customized prescription-based treatment plan:

Medications Prescribed:

• Ketoconazole 2% Shampoo: To be used 3 times per week, left on for at least 3 minutes before rinsing. This antifungal helps reduce yeast on the scalp that contributes to seborrheic dermatitis.

• Fluocinonide 0.05% Topical Solution: Applied twice daily for up to 2 weeks during flares. This high-potency corticosteroid helps reduce inflammation and itching.

Additional Counseling:

We educated the patient on key skin care strategies:

• Use of gentle emollients

• Shampoos with tar, selenium sulfide, or zinc pyrithione

• Avoiding triggers like stress and harsh detergents

We also discussed potential side effects of long-term steroid use, such as skin thinning, hypopigmentation, and telangiectasia, especially when used on sensitive areas like the face.

Follow-Up Plan

The patient was advised to follow up annually, unless symptoms worsen or fail to respond to treatment. Ongoing management will include recognizing early signs of flares and adjusting treatment as needed.

Why This Matters for Katy and Houston Residents

Chronic skin conditions like seborrheic dermatitis are highly manageable with the right guidance. If you or a loved one in Katy or Houston, Texas experiences persistent scalp or facial rashes that come and go, Village Dermatology offers expert care tailored to your needs. With an emphasis on evidence-based treatment and patient education, we help our patients take control of their skin health—one flare at a time.

Persistent Rash in Skin Folds: Intertrigo in a 77-Year-Old Male

by: Ashley Baldree

At Village Dermatology in Katy and Houston, Texas, we often see skin conditions that become more problematic with age due to changes in skin elasticity, moisture balance, and immune response. One such condition is intertrigo — a rash that develops in warm, moist skin folds.

Case Overview

A 77-year-old male visited our clinic with a bumpy, burning, and itchy rash on his lower back and buttock crease that had persisted for several months. He had already tried over-the-counter treatments including hydrocortisone cream, ketoconazole cream, and triple paste, but the rash continued to worsen.

On examination, the rash was located in the skin fold between the buttocks (intergluteal area) and displayed redness, irritation, and signs of chronic inflammation. The KOH skin scraping test was performed to help determine if a fungal component was present.

Diagnosis

The patient was diagnosed with intertrigo, a skin condition commonly triggered by friction, trapped moisture, and heat. This type of environment can encourage yeast or bacterial overgrowth, making symptoms worse.

Treatment Plan

To address the persistent rash, we prescribed a multi-step treatment regimen:

• Silvadene cream to be applied nightly to soothe irritation and prevent infection.

• Ketoconazole 2% cream applied in the morning for 6 weeks to target fungal overgrowth.

• Zeasorb-AF powder to keep the area dry and reduce recurrence risk.

We also reviewed important skin care tips for preventing intertrigo flare-ups:

• Keep skin folds clean and dry.

• Use absorbent powders in high-friction areas.

• Wear breathable, moisture-wicking clothing.

The patient will follow up in 6 weeks to monitor progress.

Why This Matters

For seniors, intertrigo can become a recurrent problem if not managed properly. Because it occurs in skin folds, it may be overlooked or misdiagnosed, delaying effective treatment. At Village Dermatology, we help patients in Katy and Houston, TX manage skin conditions like intertrigo with personalized treatment plans that address both the symptoms and underlying causes.

Painful Lipoma on the Upper Back: A 44-Year-Old Male Case Study from Katy & Houston, TX

By: Dr. Caroline Vaughn

At Village Dermatology, we routinely evaluate skin growths that cause discomfort, cosmetic concern, or uncertainty. One common condition we encounter is a lipoma—a benign fatty tumor that can grow under the skin. In this case, we assessed a 44-year-old male from the Katy and Houston, Texas area with a painful skin lesion on his right upper back.

Patient Presentation

This established patient came in with a moderately painful bump that had been present for several years but had recently begun to cause discomfort. The lesion was located on the right superior upper back, measuring approximately 4 cm x 5 cm.

He was particularly concerned about how treatment might impact his ability to maintain his workout routine and was looking for the least invasive treatment option possible.

Clinical Examination

A thorough physical exam, including dermatoscopic evaluation, was performed. The patient was:

• Well-developed and well-nourished

• Alert and oriented

• In no acute distress

Based on the findings, the lesion was consistent with a lipoma—a soft, mobile, subcutaneous mass.

What Is a Lipoma?

A lipoma is a benign (non-cancerous) fatty tumor that typically develops between the skin and the underlying muscle. Lipomas are:

• Usually soft and doughy to the touch

• Moveable under the skin

• Slow-growing

• Often painless—but may become uncomfortable or painful depending on size or location

They are most common in adults between 40 and 60 years of age.

Treatment Options Discussed

We had an in-depth conversation with the patient about multiple treatment strategies, weighing the risks, benefits, and downtime associated with each:

1. Surgical Excision

• Most definitive method

• Preferred by the patient if performed by Dr. Vaughn

• Involves removal of the entire lipoma, usually under local anesthesia

• Downtime required, but highly effective and permanent

2. Non-Surgical Options (Alternative/Experimental)

• Kybella: An injectable treatment typically used for dissolving fat under the chin. May offer benefit in reducing small lipomas, though not widely studied for this use.

• CoolSculpting: A non-invasive fat reduction technique using cryolipolysis. Its effectiveness for treating lipomas is not well-established.

While the patient was initially interested in options that minimize scarring and downtime, he ultimately leaned toward excision with Dr. Vaughn as his preferred path forward.

Patient Counseling

We provided detailed counseling, including:

• Lipomas are benign and do not require removal unless they are painful, growing, or cosmetically concerning.

• Surgical removal is curative, but carries a risk of scarring.

• Non-surgical options may not offer predictable results and are not standard of care.

The patient was advised to follow up via Klara to schedule the excision if and when ready.

