IN-PATIENT DERMATOLOGY

The University of Miami School of Medicine, Department of Dermatology and Cutaneous Surgery has one of the largest in-patient dermatology service units in the United States . The unit is located at Cedars Medical Center on the medical campus and specializes in the treatment of severe skin diseases. Approximately 500 patients are admitted to the hospital during a calendar year. The diseases treated vary from psoriasis, atopic dermatitis, cutaneous lymphoma, severe infections of the skin, immunobullous disorders, and severe reactions to medicines such as toxic epidermal necrolysis. The dermatology unit has individual rooms and therapeutic modalities such as ultraviolet light therapy, photopheresis, and hydrotherapy.

WOUND HEALING PROGRAM

The department's wound healing program offers complete diagnostic and therapeutic care for the treatment of leg ulcers and other chronic refractory wounds. A state-of-the-art out-patient wound healing facility is augmented with the adjuvant inpatient care. Offered are a variety of treatments including medical, surgical and physical therapy, hyperbaric oxygen, hydrotherapy, electrical stimulation, physical modalities for healing, tissue-engineered skin therapy and skin grafting.

In addition, an active clinical trial program studying new wound healing therapies is available for selected candidates.

LASER THERAPY PROGRAM (ENGLISH/SPANISH)

Recent innovations in laser technologies now allow for the successful treatment of a variety of previously difficult-to-treat skin conditions. The University of Miami School of Medicine, Mohs/Laser Center, offers state-of-the-art lasers in the treatment of a variety of conditions including, but not limited to: hair removal, port wine stains, hemangiomas, tattoos, birthmarks, spider veins, facial and leg veins, pigmented growths such as freckles, nevus of ota/ito and café au lait macules, wrinkles/rhytides, scars, keloids, and destruction of growths such as viral warts and epidermal nevi. The full-time experienced staff assigned to the Center, coordinates laser treatments.

For further information or to arrange for a consultation, call Dr. Keyvan Nouri, Director of University of Miami Laser Center, 305-243-4183. Dr. Nouri is a member of the Hair Removal Journal (http://www.hairremovaljournal.org) as well as the Patient's Guide websites for Wrinkles, Stretch Marks, Collagen, Acne Scars, Age Spots and Freckles which offer information about the use of laser in treating these conditions..

PSORIASIS TREATMENT PROGRAM

The department has an active clinical program for the management of patients suffering from psoriasis. Members of the faculty are both familiar and comfortable using all of the existing modalities available for the care of patients with psoriasis. Patients can be managed with topical or systemic medications as an out-patient or, if necessary, in the hospital. Our in-patient service is the largest in the United States and is located at Cedars Medical Center where facilities are equipped with the newest equipment. Care is our first priority.

Our faculty are also experienced in the use of many of the treatments necessary for the management of severe psoriasis that may not be readily available outside of a major medical center. Patients can be managed with methotrexate, Soriatane, hydroxyurea, cyclosporine, CellCept, UVB, and PUVA, as well as the newer biologic agents such as Enbrel, Amevieve, