Skin Diseases Require Skilled Diagnosis

Each year, countless visits are made to the doctor's office in order to diagnose and treat skin diseases. The past decade has seen a shortage of dermatologists develop at a time when information regarding skin disorders has skyrocketed, making it a challenge for even a specialist to keep abreast of the field.

"I can recall that before formal training in my specialty, I received only two weeks of lectures on diseases of the skin in medical school," said Dr. Charles Sexton, a Board Certified dermatologist working in Irvine.

"I also believe that it was on average one of the poorest attended lecture series in the program."

Since that time, however, numerous influences have changed the relationship between skin diseases, the patients they afflict, and the caregivers who treat them. What hasn't changed is the need for patients with skin diseases to get the best care available and for continued effort to minimize suffering that accompanies skin disorders.

"There are relatively few diseases that make up the bulk of dermatology visits to caregivers, but even mastering those requires a great deal of knowledge and information," Dr. Sexton said.

"For example, psoriasis, a hereditary disorder that affects an estimated 2 to 5 percent of the population, can actually be triggered for the first time, or occultly perpetuated by choice of medications for blood pressure, eye diseases and even vaccinations.

"I have seen numerous cases of disease flares in patients whose skin was stable, but then developed hypertension, the subsequent treatment of which triggered a downward spiral of their psoriasis. The same process will occur rather predictably if one elects to utilize certain systemic antiinflammatory medications to control psoriasis, and their use should be avoided in patients with this disease."

Acne is another disease that is often inadequately treated due to concerns about systemic treatments and possible side effects of the medications available. Even topical medications are often ineffectively used due to over emphasis of potential side effects that can theoretically occur, but which rarely do.

"I have seen practicioners recommend use of agents that worsen the acne itself in order to avoid side effects that haven't even occurred," Dr. Sexton said. "Unfortunately, it is easier to prevent acne scarring than to treat it, and it is urgent that patients who are unresponsive to one regimen be closely monitored and switched in time to prevent this unfortunate consequence.

"This monitoring requires knowledge of timing of expected results and intimate detail in the correct application as well as minimization of side effects predictable with each agent.

"Above all, it requires constant monitoring at regular intervals until the disease process is under control."
Along similar lines, Dr. Sexton has noted a large number of patients with chronic rashes affecting their feet and groin which are frequently diagnosed as "athlete's foot" and "'jock itch."

"If athletes foot is present, then a simple in-office test can confirm this in under five minutes," Dr. Sexton said.
Accurate diagnosis is essential, as it can avoid months of inappropriate usage of medicines that can actually worsen the condition and even cause irreversible damage to the skin.

"Some forms of treatment attempt to combine active ingredients so that accurate diagnosis seems unnecessary, similar to using anti-histamines and decongestants in combination for cold preparations," Dr. Sexton said.

"I have found that the antifungal agents have little effect on the growth of the fungus in these diseases, and what is worse is that use of these agents for jock itch commonly causes permanent stretch marks and rashes from the presence of higher strength steroids in the preparation," Dr. Sexton said. "The bottom line, if you have been given combo (more than one active ingredient listed) therapy for a disorder in these locations, and they are still present after several weeks' use, it would be best to discontinue them and re-evaluate the condition.

From these examples, Dr. Sexton points out that the care of your skin, while often marginalized for more pressing medical problems, requires expertise and knowledge. This general principle is simply demonstrated with these few examples.

If you have a skin disease or desire cosmetic treatments for your skin, contact Dr. Sexton from 8 a.m. to 5 p.m. for an appointment. His office is at 15825 Laguna Canyon Road, Suite 203, Irvine. The phone number is 949-679-6900. His Web site is www.drsexton.net.

Irvine Dermatology Facility at Cutting Edge of Skin Care

Dr. Charles R. Sexton, M.D. is very enthusiastic about the recent opening of his state-of-the-art dermatology facility in the newly constructed Spectrum Medical Plaza near Irvine Regional Hospital.

"I am having a fantastic time seeing my patients in a comfortable, stress-free environment. It allows me to address all of their dermatology concerns without the restrictions of managed care."

Dr. Sexton, a diplomate of the American Board of Dermatology, has been treating patients in the Southern California area for the past 12 years.

He arrived in the San Diego area after finishing his residency at the prestigious Cleveland Clinic, where the dermatology program offered a broad array of training in his field. This included cutting-edge cosmetic technologies, as well as subspecialty training in the surgical and pathology disciplines.

"As a tertiary referral center, I was exposed to interesting and diverse patients from all over the region, country, and even the world," Dr. Sexton said.

It wasn't unusual for his patient list to include United States senators, professional athletes or foreign diplomats on any given day.

"I think the best part of my training was that, in addition to the common diseases, I was exposed to many skin disorders that most people only get to read about due to their extremely rare incidence."

He further honed his cosmetic skills by associating with a wellestablished cosmetic dermatology practice his first year after residency.

"The past decade has seen this aspect of dermatology explode with new choices for reversing sun- and age-related skin damage.

"My patients want to know what is new, available, safe and, most of all, effective. They also keep the emphasis on ease of recovery, so that they can achieve these results during their usual busy routines."

Currently, Dr. Sexton's most popular procedure is the Pro-lite facial, a form of intense pulsedlight therapy, or IPL.

"The IPL is a good example of patient-demand-driven technology. It is a quick and relatively painless procedure that is so minimally invasive that patients can re-apply their makeup in my office after the session is over. As a result, they can return to work the same day."

Dr. Sexton has found this treatment effective for the most common complaint in the areas of the face, neck, chest and hands - namely, that of red and brown discolorations.

Rosacea and sun damage top the list of causes of these imperfections. However, Dr. Sexton has also had success with related disorders such as stretch marks, enlarged pores, acne scarring and wrinkles.

"Further studies are needed to verify the extent of this and other pending technologies' effectiveness, but there seems to be no end in sight for the demand for skin rejuvenation," Dr. Sexton said.

A large portion of his practice is devoted to general dermatology, and Dr. Sexton estimates that he has had more than 50,000 patient encounters, with people afflicted by problems from the routine to the exotic.

"I enjoy the detective work associated with skin disorders because, in reality, the skin can only manifest disease in a finite number of ways," Dr. Sexton said.

"It is my privilege to collect the important historical data from the patient and then order the appropriate tests in order to distinguish one from the other, as there are literally thousands of different skin diseases.

"Helping people with these problems is truly a rewarding experience.

"It is nice to be involved with a specialty that allows me to see a 2-month-old in one room followed by an octogenarian in the next. Naturally, the problems and challenges will be different, and this allows me to keep my clinical skills sharp."

Dr. Sexton also enjoys academic pursuits and has contributed numerous articles to the peerreviewed scientific literature as well as book chapters for a plastic-surgery text.

He has trained residents from the University of California at San Diego and at Irvine, and he currently is on staff at Hoag and Irvine Regional hospitals.

"At the Spectrum Medical Plaza, I have created a longsought personal and professional goal, and I look forward to helping people in the area for many years to come."

If you have skin concerns, visit Dr. Sexton's office at 15825 Laguna Canyon Road, Suite 203, in Irvine.

The phone number is 949-679-6900, and he can be seen from 8 a.m. to 5 p.m. Mondays through Fridays. His Web site is www.drsexton.net.