Why This Matters for Katy and Houston Residents

If you're noticing a painful or growing lump under your skin, it could be a lipoma. At Village Dermatology, we offer personalized treatment plans tailored to your lifestyle and cosmetic preferences. Whether you're an athlete concerned about downtime or someone looking for peace of mind, our team is here to guide you every step of the way.

Residents of Katy and Houston, TX can trust our board-certified dermatologists for both medical and cosmetic dermatologic care.

Persistent Rash on Arms and Legs – Case Report from Village Dermatology in Katy & Houston, Texas

by: Caroline Vaughn

At Village Dermatology, we often see patients with rashes that don’t respond to initial treatment. This case features a 53-year-old woman who presented with a months-long itchy, red rash affecting her arms and legs. Careful evaluation and a targeted treatment plan are key to helping such patients achieve relief.

Patient Background

The patient, new to our clinic, reported a moderately severe itchy and red rash that had been present for approximately three months. She had previously seen her primary care physician, who prescribed one round of cephalexin and two courses of prednisone, but saw no improvement.

Clinical Examination

A focused skin exam of the right forearm, left forearm, right lower leg, and left lower leg revealed follicular erythematous papules on the lower legs. The patient was otherwise healthy, alert, and in no acute distress.

Assessment & Differential Diagnosis

The appearance and history of the rash suggested several possible causes:

• Keratosis Pilaris – a common skin condition causing rough, small bumps.

• Irritant Contact Dermatitis – rash due to repeated exposure to an irritating substance.

• Dermatitis, Unspecified – broader category when the cause is unclear.

Treatment Plan

To target both inflammation and dryness, we prescribed:

• Derma-Smoothe/FS Body Oil – apply to affected areas twice daily for 2 weeks.

• Recommended AmLactin lotion or CeraVe moisturizing cream for ongoing hydration.

• Advised avoiding scrubbing or exfoliating the rash to prevent further irritation.

• Suggested over-the-counter antihistamines for itching and gentle, non-irritating cleansers.

The patient was counseled on the proper use of topical steroids, including risks of skin thinning, hypopigmentation, and telangiectasias, as well as the importance of avoiding high-potency steroids on the face, groin, or skin folds.

Additional Findings – Benign Nevi

During the visit, the patient also mentioned a mole on her right breast. Examination revealed a 0.5 cm x 0.6 cm regular, symmetrical, evenly pigmented nevus on the left medial breast (10–11:00 position). This lesion appeared benign.

We advised monthly self-skin checks, continued use of SPF 30+ broad-spectrum sunscreen, and monitoring for changes in size, shape, color, or symptoms such as itching or bleeding.

Follow-Up

The patient will return in three weeks for reassessment of her rash. If symptoms persist, further diagnostic testing or a modified treatment plan will be considered.

Key Takeaway for Patients in Katy & Houston, Texas

If a rash persists despite antibiotics or steroids, it may require a different approach, including moisturizers, gentle skin care, and targeted anti-inflammatory treatment. At Village Dermatology, we specialize in evaluating stubborn rashes and developing effective, personalized treatment plans.

Scalp Rash and Burning Itch: Managing Seborrheic Dermatitis in a 27-Year-Old Woman

By: Dr. Ashley Baldree

At Village Dermatology, we frequently see patients who struggle with persistent scalp irritation that disrupts daily life. A common culprit? Seborrheic dermatitis, a chronic, inflammatory skin condition that causes itchy, flaky, and sometimes painful rashes—especially on the scalp. In this case, a 27-year-old woman from the Katy and Houston, Texas area came to us with a burning, itchy scalp rash that had persisted for months.

Patient Presentation

The patient reported:

• Burning and itching on the scalp

• Symptoms that were moderate in severity

• Rash present for several months without resolution

She had not received prior treatment and was seeking relief and long-term management.

Physical Examination

A thorough exam was performed with a dermatoscope to evaluate the scalp and surrounding areas including the:

• Face

• Ears

• Lips

• Arms

The patient appeared alert, healthy, and in no acute distress.

Findings revealed signs consistent with seborrheic dermatitis, a chronic condition that commonly affects oily areas of the body, particularly the scalp.

Diagnosis: Seborrheic Dermatitis

Seborrheic dermatitis is a chronic inflammatory condition caused by a combination of yeast overgrowth (Malassezia), genetics, oily skin, and triggers like stress or weather changes. On the scalp, it often presents as:

• Flaky, white or yellowish scales

• Redness or pink patches

• Itching or burning

• Periods of flares and remissions

Personalized Treatment Plan

Because the condition was persistent and causing distress, we prescribed a targeted treatment regimen including both topical antifungal shampoo and scalp corticosteroid oil:

Medications Prescribed:

• Ketoconazole 2% Shampoo
  Usage: Lather into scalp for 5–10 minutes before rinsing. Use 1–3 times per week for maintenance.
  Purpose: Helps reduce yeast and inflammation.

• Derma-Smoothe/FS Scalp Oil (Fluocinolone 0.01%)
  Usage: Apply daily for 2 weeks, then use as needed for flares.
  Purpose: Reduces inflammation and itching during flare-ups.

Counseling and Expectations

We spent time educating the patient on:

• The chronic nature of seborrheic dermatitis

• Importance of regular shampooing with antifungal ingredients

• Use of topical steroids only for flares, to avoid side effects like skin thinning or discoloration

• Avoiding high-potency steroids on the face, folds, and sensitive areas

The patient verbalized full understanding and was provided a written treatment guide.

Follow-Up Plan

We scheduled a follow-up visit in 4 weeks to evaluate progress and determine whether additional therapies or maintenance strategies are needed.

Why It Matters for Katy and Houston Patients

If you're living in Katy or Houston, TX and dealing with chronic scalp irritation, you're not alone. Seborrheic dermatitis is one of the most common scalp issues we treat at Village Dermatology—and with the right plan, it’s highly manageable. Whether you're frustrated by flakes, itching, or persistent scalp redness, our team can help you find lasting relief.

Managing Nummular Eczema and Allergic Contact Dermatitis: A Case Study from Village Dermatology

By: Dr. Caroline Vaughn

At Village Dermatology in Katy and Houston, Texas, our dermatology team treats a wide range of skin conditions, from chronic inflammatory rashes to pigment changes and allergic reactions. This case features a 59-year-old female returning for follow-up care after treatment for nummular eczema, with additional concerns of post-inflammatory hyperpigmentation, scar care, and a new rash consistent with allergic contact dermatitis.

Patient Overview

The patient was first seen on June 3, 2025, for nummular eczema involving multiple areas, including:

• Right knee

• Left anterior distal thigh

• Left and right popliteal areas

• Right and left radial dorsal hands

She was treated with triamcinolone acetonide 0.1% cream, applied twice daily to affected areas as needed for flare-ups. Today, she returned for follow-up and reported significant improvement in itchiness, with no active rash present.

1. Nummular Eczema – Improved with Topical Steroids

Exam Findings:
No active eczema lesions; only residual post-inflammatory hyperpigmentation (PIH) visible.

Plan:

• Discontinue triamcinolone cream for now

• Restart during future flare-ups only

• Skin care recommendations included:

  • Bathing with lukewarm water and gentle cleansers

  • Applying emollients 2–3 times daily

  • Avoiding scented detergents and fabric softeners

  • Keeping fingernails short to reduce scratching damage

Patient Education:
Eczema is chronic and may worsen with triggers such as dry weather, stress, certain soaps, and scratching. Ongoing moisturization is key to prevention.

2. Post-Inflammatory Hyperpigmentation (PIH)

Exam Findings:
Mild hyperpigmented patches on the right proximal pretibial region.

Plan:

• Minimize sun exposure

• Wear SPF 30+ broad-spectrum sunscreen daily

• Educated the patient that PIH often fades over months to years

3. Scar Care – Epigastric Area

Exam Findings:
Well-healed scar secondary to a recent shave biopsy.

Plan:

• Reassurance that scar color and texture may improve over time

• Monitor for changes such as raised texture or itchiness (possible keloid formation)

• Consider intralesional Kenalog (ILK) in the future if the scar becomes symptomatic

4. Allergic Contact Dermatitis (ACD) – New Rash on Buttocks

History:
Patient reported a mild rash on the gluteal cleft starting a few weeks ago, partially improved with one application of triamcinolone.

Exam Findings:
Well-demarcated, geometric eczematous patches in the buttocks area.

Plan:

• Hydrocortisone 2.5% ointment applied twice daily for 2 weeks (max 2 weeks/month)

• Switch to fragrance-free, hypoallergenic personal care products

• Avoid potential triggers such as scented wipes, soaps, detergents, or lotions

• Educated the patient on possible side effects of prolonged topical steroid use, including skin thinning and lightening

Key Takeaways for Skin Health

This case highlights how chronic skin conditions can be managed successfully with consistent care, trigger avoidance, and proper medication use. It also emphasizes the importance of differentiating between eczema flare-ups and new skin reactions like allergic contact dermatitis.

Do You Have Persistent Rashes or Skin Discoloration?

At Village Dermatology, we specialize in diagnosing and managing skin conditions like eczema, contact dermatitis, and pigment changes. We tailor every treatment plan to your needs, ensuring long-term control and skin health.

📍 Now accepting patients in Katy and Houston, Texas
📞 Call us today to schedule your skin evaluation

Androgenetic Alopecia and Telogen Effluvium in a 34-Year-Old Male: Comprehensive Hair Loss Care in Katy & Houston, TX

by: Caroline Vaughn

At Village Dermatology, many men in their 30s come to us with concerns about thinning hair, not realizing that more than one type of hair loss may be at play. In this case, a 34-year-old male presented with both androgenetic alopecia (male-pattern hair loss) and telogen effluvium (temporary excessive shedding).

Patient History

The patient reported:

• Gradual crown and temple thinning for 6 months

• Moderate severity hair loss

• History of 25-pound weight loss over 7 months

• Hair loss worsened after a car accident 4 years ago

• Family history of hair thinning but no complete baldness

• Currently using topical minoxidil

Clinical Examination

Using dermatoscopy, we found:

• Patterned thinning at the crown and temples consistent with AGA

• Positive hair pull test with telogen hairs, confirming TE

• Diffuse, non-scarring hair loss at the mid-parietal scalp

Diagnosis

1. Androgenetic Alopecia (AGA)

   • Chronic, genetically driven miniaturization of hair follicles

   • Gradual thinning in predictable patterns

2. Telogen Effluvium (TE)

   • Temporary increase in hair shedding

   • Triggered by stress, illness, or physical changes (e.g., weight loss)

   • Often self-limiting but can overlap with AGA

Treatment Plan

After reviewing options—including topical/oral minoxidil, finasteride, platelet-rich plasma (PRP), and AlmaTED—the patient chose oral minoxidil.

Prescribed:

• Oral Minoxidil 2.5 mg once daily (in addition to topical minoxidil)

• Education on side effects (low blood pressure, swelling, unwanted hair growth)

• PRP discussed as a potential future add-on for enhanced regrowth and shedding reduction

Counseling & Education

For AGA:

• Long-term maintenance is key; results take ~6 months to appear

• Discussed risks of finasteride (sexual side effects, mood changes)

For TE:

• Often resolves once triggers are addressed

• Nutritional supplements such as Nutrafol or Viviscal may support regrowth

• Minoxidil can help shorten the regrowth phase

• Advised gentle hair care and avoiding harsh products or styling

Follow-Up Plan

• Recheck in 4–6 months to assess response

• Consider PRP or AlmaTED if progress plateaus

• Maintain both oral and topical therapy for sustained improvement

Why This Matters for Katy & Houston Residents

Men experiencing hair loss should know that it’s common to have more than one type at the same time. Correct diagnosis—like in this case—ensures personalized, effective treatment. At Village Dermatology, we combine medical therapies, in-office procedures, and patient education to optimize long-term hair health.

MRSA Skin Infection and Congenital Nevus in a 14-Year-Old Male

by: Ashley Baldree

At Village Dermatology in Katy and Houston, Texas, we treat a wide range of skin conditions in patients of all ages. In this case, we evaluated a 14-year-old male who presented with an itchy, red rash on his right leg that had been present for several months. The rash was moderate in severity and had not responded to prior home care.

Clinical Presentation

The patient and his mother reported persistent irritation and redness localized to the right lower leg. On examination, the rash displayed features consistent with impetigo, a superficial bacterial skin infection often caused by Staphylococcus aureus (including MRSA strains) or Streptococcus pyogenes. The lesions were crusted, and the patient admitted to scratching, which likely worsened the spread.

During the exam, we also identified a congenital nevus on the left forearm — a benign pigmented mole present since birth. While unrelated to the current rash, this finding was documented for ongoing monitoring.

Diagnosis

1. MRSA Skin Infection (Impetigo) — Common in children and highly contagious, often arising after minor skin trauma.

2. Congenital Nevus — A stable, benign mole with no current signs of malignancy.

Treatment Plan

For the MRSA skin infection, the following regimen was initiated:

• Oral doxycycline twice daily for 10 days.

• Topical mupirocin ointment applied three times daily for 5 days to the rash and inside the nostrils to reduce bacterial colonization.

• Bleach baths as an adjunct to help lower bacterial presence on the skin’s surface.

The patient’s mother was counseled on the contagious nature of MRSA, the importance of completing all medications, and hygiene measures to prevent spread within the household.

For the congenital nevus, no immediate treatment was required. We recommended monthly self-skin checks and the use of broad-spectrum sunscreen SPF 30+ to protect against UV-related changes.

Follow-Up

The patient will return in one month for reassessment of the rash and to ensure complete resolution of the infection. Long-term monitoring of the congenital nevus will continue during routine visits.

Key Takeaways

• Early diagnosis of MRSA skin infections is important to prevent spread and complications.

• Combination therapy with oral and topical antibiotics, along with decolonization strategies, can be highly effective.

• Even unrelated skin findings, like congenital nevi, should be documented and monitored for any changes.

Inflamed Epidermal Inclusion Cyst on the Upper Back – A 67-Year-Old Female Case in Katy & Houston, Texas

by: Ashley Baldree

Case Overview
A 67-year-old female presented to Village Dermatology in Katy, Texas, with an inflamed, enlarging skin lesion on the left upper back. The lesion, present for approximately two weeks, was moderately painful, red, and swollen.

The patient reported a unique history — over 20 years ago, she sustained a thorn injury at the same location. She suspected that part of the thorn may still be embedded under the skin. Despite previous evaluations by other dermatologists, no definitive treatment had been provided.

Clinical Examination

• Location: Left lateral upper back

• Size: Approximately 2.5 cm

• Appearance: Inflamed, tender, and erythematous lesion

• Diagnostic tools: Dermatoscopic examination to assess lesion borders and skin changes

The findings were consistent with an inflamed epidermal inclusion cyst, likely exacerbated by localized irritation or possible infection.

Diagnosis

• Epidermal Inclusion Cyst (L72.8)

• Benign, non-cancerous growth consisting of keratin-filled sac beneath the skin

• Current presentation complicated by inflammation and pain

Treatment Plan
The patient’s treatment plan included:

1. Antibiotic therapy – Doxycycline 100 mg by mouth twice daily for 14 days to address inflammation and potential secondary bacterial infection.

2. Definitive treatment – Cyst excision scheduled for the following week to remove the lesion entirely and prevent recurrence.

3. Skin care guidance – No special topical skin care required, but patient was advised to monitor for changes.

Patient Counseling

• Epidermal inclusion cysts are benign and not cancerous.

• They can become inflamed or infected, particularly if irritated.

• Complete excision is the most effective long-term solution.

• Warning signs of worsening inflammation include increased redness, swelling, drainage, or pain.

Dermatology Insight – Katy & Houston Focus
At Village Dermatology in Katy and Houston, Texas, we commonly treat epidermal inclusion cysts. While many are harmless and can be left alone, inflamed cysts often require antibiotics and eventual surgical removal. This case illustrates how early dermatology intervention can prevent worsening infection and recurrence.

Follow-Up Skin Lesion Care and Cryotherapy Treatment in Katy and Houston, Texas

by: Caroline Vaughn

At Village Dermatology, we often see patients for ongoing monitoring and treatment of benign skin lesions. This case highlights a 47-year-old male patient from the Houston/Katy area who returned for follow-up of a skin lesion on his left upper back and right ear.

Case Overview

The patient’s primary concern was a persistent lesion on the right ear and an additional skin growth on the foot. Both lesions had been present for months and had not resolved since his last visit. The ear lesion was identified as seborrheic keratosis, a common and benign skin growth that tends to increase in number with age. While seborrheic keratoses do not require treatment, patients often choose removal for cosmetic reasons.

After discussing treatment options, the patient elected to undergo liquid nitrogen cryotherapy for the ear lesion. Cryotherapy works by freezing the lesion, causing it to blister and eventually fall off. The patient was counseled on the expected healing process, post-treatment care, and the potential for temporary pigment changes.

Second Concern: Lesion on the Foot

During the visit, a separate lesion was noted on the right plantar forefoot overlying the fourth metatarsal. This growth was a pink papule, and the differential diagnosis included:

• Neoplasm of uncertain behavior

• Wart

• Amelanotic melanoma (AMM)

• Poroma

To determine the exact nature of this lesion, a shave biopsy was performed. The procedure involved local anesthesia, a sterile dermablade, and immediate hemostasis. The tissue sample was sent to pathology for analysis, and the patient was advised to expect results within two weeks.

