New-Onset Plantar Warts in an 11-Year-Old Male – Case Report from Village Dermatology in Katy & Houston, Texas

By: Dr. Caroline Vaughn

At Village Dermatology, we frequently treat verruca vulgaris (common warts) in children, teens, and adults. These growths, caused by the human papillomavirus (HPV), often appear on the hands or feet and can be stubborn — especially when located on weight-bearing areas like the soles. This case highlights early intervention in a pediatric patient with painful plantar warts.

Patient Background

An 11-year-old male presented with painful warts on the bottoms of both feet. The lesions had been present for about three weeks and were increasing in size. The patient had already tried over-the-counter salicylic acid and cryotherapy without improvement.

Clinical Examination

A focused skin exam of both feet revealed:

• Left medial plantar heel – enlarging wart.

• Right medial plantar midfoot – enlarging wart.

The patient was otherwise healthy, alert, and in no distress.

Discussion & Education

The patient and his mother were educated on verruca vulgaris, including:

• Warts are cauliflower-like bumps caused by HPV.

• They are not dangerous but can be contagious through direct contact.

• They may resolve spontaneously, but treatment can speed resolution and reduce discomfort.

• Multiple treatment sessions may be needed for complete clearance.

Treatment Plan

After reviewing options — liquid nitrogen cryotherapy, cantharidin application, and candida antigen injection — the family chose liquid nitrogen (LN2) therapy.

• Cryotherapy Procedure:

  • Treated two lesions with LN2.

  • Discussed risks including crusting, blistering, pigment changes, scarring, recurrence, incomplete removal, and infection.

  • Obtained verbal consent before treatment.

Follow-Up

The patient will return in one month for reassessment and additional treatments if needed.

Key Takeaway for Parents in Katy & Houston, Texas

Plantar warts in children can be painful, especially when located on pressure points of the feet. Over-the-counter treatments may not always work, and professional care with options like liquid nitrogen cryotherapy can provide more effective results. At Village Dermatology, we use a variety of treatments tailored to the patient’s needs to help remove warts and prevent recurrence.

If your child has painful or persistent warts, schedule an appointment at our Katy or Houston, Texas locations for expert evaluation and treatment.

Managing Persistent Allergic Contact Dermatitis in a 34-Year-Old Male – Case Report from Village Dermatology in Katy & Houston, Texas

by: Ashley Baldree

At Village Dermatology, we frequently see patients with allergic contact dermatitis (ACD) – a common but sometimes stubborn skin condition that can cause itching, redness, and inflammation. This case highlights how timely evaluation and treatment adjustments can help patients achieve relief, especially when symptoms persist despite initial therapy.

Patient Background

A 34-year-old male presented for follow-up of allergic contact dermatitis initially evaluated on July 21, 2025. At his first visit, he was prescribed a prednisone taper to control inflammation. He returned four days into treatment, reporting worsening rash and discomfort, particularly over the knees.

Clinical Examination

A full skin exam was performed, including the scalp, head, face, neck, upper and lower extremities, and feet. The patient was in good general health, alert, and oriented. Examination revealed well-demarcated, geometric, eczematous patches on the knees, consistent with allergic contact dermatitis. However, the inflammation appeared to be progressing.

Treatment Plan and Adjustments

Given the persistent and worsening nature of the rash, the treatment plan was modified:

• Intramuscular Kenalog Injection – A 60 mg dose was administered to rapidly reduce inflammation and help control the flare.

• Gabapentin 300 mg – Prescribed for nightly use to help relieve itching and burning sensations associated with the dermatitis.

• Revised Prednisone Taper – Adjusted dosing to ensure better control over the flare while minimizing long-term steroid risks.

The patient received counseling on skin care and allergen avoidance:

• Use only hypoallergenic, fragrance-free soaps and moisturizers.

• Avoid new cosmetics, hair products, nail products, plants, metals, and sunscreens until the cause is identified.

• Understand that ACD may take several weeks to fully resolve and may require patch testing if the allergen is unknown.

Medication Safety Counseling

We discussed the risks and side effects of prednisone, Kenalog, and gabapentin, including skin thinning, mood changes, dizziness, and potential long-term health effects with extended use. The patient verbalized understanding and agreed to the treatment plan.

Outcome Goals

Our aim is to reduce the inflammation quickly, control symptoms, and prevent recurrence through trigger identification and avoidance. Follow-up will be on an as-needed basis, with the option for further diagnostic testing if symptoms persist.

Key Takeaway for Patients in Katy & Houston, Texas

Persistent allergic contact dermatitis may require treatment escalation, including intramuscular steroids and supportive medications, when topical or oral therapy alone is not enough. At Village Dermatology, our goal is to provide personalized, effective treatment plans to help patients get back to healthy, comfortable skin.

If you are experiencing a stubborn skin rash that isn’t improving with initial treatment, schedule a consultation with our dermatology team in Katy or Houston, Texas.

Comprehensive Skin Exam for a 50-Year-Old Female with Family History of Non-Melanoma Skin Cancer

by: Ashley Baldree

At Village Dermatology in Katy and Houston, Texas, we understand that a strong family history of skin cancer requires extra vigilance. This case highlights the importance of annual full body skin examinations in patients with a family history of non-melanoma skin cancer.

Case Overview

A 50-year-old female presented for her first visit to our clinic for a full body skin examination. She reported no personal history of skin cancer but has a family history of basal cell carcinoma on her mother’s side. She expressed interest in routine monitoring for suspicious lesions and guidance on skin protection.

Clinical Examination

A thorough dermatologic examination was performed, including the scalp, face, trunk, extremities, hands, feet, nails, and skin folds. A dermatoscope was used for precise lesion assessment. Findings included:

• Lentigines – reticulated light tan macules in sun-exposed areas (left and right malar cheeks, mid-forehead).

• Seborrheic keratoses – pigmented, waxy papules and flat lesions on the left anterior shoulder, left forearm, and left calf.

• Cherry angiomas – bright red papules scattered on the trunk and extremities.

No suspicious lesions for malignancy were detected.

Assessment and Plan

1. Family history of non-melanoma skin cancer

   • Counseling on sun protective strategies including daily broad-spectrum SPF 30+ sunscreen and protective clothing.

   • Education on monthly self-skin checks to monitor for new or changing lesions.

   • Annual professional skin exams recommended.

2. Lentigines

   • Discussed treatment options including sunscreen, topical lightening agents, retinoids, chemical peels, and laser therapy.

3. Seborrheic keratoses

   • Reassurance given; no treatment required unless lesions become irritated.

4. Cherry angiomas

   • Benign; removal possible for cosmetic reasons.

Why This Matters

Patients with a family history of skin cancer, even without personal history, have an increased lifetime risk. Early detection through preventive skin exams is the best defense against skin cancer. Regular visits to a board-certified dermatologist in Katy or Houston can make the difference between early treatment and late detection.

Key Takeaways for Skin Health

• Perform self-skin checks monthly.

• Use SPF 30+ sunscreen daily, reapplying every 2 hours with ongoing sun exposure.

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

• Schedule annual dermatology visits for professional skin evaluations.

Comprehensive Skin Examination Reveals Multiple Benign Skin Conditions in Katy, Texas Patient

by: Ashley Baldree

At Village Dermatology in Katy and Houston, Texas, we understand the importance of regular skin evaluations—especially for patients with long-standing skin lesions or concerns about new growths. In this recent case, a 45-year-old female presented for a comprehensive skin examination and evaluation of multiple lesions that had been present for years. Her visit highlights how a full-body skin check can identify and manage a variety of skin conditions—many of them benign, but still important to monitor.

Patient Presentation

The patient reported multiple asymptomatic skin lesions distributed throughout the body, some present for many years. She was also interested in counseling on sun safety, evaluating suspicious growths, and reviewing her existing moles for any changes.

Full-Body Skin Examination Findings

A thorough head-to-toe examination was performed, including the scalp, face, neck, trunk, extremities, and nails. Findings included:

• Benign Nevi (D22.9) – Regular, symmetrical, evenly pigmented moles.

• Lentigines (L81.4) – Sun-induced light brown spots in a reticulated pattern, common in sun-exposed areas.

• Seborrheic Keratosis (L82.1) – Waxy, pigmented growths associated with aging.

• Cherry Angiomas (D18.01) – Small, bright red vascular spots on the skin.

• Dermatofibromas (D23.72, D23.61) – Firm, scar-like nodules, primarily on the extremities.

• Ingrown Hair (L73.8) – In the right suprapubic area, treated with topical clindamycin and benzoyl peroxide washes.

• Androgenetic Alopecia (L64.8) – Patterned hair thinning consistent with female pattern hair loss, for which oral minoxidil was initiated.

Diagnosis & Management

While all of the patient’s pigmented lesions were benign, each condition was discussed in detail to ensure understanding. Preventive care recommendations included:

• Sun Protection: Broad spectrum SPF 30+ sunscreen applied daily, with reapplication every 2 hours during sun exposure.

• Self-Monitoring: Monthly self-skin checks for any mole changes.

• Hair Loss Management: Initiation of oral minoxidil 2.5 mg daily and Nutrafol supplementation to support hair health.

• Targeted Treatment: Topical clindamycin for ingrown hair prevention.

Why Annual Skin Exams Matter

Even when skin lesions appear harmless, changes in size, shape, or color can be early warning signs of skin cancer. A yearly full-body skin check at Village Dermatology can detect potential issues early—when they are most treatable.

Our Commitment to Skin Health in Katy & Houston, TX

Our board-certified dermatologists are passionate about educating patients on sun protection, skin cancer prevention, and proactive skin care. Whether you have a family history of melanoma, are concerned about new lesions, or simply want a thorough skin check, our team is here to help.

✅ Bottom Line: This case underscores the value of comprehensive dermatologic care. By combining preventive measures, patient education, and targeted treatment, we help our patients maintain healthy skin for life.

Persistent Periungual Warts in a 39-Year-Old Male: Ongoing Management with Candida Antigen and Cryotherapy

by: Ashley Baldree

Village Dermatology – Katy & Houston, Texas

A 39-year-old male returned to our clinic for follow-up treatment of multiple warts located on the left dorsal thumb metacarpophalangeal joint and periungual skin of both the left thumb and left index finger. The patient was last evaluated on June 26, 2025, when the lesions were treated with Candida antigen injections and liquid nitrogen cryotherapy.

History and Patient Experience

The patient reported slow but noticeable improvement following prior treatments. While alternative options, such as bleomycin injections or cauterization, were discussed, he preferred to continue with the current regimen and reassess progress at the next visit.

Examination Findings

On examination, three wart lesions remained present—thickened, hyperkeratotic, and located near the nail folds and dorsal thumb joint. These periungual warts are particularly challenging due to their proximity to the nail matrix and higher recurrence rates.

Diagnosis

• Verruca Vulgaris (Common Warts) – periungual and dorsal thumb joint

• Contagious viral skin lesions caused by human papillomavirus (HPV)

• Associated mild inflammation and skin irritation

Treatment Plan

The patient underwent a sixth treatment session, which included:

• Candida antigen injections to stimulate a localized immune response against HPV

• Cryotherapy with liquid nitrogen to destroy wart tissue

These procedures are performed because untreated periungual warts can enlarge, cause pain, spread to other areas, and lead to nail dystrophy.

The patient was counseled on:

• Avoiding direct contact with the lesions to reduce transmission

• Expected treatment course—warts may require multiple sessions over several months

• Possible side effects including blistering, pigment changes, or incomplete clearance

Follow-up is scheduled in 4 weeks to monitor progress and consider additional options if improvement stalls.

Why Treating Periungual Warts Early Matters

Periungual warts can be more than a cosmetic concern—they can damage the nail structure and spread to surrounding skin. Early treatment increases the chance of complete resolution and helps prevent complications.

If you live in Katy or Houston, Texas and have stubborn or recurring warts, Village Dermatology offers targeted, evidence-based treatments including cryotherapy, immunotherapy, and advanced removal techniques.

Managing Molluscum Contagiosum: A 43-Year-Old Male with Axillary Rash

By: Dr. Ashley Baldree

At Village Dermatology, we regularly evaluate and treat patients with viral skin conditions that can resemble other common rashes. One frequently misdiagnosed condition is molluscum contagiosum, a viral infection characterized by small, pink, dome-shaped bumps that may become irritated. This case highlights the successful management of molluscum contagiosum in a 43-year-old male from the Katy and Houston, Texas area.

Patient Overview

A 43-year-old established male patient presented to our clinic with a moderate bumpy rash located in the left axilla (underarm region). The rash had been present for approximately two weeks, was not itchy, and the patient had not started any treatment before this visit.

