Dermatología OncológicaOncological dermatology

Oncological dermatology

Early detection of skin cancer

EMalignant skin cancer is classified into melanoma and non-melanoma cancer. Skin melanoma can be diagnosed at an early stage through an examination and medical assessment performed by dermatologists specialising in oncological dermatology.

Our dermatologists use digital dermoscopy (FotoFinder) for the monitoring of all moles suspected of becoming malignant melanoma, taking both macroscopic and microscopic high-resolution photographs, which allow new lesions to be discovered and to detect if the condition of the existing lesions has changed. Scientific studies have demonstrated that it is the most useful method for the early diagnosis of melanoma.

Non-melanoma skin cancer can be eliminated very efficiently using laser techniques that avoid scars and reduce the risk of the malignant tumour recurring. In those cases in which the tumour is found in areas at high risk of relapse or recurrence, we use Mohs surgery.

Every year, four thousand new skin cancer cases are diagnosed in Spain, but, according to the Spanish Academy of Dermatology and Venereology, the mortality rate for this condition has not increased thanks to medical advances. Our oncological dermatology unit is part of the limited number of specialists who remove skin tumours using Mohs micrographic surgery, which allows for an immediate examination of the extent of the lesion. The dermatologist extracts the tumour tissue and reconstructs the area, and the pathologist analyses it through a microscope to identify all the roots of the cancer, and to detect possible residual tumours that require a new removal. This surgery achieves a high cure rate, and also avoids destroying healthy tissue.

Melanoma: Risk profile

EThere are a series of criteria that are considered universal when classifying individuals who are more vulnerable to suffering melanoma (skin cancer). The theory is clear: if we are looking at the risk factor profile, we should carry out an annual dermatological check-up to monitor the moles, but, in practice, this assessment is sometimes done when it is already very late.

In the following cases, a regular dermatological review is mandatory:

• • Family history of melanoma.
  • Having suffered melanoma.
  • Having 50 or more atypical moles.
  • Having suffered sunburns during childhood and youth or having continuously used UVA lamps.

  • Belonging to the fair skin phototype (people with blond hair, redheads, light-coloured eyes).

The annual dermatological review identifies birthmarks or asymmetrical moles, and highlights which are the most prone to becoming carcinogenic.

Dermatología PediátricaPaediatric dermatology

Paediatric dermatology

Paediatric dermatology is much more than an extension of this branch of medicine that deals with skin care. Children present a series of skin conditions that manifest in a very specific way, and they require very personalised treatment. Early diagnosis interrupts and resolves certain conditions that can extend to adulthood.

Treatment of most common conditions in infants and children:

• Atopic Dermatitis

Atopic dermatitis is a condition that affects 20% of children all over the world. It is a chronic condition, that tends to develop from the age of five, but there is a high percentage of babies and children in whom the condition becomes transient. Whatever the degree, good care of the skin relieves symptoms which tend to appear on the face, scalp and some areas of the body.

Babies are very vulnerable to this condition. At the age of just two or three months, they already present the first symptoms that are represented by a rash that makes the skin peel and causes the baby to cry due to the uncontrollable itch. There are cases in which the skin can even suppurate. The most affected areas are usually the face and, in particular, the cheeks. Although it can lead to confusion, it is not normal for atopic dermatitis to present in the nappy area. Abnormalities in this area correspond to another condition called, exactly as its name indicates, nappy dermatitis.

Atopic dermatitis in children manifests with a rash that generates a lot of itching and appears in the folds of the elbows and knees, ankles and wrists. The condition is very irritating, and it also affects the parents for whom it is very difficult to prevent their children from scratching, and it is very harmful since they can end up developing other skin infections. It is therefore crucial to see aspecialised dermatologistso that they can prescribe an effective treatment to relieve discomfort.

Treatment of Atopic dermatitis:

Hydration is basic, but it is essential to make use of emollients with extra nutrition. In the event of continuous outbreaks, the dermatologist may prescribe topical or oral treatment with corticosteroids depending on whether they are milder or more severe..

• Warts and mollusca

LThe human papillomavirus causes warts. They can appear in any area of the body, but the most common areas where they tend to appear during childhood are the hands, soles of the feet, elbows and knees. According to their morphology, they are classified into: Common: dark in colour, and rough surface. Flat: smaller warts with a smooth surface and they are lighter in colour. Filiform: they are long and narrow, and usually appear on the face.