Patient Education and Follow-Up

At Village Dermatology, patient education is a key part of care. This patient was counseled on:

• Sun protection to reduce future skin damage

• Avoiding picking or scratching treated areas

• Applying Vaseline to any crusted or healing skin

• Monitoring for changes in moles, growths, or healing sites

Follow-up will be arranged as needed based on pathology results or further cosmetic concerns.

Why Choose Village Dermatology for Skin Lesion Treatment in Katy & Houston

Whether you’re concerned about a benign growth, suspicious mole, or want cosmetic lesion removal, our dermatology team in Katy and Houston provides thorough evaluations, advanced treatment options, and compassionate care. From cryotherapy to biopsies, we ensure every patient receives personalized attention and education for optimal skin health.

Follow-Up Care for Nummular Eczema and Hypertrophic Scar: A 37-Year-Old Female Case in Katy & Houston, TX

by: Caroline Vaughn

At Village Dermatology, patient care doesn’t stop after the initial diagnosis. Follow-up visits are crucial for monitoring skin conditions, adjusting treatments, and ensuring optimal long-term results. This case involves a 37-year-old female from the Katy and Houston, Texas area who returned for follow-up after a confirmed diagnosis of nummular eczema and evaluation of a hypertrophic scar.

Patient History

On June 3, 2025, the patient presented with itchy, inflamed skin lesions on her right upper arm and right thigh. A punch biopsy confirmed the diagnosis of nummular eczematous dermatitis. At that time, she was prescribed triamcinolone ointment and given detailed skin care instructions.

The patient also had a biopsied spot on her right upper arm that developed into a thickened, itchy scar—later identified as a hypertrophic scar.

Follow-Up Visit Findings

At her one-month follow-up:

• Nummular eczema:

  • Significant improvement

  • No new lesions reported

  • Some hypopigmentation present in treated areas

• Hypertrophic scar:

  • Still thickened and itchy

  • Intralesional corticosteroid injections (ILK) discussed but deferred due to pregnancy

Understanding Nummular Eczema

Nummular eczema (also called discoid eczema) is a chronic condition that presents as:

• Round, coin-shaped patches of inflamed skin

• Itching and discomfort

• Often triggered by dry skin, fragrance-containing products, and cold weather

In this case, consistent use of triamcinolone ointment and adherence to moisturizing routines led to marked improvement.

Skin Care Recommendations

The patient was counseled to:

• Bathe in lukewarm water for 10 minutes or less

• Use gentle cleansers such as Dove Sensitive Skin

• Moisturize 2–3 times daily with cream-based moisturizers

• Avoid scented detergents, fabric softeners, and harsh soaps

• Keep fingernails short to reduce scratching damage

Understanding Hypertrophic Scars

A hypertrophic scar is a thickened, raised scar that develops after skin injury or surgery.
Treatment options include:

• Intralesional steroid injections (ILK) to reduce thickness and itching

• Topical high-potency steroids

• Pulse dye laser therapy for redness and vascularity

Since the patient is currently pregnant, ILK injections will be reconsidered after delivery.

Plan Moving Forward

• Continue triamcinolone ointment as needed for eczema flares

• Maintain a strict moisturizing routine

• Monitor scar and reassess for possible ILK treatment postpartum

• Follow up as needed for any recurrence or worsening of symptoms

Why This Case Matters for Katy & Houston Residents

Chronic skin conditions like eczema require ongoing care and tailored treatment plans. At Village Dermatology, we focus on:

• Accurate diagnosis

• Patient education

• Safe treatment options, even during pregnancy

• Cosmetic and functional scar management

Whether you’re managing eczema, scars, or other skin concerns, our dermatology team in Katy and Houston, TX provides compassionate, expert care.

Comedonal Acne in a 20-Year-Old Female: A Case from Village Dermatology, Katy & Houston, Texas

by: Ashley Baldree

Case Overview
A 20-year-old female presented to Village Dermatology for evaluation and management of persistent acne located on the face. She reported blackheads, whiteheads, and occasional pimples that had been present for several months. Her only prior and current treatment included benzoyl peroxide lotion.

Clinical Examination
A comprehensive skin examination, including scalp, face, ears, neck, and upper extremities, revealed:

• Primary findings: Open and closed comedones (blackheads and whiteheads)

• Additional findings: Mild inflammatory papules and pustules concentrated on the forehead, cheeks, and chin

• No evidence of cystic or nodular lesions

• Skin otherwise well-nourished, with no signs of infection or scarring

Diagnosis

• Comedonal Acne (L70.0) with mild inflammatory component

• Distribution: Face (forehead, nose, cheeks, and chin)

Treatment Plan
To enhance the patient’s current regimen and improve acne control, the following steps were recommended:

1. Continue benzoyl peroxide lotion for antimicrobial and anti-inflammatory benefits.

2. Add a salicylic acid cleanser to help exfoliate and unclog pores.

3. Initiate topical tretinoin microspheres 0.04% gel – apply a pea-sized amount nightly to the entire face to promote cell turnover and prevent new comedones.

4. Skin care counseling:

   • Use non-comedogenic cleansers and moisturizers.

   • Always apply broad-spectrum sunscreen SPF 30+ during the day.

   • Expect initial irritation and dryness, which can be minimized with moisturizer.

5. Follow-up in 4–5 months to monitor progress and adjust treatment as necessary.

Patient Counseling & Expectations

• Improvement typically occurs gradually, with 60–80% clearance expected within 2–3 months of consistent use.

• Avoid picking or squeezing lesions to prevent scarring.

• Monitor for excessive redness, peeling, or sensitivity and adjust use as needed.

Dermatology Insight – Katy & Houston Focus
Comedonal acne is one of the most common skin conditions we treat at Village Dermatology in Katy and Houston, Texas. Early intervention is key to preventing scarring and hyperpigmentation. Combining benzoyl peroxide, salicylic acid, and tretinoin is a proven regimen that addresses both pore blockage and skin turnover, leading to smoother, clearer skin.