Upon examination, additional lesions were noted on the left rib cage, axillary vault, posterior axilla, and lateral inferior chest, consistent with molluscum contagiosum.

Diagnosis: Molluscum Contagiosum

Molluscum contagiosum is a contagious viral skin infection caused by a poxvirus, commonly seen in both children and adults. It spreads via skin-to-skin contact or contaminated surfaces, including towels and shared water sources like swimming pools.

Characteristics Noted:

• Umbilicated (central indentation) pink papules

• Moderate inflammation

• Distribution across the left chest and axillary region

• Some lesions were irritated and itchy

Treatment Plan

At the patient’s previous visit, cryotherapy with liquid nitrogen (LN2) had been initiated. During this follow-up appointment, the patient reported significant improvement in his condition.

On this visit:

• 57 molluscum lesions were treated with 2 freeze-thaw cycles using a cotton-tipped applicator

• Cryotherapy was used due to signs of inflammation and irritation

• The procedure was medically necessary and consent was obtained

Counseling included:

• Skin care tips to avoid spreading: avoid sharing towels, tight clothing, or scratching lesions

• Treatment options discussed: cryotherapy, cantharidin, tape stripping

• Follow-up scheduled in 1 month to monitor progress and provide additional treatment if needed

Why Cryotherapy Works for Molluscum

Cryotherapy involves freezing the lesion with liquid nitrogen, which helps destroy the infected tissue and stimulate the immune response. Most patients require multiple treatments, especially when the infection is widespread. For this patient, progress was already noted after just one session.

Preventing the Spread of Molluscum

Molluscum contagiosum is contagious but manageable. To minimize transmission:

• Avoid scratching or picking lesions

• Do not share towels, razors, or clothing

• Practice good hygiene, especially after workouts or swimming

• Use barriers (like clothing or bandages) over affected areas if needed

Conclusion

This case underscores the importance of early recognition and proper management of molluscum contagiosum in adults. At Village Dermatology in Katy and Houston, Texas, our providers are experienced in differentiating molluscum from other skin rashes and offering safe, effective in-office treatments like cryotherapy.

If you or someone you know has unexplained bumps or a persistent rash, don’t wait—schedule a skin evaluation today with our expert dermatology team.

📍 Serving Katy and Houston, TX
📞 Call us today to book an appointment

Follow-Up Wart Treatment in a 13-Year-Old Male – Case Report from Village Dermatology in Katy & Houston, Texas

by: Caroline Vaughn

At Village Dermatology, we often treat verruca vulgaris (common warts) in both children and adults. These small, rough growths are caused by the human papillomavirus (HPV) and can be stubborn, requiring multiple treatments to fully resolve. This case highlights the importance of follow-up care for persistent or recurring warts.

Patient Background

A 13-year-old male returned for a follow-up visit after his initial evaluation on June 26, 2025 for verruca vulgaris affecting the left lateral dorsal foot and left proximal ulnar dorsal small finger. At his first visit, the lesions were treated with liquid nitrogen cryotherapy.

The patient reported that his finger wart had resolved completely, but a new wart developed on the bottom of his left big toe.

Clinical Examination

A focused skin exam of the hands and feet revealed:

• Resolved lesion on the left small finger.

• Persistent wart on the left lateral dorsal foot.

• New wart on the left medial plantar surface of the great toe.

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

Treatment Plan

Given the persistence and new lesion, we proceeded with:

• Cryotherapy with liquid nitrogen for two lesions – one on the dorsal foot and one on the plantar surface of the big toe.

• Reviewed risks including crusting, blistering, pigment changes, scarring, recurrence, and incomplete removal.

• Reinforced that verruca vulgaris can spread through direct contact and that proper hygiene is important to prevent recurrence.

We also discussed alternative treatments such as topical salicylic acid, retinoids, and immune-modulating creams like Aldara.

Follow-Up

The patient will return in one month to assess healing and determine if additional treatments are needed.

Key Takeaway for Patients in Katy & Houston, Texas

Warts are common in children and teens, but they can be persistent. Cryotherapy is an effective treatment, but follow-up care is often needed to ensure complete removal and to address new lesions if they appear. At Village Dermatology, we tailor wart treatment plans to each patient’s needs for the best possible outcome.

If you have warts that keep coming back, schedule a visit with our dermatology team in Katy or Houston, Texas for expert treatment.

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.