The dermatologist should assess the type of wart and will prescribe the most suitable treatment. The more common treatments are:

• • • • • Cryotherapy with liquid nitrogen
        • Removal
        • Laser surgery
        • Treatment with salicylic or lactic acid

LMolluscum contagiosum is a viral infection that causes extreme itchiness. It primarily affects children with atopic dermatitis since their skin barrier is weakened. Its presence is increased in 5-year-old children and decreases from the age of 12.

Treatments vary between:

• • • • • Topical Creams: they allow treatment to be carried out at home. After application of the cream, the lesion becomes inflamed and disappears after a month and a half.
        • Curettage: This is resorted to when topical creams do not solve the abnormality. It is a surgical procedure that consists of removing the mollusca with a curette (cutting instrument). As they are children, an anaesthetic cream is applied so that they do not feel any pain.
        • Photodynamic therapy.

• Angiomas and Haemangiomas

They are also known as the birthmarks of many babies.

An angioma is a benign tumour that occurs on an area of the skin where there are more blood vessels than normal. They can exist from birth or appear immediately after birth. They do not pose any danger apart from being a problem from an aesthetic point of view. They can be removed with laser treatment once the baby reaches the appropriate age.

Haemangiomas appear in different areas of the skin where there is major accumulation of tissue with blood vessels that form a lump under or on the skin. There are two types:

• • • • • Congenital haemangiomas: they require the intervention of a specialist dermatologist who usually prescribes oral and topical treatment, most notably in the breastfeeding period.
        • Progressive haemangiomas grow in the first few years of life, and then disappear.

Our team has the most advanced laser technology for the treatment of angiomas and other childhood skin disorders.

• Moles

Melanoma does not tend to develop during childhood, but that does not mean that it should not be paid the same amount of attention as in adulthood. Parents should watch out for any change in the morphology or colour of the moles of young children and, if necessary, the dermatologist will use a dermatoscope to perform an appropriate follow-up.

• Acne

EAcne is the most common problem among adolescents, and it affects their self-esteem. It presents in varying degrees, and there are some severe lesions that leave scars.

The dermatologist will prescribe the most appropriate treatment for the young person or adolescent's needs, but, as a general rule, the prescription consists of combinations of topical treatments to eliminate the formation of blackheads with anti-inflammatory effect. In the most acute cases, it is combined with specific oral treatment, and, if the acne is comedonal (as a result of having very blocked pores), it is necessary to carry out a regular skin cleansing that will consist of a specific peel. In many cases, more extensive therapies will be carried out over time, but with a visible solution such as laser therapy or the unique treatment that reduces inflammation and uses high technology to stimulate skin renewal, Kleresca.

Hiperhidrosis o Sudoración ExcesivaHyperhidrosis or excessive sweating

Hyperhidrosis or excessive sweating

LHyperhidrosis or excessive and uncontrollable sweating is a condition caused by hyperactivity of the sweat glands. The treatment to be followed to eliminate it varies depending on the area of the body where it manifests.

• Palmar hyperhidrosis (palms of the hands or soles of the feet)

Intense sweating in the palms of the hands and soles of the feet is treated with botulinum toxin (botox). Botulinum toxin is injected to temporarily block the nerves that stimulate the sweat glands, responsible for episodes of excessive sweating.

Treatment should be carried out in a consultation under the supervision of a dermatologist specialising in hyperhidrosis and should be repeated after a few months, as the effect of botulinum toxin disappears over time.

• Axillary hyperhidrosis

Excessive sweating that occurs in the armpits can be treated either with botulinum toxin, with which we will achieve a reduction of the sweating temporarily or with electromagnetic energy miraDry, the advanced technology that manages to permanently remove underarm sweat and odour.

• Miradry®: permanent elimination of underarm sweat and odour

  MiraDry is an innovative treatment which has been approved and certified by the US Food and Drug Administration (FDA), which uses electromagnetic energy to remove the sweat glands causing the underarm sweat and odour in a controlled way, eliminating underarm sweat and odour problems immediately, permanently, safely and in a non-invasive manner.

  The effect is immediate, as is the incorporation to the patient's normal life. The result is permanent since removed glands do not develop again.

  MiraDry does not cause compensatory sweating.

  Treatment with MiraDry is a fast procedure, as the session lasts between 1 hour and 1 hour and a half, is performed in a consultation and under the supervision of our team of dermatologists. Treatment can consist of 2 or 3 sessions.

Psoriasis, Unidad MultidisciplinarPsoriasis, Multidisciplinary Unit

Psoriasis, Multidisciplinary Unit

Psoriasis is a chronic inflammatory skin condition, that occurs in outbreaks, presenting periods of condition and flare-ups. Psoriasis occurs with "flaky and crusty plaques" which are clearly defined, frequently on the elbows, knees and hands. It is considered an autoimmune disorder in which the immune system itself attacks by mistake and inflames healthy tissue.

Apart from the skin lesions or previously mentioned "plaques" on the elbows or knees, flaking usually also occurs on the face or in the scalp. Some patients also suffer joint pains or arthropathies, as well as being overweight, obese and high glucose and cholesterol levels, which is known as a metabolic syndrome.

Recent studies show that it is not a condition that only affects the skin, but instead that patients with psoriasis also present cardiac, metabolic, psychological, orthopaedic, liver and dental abnormalities. For this reason, our Psoriasis medical unit is made up of a dermatologist, a rheumatologist, an orthopaedic surgeon, a cardiologist, an endocrinologist, a psychologist, a nutritionist and a physical trainer with training in this pathology. We also have nursing staff trained in psoriasis and inflammatory joint disease.

With specialised multidisciplinary treatment, the appearance of outbreaks and their effects can be minimised, but we must be aware that, as it is a chronic condition, there is no treatment that eradicates it completely and that environmental factors, such as stress, any emotional impact, infections and the taking of medicines such as anti-inflammatory drugs, beta-blockers or antimalarial drugs can trigger outbreaks of psoriasis.

Our unit specialising in psoriasis provides our patients with a diagnosis and multidisciplinary treatment that manages to control the condition and increase their quality of life considerably.

Estudios recientes demuestran que no es una patología que afecta únicamente a la piel, sino que los pacientes psoriásicos también presentan alteraciones cardíacas, metabólicas, psicológicas, traumatológicas, hepáticas y odontológicas. Por ello nuestra unidad médica de Psoriasis está compuesta por una dermatóloga, un reumatólogo, un traumatólogo, una cardióloga, un endocrino, un psicólogo, un nutricionista y un preparador físico con formación en esta patología. Además de contar con personal de enfermería entrenado en psoriasis y patología inflamatoria articular.

Con tratamiento multidisciplinar especializado, se pueden minimizar o espaciar la aparición de brotes y sus efectos, pero debemos ser conscientes de que al tratarse de una enfermedad de carácter crónico, no existe tratamiento que la erradique completamente y que los factores ambientales, como el stress, cualquier impacto emocional, las infecciones y la toma de fármacos como antiflamatorios, betabloqueantes o antipalúdicos pueden desencadenar brotes de psoriasis.

Nuestra unidad especializada en psoriasis proporciona a nuestros pacientes un diagnóstico y tratamiento multidisciplinar que logran controlar la enfermedad y aumentar su calidad de vida considerablemente.

Dermatología EstéticaAesthetic Dermatology

Aesthetic Dermatology

Given that ageing occurs and is shown mostly in our skin, it should be the dermatologist, as a doctor specialising in it, who diagnoses and treats it.

Our aesthetic dermatology unit is pioneering for:

• Being made up of dermatologists
• Influencing preventive aesthetic dermatology
• Offering our patients the most pioneering treatments that guarantee beautiful naturalness.
  
  

Laser technology: elimination of blemishes and skin lesions

Treatment with dermatological lasers makes it possible to remove sunspots, pigmented lesions, lesions derived from severe acne, close open pores, get rid of broken capillaries, destroy vascular lesions and allow for alterations caused by rosacea or couperose to be treated.

Thanks to the breakthrough brought about by dermatological lasers, the treatment of ageing on the face, neck, neckline and hands can be combated in a single session, acting on the main factors that age our skin such as blemishes, redness, spider veins, lack of tone and vitality, as well as wrinkles.

• Elimination of blemishes
  

  We use state-of-the-art technology to remove blemishes on the skin via the emission of fractionated energy that allows the function of the treatment to be sped up. We combine, depending on the nature of the blemish, IPL, picosecond, Q-Switched or CO2 lasers which applies a photothermal impact on pigments at different depths and intensities to fragment the blemish into small particles so that the body can eliminate them more quickly and naturally.
  