Managing Androgenetic Alopecia in a 32-Year-Old Female: Dose Adjustment and Long-Term Hair Restoration Planning

by: Ashley Baldree

At Village Dermatology, serving Katy and Houston, Texas, we often see patients seeking long-term solutions for progressive hair thinning. This case features a 32-year-old female patient returning for follow-up care after her initial diagnosis of androgenetic alopecia (AGA) affecting the mid-frontal scalp and left superior parietal scalp.

Patient Background

The patient was first evaluated on March 12, 2025, and started on oral minoxidil 2.5 mg, with a gradual dose escalation plan beginning at ¼ tablet daily, increasing to ½ tablet daily. At her follow-up visit, she reported no significant side effects and noted that her hair loss appeared stable.

Clinical Findings

A thorough scalp examination with dermatoscopy revealed diffuse non-scarring hair loss and patterned thinning consistent with AGA. No scalp inflammation or scarring was observed.

Treatment Plan and Counseling

To further optimize results, the patient’s oral minoxidil dose was increased from ½ tablet to 1 full tablet daily. She was counseled on the potential side effects, including:

• Chest pain

• Ankle swelling

• Fluid retention

• Low blood pressure

• Dizziness or lightheadedness

• Unwanted hair growth

We also discussed additional hair restoration options, including:

• Oral spironolactone – for its anti-androgen effects in women

• ALMA TED – a non-invasive, in-office treatment designed to stimulate hair growth and improve scalp health

The patient elected to proceed with the higher minoxidil dose at this time and received an ALMA TED information handout for future consideration.

Education & Expectations

Patients with AGA are counseled that the condition is genetically pre-determined and slowly progressive. While treatments like minoxidil and spironolactone can help slow shedding and promote regrowth, results typically take 6 months or longer and require ongoing maintenance.

We also provided hair care guidance, recommending gentle shampooing, avoiding excessive heat styling, and ensuring proper scalp hydration.

Follow-Up

The patient will return in 6 months to evaluate treatment response and discuss whether to incorporate ALMA TED or other supportive therapies into her regimen.

Treating Genital Warts and Benign Facial Lesions: A 45-Year-Old Male Case in Katy & Houston, TX

by: Dr. Caroline Vaughn

At Village Dermatology, we provide both medical and cosmetic dermatologic care for a wide range of conditions. This case highlights a 45-year-old male from the Katy and Houston, Texas area who presented with genital warts and benign facial growths known as dermatosis papulosa nigra.

Patient Presentation

The patient came in for:

1. Genital warts – Located on the suprapubic area, penis, and proximal thigh, present for several years and recently spreading.

2. Brown facial lesions – Located on both cheeks, present for years without treatment.

He reported that:

• The warts had recurred after 7 years

• Over-the-counter cryotherapy did not help

• No personal or family history of skin cancer

• No family history of melanoma

Clinical Examination

Using a dermatoscope, we identified:

Facial Lesions: Dermatosis Papulosa Nigra

• Brown, small, verrucous papules

• Located on both cheeks

• Benign in nature

• Cosmetic removal possible via light electrodesiccation (patient declined treatment for now)

Genital Warts: Verruca Vulgaris (Condyloma)

• Multiple lesions on:

  • Suprapubic skin

  • Left dorsal shaft of penis

  • Base of penis

  • Right dorsal shaft of penis

  • Right anterior proximal thigh

• Associated mild inflammation

Understanding the Conditions

Dermatosis Papulosa Nigra
A benign skin growth common in people with darker skin tones. These lesions:

• Are harmless

• Do not require treatment unless for cosmetic reasons

• Can be removed with minor in-office procedures

Genital Warts (Condyloma Acuminata)
Caused by the human papillomavirus (HPV):

• Sexually transmitted

• Can recur even after treatment

• Linked to certain cancers, particularly cervical cancer in women

Treatment Plan

For Genital Warts

• Liquid nitrogen cryotherapy performed on 15 lesions during the visit

• Patient counseled on:

  • The possibility of recurrence

  • Preventing transmission through abstinence until cleared

  • Ensuring all sexual partners, especially females, receive regular Pap smears

For Dermatosis Papulosa Nigra

• Observation for now

• Option for cosmetic removal in the future if desired

Follow-Up Plan

• One-month follow-up for re-evaluation and additional cryotherapy if needed

• Patient advised to return sooner if:

  • Lesions worsen

  • New warts appear

  • Any changes in facial lesions are noticed

Why This Matters for Katy & Houston Residents

At Village Dermatology, we combine medical expertise and patient education to manage both health-related and cosmetic skin concerns. Whether it’s HPV-related genital warts or benign facial lesions, our approach focuses on:

• Accurate diagnosis

• Tailored treatment plans

• Preventive education to reduce recurrence and complications

If you live in Katy or Houston, Texas and have skin lesions that are spreading, changing, or causing concern, our team is here to help.

Managing Chronic Scalp Psoriasis in Young Adults: A 24-Year-Old Male Case Study in Katy & Houston, TX

By: Dr. Ashley Baldree

Psoriasis is a chronic autoimmune condition that often affects the scalp, causing itching, redness, and thick scaling that can significantly impact quality of life. At Village Dermatology, we frequently treat patients in Katy and Houston, Texas, who have been living with psoriasis for years and are seeking lasting solutions. This case features a 24-year-old male with moderate scalp psoriasis who had previously tried multiple systemic and topical treatments without long-term success.

