NORTH CAROLINA TRIANGLE’S PREMIER HEALTH PUBLICATION • WITH 70,000+ HEALTH-CONSCIOUS READERS BIMONTHLY

SOUTHERN DERMATOLOGY & SKIN CANCER CENTER
An Affiliate of Anne Arundel Dermatology

pdf of this article
 

For more information about skin conditions and their treatment, contact:


THE DERMATOLOGY & SKIN CANCER CENTER

Gregory J. Wilmoth, MD
Eric D. Challgren, MD
Margaret B. Boyse, MD
Laura D. Briley, MD
Tracey Cloninger, PA-C

Stephanie S. Pascale, FNP-C

4201 Lake Boone Trail, #200
Raleigh, NC 27607
Telephone: (919) 782-2152


THE SKIN RENEWAL CENTER AT SOUTHERN DERMATOLOGY

4201 Lake Boone Trail, #207
Raleigh, NC 27607
Telephone: (919) 863-0073

Essential Skin Care During a Pandemic

“I was struck a couple of months ago,” says Dr. Gregory Wilmoth of Southern Dermatology, “by a newspaper article suggesting that dermatologists were doing a disservice by staying open during the pandemic. Now, this was at the beginning of the crisis, at a time when emergency rooms were overflowing in New York and other states and the medical establishment was feeling overwhelmed. Nonetheless, it was an unfortunate suggestion that reflected a misunderstanding—maybe several misconceptions—about the nature and importance of dermatological care.

Dr. Wilmoth.

“The truth is, for most of our patients, skin care is essential—perhaps especially during this pandemic. Certainly, it’s likely that something like a removal of a wart or an elective cosmetic treatment can wait,” he observes. “But, for many of our patients, care should not be neglected—and COVID-19 makes that more difficult. That’s because many—such as those dealing with psoriasis, lupus, or cancer—are immuno-suppressed, and the people most at risk of the virus.”

That combination—of high-risk patients who also need ongoing care—notes Dr. Wilmoth, has posed special challenges for his practice. “Clearly, our first priority is to ensure that all our patients can receive necessary care safely. And, we have restructured our practice carefully to accomplish that—for even the most vulnerable patients.

“We have found,” he says, “that a combination of in-person and tele-health visits can work very successfully—to address the full range of issues our patients deal with. I’d acknowledge that dermatology is pretty much a hands-on practice, so there are certainly many things that can’t be done on-line. And, for something like examining an abnormal mole or a rash, we’ll need to see patients. At the same time, we’ve also found that there’s a great deal of routine care—such as consulting with patients to manage symptoms and medications—that can be done remotely.”

A Safe Healing Environment

For the patients they see in person, says Dr. Wilmoth, “we have done everything we can to ensure a safe environment. “First, of course, we comply with all WHO and CDC COVID-19 guidelines. Our staff and patients must wear masks, social distance, wash hands, and be screened for fever and flu symptoms. Other steps we’re taking is to clean all exam rooms—before and after each patient—with EPA registered disinfectants; and we’ve made the waiting rooms safe by eliminating magazines, pamphlets, and toys. Our website includes more details about the routine precautions we’re taking.”

Dr. Wilmoth explains that they also pay special attention to their high-risk patients, especially as numbers of COVID-19 cases are on the rise. “We encourage all high-risk patients to seriously consider whether they should come into the office. These are the patients who are older, who have underlying medical conditions that aren’t well controlled, such as chronic lung disease, moderate to severe asthma, diabetes, a heart condition, are immunocompromised, are undergoing dialysis, or have liver disease. That doesn’t mean they don’t need care or that we can’t help them. For those high-risk patients, we counsel them on the phone or through telemedicine and it it’s important for them to be seen, we take care to isolate them as much as possible.”

Dr. Wilmoth reports that telehealth consultations have been remarkably effective—and safe—in handling many cases. “We’ve been doing about 10 calls a day in our practice. The calls may just be a check-in for medication refills or management, failure of previous therapy, or diagnosis. I saw a gentleman this morning with psoriasis. His previous treatment wasn’t working well, so we were able to discuss what other options he may have and initiate those therapies through a telehealth visit. Patients can send us a photo of their problem, if the video feed doesn’t have great resolution. Usually, we can screen people rather rapidly, letting them know whether they should be seen immediately, or can wait till they feel comfortable coming into the office. In some cases, like teenagers with acne, they can be treated easily by telehealth.

“There are certain things, like warts,” he notes, “where I can give you some recommendations, but I can’t really do any kind of intervention. Those things, as well as skin cancer screenings, can’t be handled over the phone.”

Conditions Not to Be Ignored

Skin cancer issues, emphasizes Dr. Wilmoth, are examples of conditions not to be ignored, and deserve immediate attention. “If someone has any concern that they’ve got skin cancer, even sometimes waiting a few weeks can be the difference between a minor or major surgery. Any concerns regarding melanoma, changing moles, new brown or black spots, should be evaluated. And, of course, any tumorous growths that could be a squamous cell carcinoma, or any kind of bleeding lesions that may be basal cell carcinoma, should be evaluated promptly in the office.

“Another red flag—not to be ignored—is if a patient is having concerns regarding an infection,” he says. “Perhaps they have an abscess, an inflamed cyst, or concerns regarding cellulitis—something that’s hot, red, and warm. You don’t want to wait on those either—sores and concerns for cutaneous infections should be evaluated immediately.”

Regular maintenance, he says, is also important—despite the concerns about COVID-19. “For example, we are not recommending that patients stop their biologic therapy, or other immune suppressants, such as methotrexate, Imuran, Cellcept, prednisone, or cyclosporine, if they’re taking them for psoriasis, psoriatic arthritis, or lupus. These treatments should continue. If you develop an illness while taking them, call your prescribing physician at once.”