  

• Vascular lesion removal
  

  TAll vascular lesions that are observed on the skin (couperose, telangiectasias, spider veins, angiomas, ruby points, capillary malformations, etc.) are caused by a dilation in the blood vessels. Treatment with dye lasers, KTP and Nd:YAG emit energy that the haemoglobin contained in blood absorbs, causing the walls of the vessel to be reduced by the thermal effect without the surrounding skin being damaged.
  
  

• Treatment of bags
  

  EPeriocular CO2 laser therapy treats unsightly bags or the blood hyperpigmentation that is produced in the lower eyelid due to poor circulation. The energy that the CO2 laser projects breaks up the pigment that creates the bag immediately, and in a single session. The application of the CO2 laser does not require anaesthesia, or another type of sedation, and after the session the patient can return to their everyday activities.
  
  

• Clear+brilliant facial laser
  

  This is a proactive, preventive laser treatment, whose objective is to maintain clear skin and without imperfections which typically appear over the years. It therefore improves tone and texture, and it can be combined with other non-invasive rejuvenation techniques, such as medical high-intensity focused ultrasound (HIFU) or injections of botulinum toxin and hyaluronic acid.
  
  

• Laser Resurfacing
  

  Resurfacing or laser treatment of facial wrinkles is an innovative technique that makes it possible to completely remove mild or moderate wrinkles and to improve the appearance of the deepest ones. CO2 laser causes a controlled ablation of the epidermal surface, allowing for cellular renewal, and activates the natural production of collagen thanks to the fact that the energy that the CO2 laser emits is absorbed by the intracellular water, causing a vaporisation and generating levels of heat that activate the collagen fibres.

  Treatment is performed with local anaesthesia, lasts just an hour and a half and our patients can return to their daily lives in just five days. Facial flabbiness is also reduced with this treatment.

• Tattoo removal
  

  Advances in dermatological lasers offer the possibility of removingskin tattoos. Lasers such as the Q-switched laser or the Picosecond laser destroy excess pigmentwithout causing damage to the surrounding skin.

Chemical peels

Peeling is a non-invasive dermatological treatment indicated to improve the texture of all skin types. It consists of a deep exfoliation of the dermis due to the application of chemical substances that produce a considerable improvement in the imperfections of the skin tone, as well as in the appearance and skin elasticity, promoting the elimination of marks and blemishes, and achieving a greater unification in the skin's tone and texture.

Different peels are applied depending on the condition to be treated:

• • Salicylic acid peel

    To treat acne and lesions resulting from it, such as superficial scars and wrinkles. Salicylic acid has comedolytic (gets rid of blackheads) and keratolytic (removes dead cells) properties, and it regulates sebum typical of people who suffer from acne.
    
    

  • Melasma peel

    to combat patches on the skin, solar lentigines and melasmas of hormonal origin. Chemical exfoliation with glycolic, retinoic or kojic acid produces a lightening effect on the skin.
    
    

  • PRX-T33 peel

    Is a revitalising technique that stimulates the dullest skins. It combines traditional peel made of trichloroacetic acid (TCA) with hydrogen peroxide, which is why it is able to penetrate faster into the dermis, thereby activating the regenerative process of the skin without being aggressive with the epidermis. It is also a photo-sensitising technique which means it is possible to carry it out at any time of year.
    
    

  • Taleum peel

    This is a biostimulation and topical skin regeneration treatment indicated for skin prone to acne, hyperpigmentation, with couperose or scars, and photoaged skin. Its formulation made of mandelic, pyruvic, glycolic or salicylic acid revitalises the dermis and makes the skin glow.
    
    

  • Obagi Blue Peel

    This is a chemical peel for medical application designed by the renowned dermatologist Zein Obagi. This chemical exfoliation activates the natural processes of skin regeneration to obtain beautiful and healthy skin. The treatment is indicated for patients with distinct signs of facial ageing such as hyperpigmentation, mild wrinkles, flabbiness, scars, altered skin texture and lack of radiance.
    
    

  • M2Beaute revitalising eye contour peel

    Exfoliation exclusively for the eye contour area. It stimulates cell renewal, moisturises and softens the area. It reduces wrinkles and eye bags to restore the skin's glow.
    
    

  • Phenol peel

    To combat facial ageing. It is the only regenerative facial treatment that achieves rejuvenation without surgery since it reaches deeper layers in the dermis than other traditional peels. It is indicated for photoaged or pigmented skin, mature skin with deep wrinkles, dull skin without shine, or skin with noticeable lesions caused by acne.