Patient Presentation

The patient reported:

• An 8-year history of scalp psoriasis

• Ongoing itching and redness, moderate in severity

• No family history of psoriasis

Despite long-standing efforts, his psoriasis had been difficult to control:

• Otezla was discontinued due to elevated liver enzymes

• Skyrizi provided good clearance but had to be stopped for the same reason

• He had also tried various topical steroids and medicated shampoos with limited results

Physical Examination

A detailed scalp and facial exam using a dermatoscope revealed:

• Red, scaly plaques located on the right superior forehead, consistent with psoriasis

• No signs of acute distress

• Patient was alert, healthy, and well-nourished

Diagnosis: Chronic Scalp Psoriasis

Scalp psoriasis is a common manifestation of chronic plaque psoriasis. It presents as:

• Well-demarcated red plaques

• Covered in silvery-white scale

• Located along the hairline, scalp, or behind the ears

• Associated with itching, burning, and social discomfort

Updated Treatment Plan

After a full review of his medical history, failed treatments, and lab results, we developed a new, tailored management strategy:

Topical Prescriptions:

• Ketoconazole 2% Shampoo –
  Lather on scalp for 5–10 minutes, use 3x per week.
  Helps reduce inflammation and yeast that may aggravate psoriasis.

• Fluocinonide 0.05% Topical Solution –
  Apply to scalp twice daily for 2 weeks, then PRN for flares.
  A potent steroid to calm active inflammation.

• Hydrocortisone 2.5% Ointment –
  Apply to facial areas twice daily for 2 weeks, then as needed.
  A lower-potency steroid for sensitive areas like the face.

Initiating Tremfya® (Guselkumab)

Given his systemic treatment failures, we recommended starting Tremfya, a biologic injection indicated for moderate-to-severe plaque psoriasis.

Tremfya Plan:

• Dosing: 100 mg subcutaneous at weeks 0 and 4, then every 8 weeks

• Monitoring:

  • Baseline TB test (PPD)

  • Annual TB re-screening

  • Liver enzyme monitoring

We discussed the risks and benefits, including rare risks such as infection, immunosuppression, and posterior leukoencephalopathy syndrome. The patient verbalized understanding and opted to begin Tremfya immediately.

Counseling Highlights

We educated the patient on:

• Chronic nature of psoriasis: flare-ups and remissions are expected

• Trigger management: stress, alcohol, strep infections, and certain medications may worsen symptoms

• Importance of ongoing monitoring during biologic therapy

The patient received a handout with his treatment regimen and will follow up in 2 months.

Why This Case Matters for Katy & Houston Residents

Scalp psoriasis can be physically uncomfortable and emotionally taxing, especially when resistant to treatment. At Village Dermatology, we offer advanced therapeutic options and personalized care plans for young adults and others suffering from chronic psoriasis. If you're located in Katy or Houston, TX, our expert team is ready to help you regain comfort and confidence in your skin.

Evaluating Skin Lesions in Young Adults: A Case of Benign Nevi in a 25-Year-Old Female

By: Dr. Caroline Vaughn

Skin health and sun protection are vital topics for all age groups—but especially for young adults who are beginning to understand the long-term importance of sun safety and skin surveillance. At Village Dermatology, we frequently provide full-body skin exams for patients in Katy and Houston, Texas, helping them take proactive steps against skin cancer and other dermatologic concerns. In this case, we evaluated a 25-year-old female who presented for an assessment of enlarging and itchy skin lesions she had noticed over several years.

Patient Presentation

This patient reported moderately itchy, enlarging lesions located throughout her body. The lesions had been present for years but had never been evaluated or treated. She also expressed interest in sun protection education and guidance for preventing future skin cancer or atypical mole development.

She had no personal or family history of melanoma or non-melanoma skin cancers.

Comprehensive Skin Exam

A thorough, head-to-toe dermatologic evaluation was performed using dermatoscopy, which included:

• Scalp and hair

• Face, ears, neck

• Trunk and extremities

• Hands, feet, nails

The only notable findings were:

• Regular, symmetrical, evenly pigmented macules and papules consistent with benign nevi (commonly known as moles), found on the:

  • Upper back

  • Left upper back

  • Right forearm

  • Right ventral proximal forearm

No suspicious or atypical features were identified.

Diagnosis: Benign Nevi

Benign nevi are common in young adults and represent clusters of pigment-producing cells (melanocytes) in the skin. They are typically uniform in shape, size, and color, and do not require treatment unless changes are observed.

In this case, the patient had no concerning lesions that warranted biopsy or removal.

Counseling and Education

Patient education is a key part of dermatologic care. We provided the following guidance:

Sun Safety & Skin Monitoring:

• Apply a broad-spectrum sunscreen (SPF 30 or higher) daily, especially on exposed areas.

• Perform monthly self-skin checks to monitor moles for changes in:

  • Size

  • Shape

  • Color

  • New symptoms (itching, bleeding, burning)

When to Seek Medical Attention:

• If any moles become asymmetric, change appearance, or develop symptoms, the patient was instructed to contact our clinic promptly for reevaluation.

No Immediate Treatment Necessary

Since the nevi were consistent with benign characteristics and the patient declined full disrobing, we opted for observation and education. The patient was advised to continue regular self-checks and schedule an annual skin exam unless earlier evaluation is needed.

Why This Case Matters for Katy and Houston Patients

Many young adults assume that mole checks and skin cancer screening are only necessary later in life—but early intervention and education are key. At Village Dermatology, we specialize in personalized skin assessments, ensuring peace of mind for our patients while equipping them with the tools to monitor and protect their skin long-term.

Whether you're in Katy or Houston, now is the time to schedule a full-body skin exam and establish a baseline for your skin health.

Treating Nodular Basal Cell Carcinoma with ED&C: A 68-Year-Old Female Case Study

By: Dr. Ashley Baldree

Basal cell carcinoma (BCC) is the most common type of skin cancer, particularly in individuals with fair skin and a history of sun exposure. At Village Dermatology in Katy and Houston, Texas, we frequently evaluate and treat BCC with methods tailored to the size, depth, and location of the tumor. This case highlights the successful management of nodular basal cell carcinoma in a 68-year-old woman using electrodesiccation and curettage (ED&C).

Patient Overview

A 68-year-old woman returned for a follow-up evaluation after a shave biopsy was performed on July 3, 2025, for a pigmented lesion on the right mid-upper back. Biopsy results revealed nodular basal cell carcinoma, a slow-growing but locally invasive form of skin cancer.

What Is Nodular Basal Cell Carcinoma?

Nodular BCC is a subtype of basal cell carcinoma that typically presents as a pearly, dome-shaped papule with visible blood vessels (telangiectasias). Though rarely metastatic, BCC can cause significant tissue damage if left untreated.

Clinical Findings

Location: Right mid-upper back
Appearance: Pearly, telangiectatic papule
Size: 0.9 cm
Tools Used: Dermatoscope for lesion visualization

Treatment: Curettage and Destruction (ED&C)

ED&C is a non-surgical treatment for superficial and nodular BCCs, especially in low-risk locations. It involves scraping away the tumor with a curette, followed by cauterization to destroy remaining cancer cells.

Procedure Details:

• Anesthesia: Local lidocaine with epinephrine

• Cycles: 2 rounds of curettage and electrodesiccation

• Final Lesion Size Post-Curettage: 0.9 cm

• Post-Treatment Care: Wound was cleaned and dressed with a pressure bandage

• Post-Op Instructions: The patient was given detailed guidance on wound care, activity restrictions, and signs of complications

Informed Consent:

All risks, benefits, and alternatives were reviewed, including:

• Risks: Infection, scarring, bleeding, recurrence, nerve injury

• Alternatives: Surgical excision, radiation therapy (XRT)

Why ED&C Is a Trusted Option for Certain Skin Cancers

Electrodesiccation and curettage is often chosen for:

• Small to moderately sized BCCs

• Non-aggressive tumor types

• Patients who may not be ideal candidates for surgery

This technique is effective, relatively quick, and performed in-office with minimal downtime.

Outcome and Follow-Up

The patient tolerated the procedure well and left the clinic with a clear post-op plan. At Village Dermatology, we will monitor the area for healing and recurrence, with the goal of complete resolution and excellent cosmetic outcome.

Protecting Against Skin Cancer

While basal cell carcinoma is common, it is also highly preventable and treatable when caught early. Key prevention strategies include:

• Daily use of broad-spectrum SPF 30+ sunscreen

• Regular full-body skin exams

• Avoiding tanning beds and minimizing UV exposure

Concerned About a Skin Lesion?

If you’ve noticed a new, growing, or changing spot on your skin, especially one that looks shiny or pearly, don’t wait. Our board-certified dermatologists in Katy and Houston, Texas are here to help with timely diagnosis and treatment.

📍 Now accepting new patients in Katy & Houston
📞 Call today to schedule a full skin evaluation

Comprehensive Dermatologic Care: Cyst, Wart, and Actinic Keratosis Treatment in a 74-Year-Old Female

By: Dr. Caroline Vaughn

At Village Dermatology, we specialize in diagnosing and treating a wide variety of skin concerns in patients of all ages. In this blog, we highlight a recent case of a 74-year-old female who came to our clinic with three skin concerns: an enlarging cyst on the right shoulder, a wart on the right index finger, and a sun-induced precancerous lesion known as actinic keratosis on the nose.

Patient Overview

The patient, new to our clinic, had been living with these lesions for years. Recently, the cyst began to enlarge, prompting her visit. The wart was asymptomatic, and the actinic keratosis on her nose was noted during routine examination.

1. Epidermal Inclusion Cyst (Right Posterior Shoulder)

Epidermal inclusion cysts are benign sacs under the skin filled with keratin. Though typically harmless, they can become painful, inflamed, or cosmetically concerning as they grow.

Exam Findings:

• Location: Right posterior shoulder

• Size: 1.1 cm × 1.2 cm

• Appearance: Enlarging, firm, subcutaneous nodule

Treatment:

• Slit Excision under local anesthesia

• Entire cyst was removed and sent for pathology

• Wound closed with simple repair using sutures

• Patient was instructed to avoid heavy lifting or swimming for 14 days

• Suture removal planned in 2 weeks

Why this matters:
Even benign cysts can enlarge or become inflamed, making excision a preventive and therapeutic option—especially in older adults.

2. Verruca Vulgaris (Common Wart on Right Index Finger)

Warts are caused by the human papillomavirus (HPV) and are contagious through direct contact. This patient’s wart had been present for years and had begun to enlarge.

Exam Findings:

• Location: Right distal palmar index finger

• Symptoms: Asymptomatic but enlarging and slightly irritated

• Appearance: Classic cauliflower-like bump

Treatment:

• Cryotherapy with liquid nitrogen

• One lesion treated using two freeze-thaw cycles

• Patient education: Warts are contagious and may recur without continued treatment

Prevention Tip:
Avoid picking at warts and wash hands regularly to prevent spreading the virus.

3. Actinic Keratosis (Precancerous Lesion on Nasal Dorsum)

Actinic keratoses (AKs) are precancerous lesions that develop in sun-damaged skin. They can evolve into squamous cell carcinoma if left untreated.

Exam Findings:

• Location: Nasal dorsum (bridge of the nose)

• Appearance: Rough, scaly patch in sun-exposed area

Treatment:

• Cryotherapy with liquid nitrogen

• Patient was counseled on sun protection and SPF 30+ sunscreen

• Discussed long-term treatment options including topical 5-FU, imiquimod, or photodynamic therapy

Comprehensive Geriatric Dermatology at Village Dermatology

This case showcases how one visit can lead to the diagnosis and treatment of multiple skin conditions in a senior patient. At Village Dermatology, we provide full-spectrum dermatologic care tailored to the unique needs of older adults, from benign lesions to cancer prevention.

If you’re noticing enlarging bumps, persistent growths, or sun-damaged skin, schedule a visit with our dermatology team in Katy or Houston, Texas.

📍 Serving Katy and Houston, TX
📞 Call now to book your consultation or skin evaluation!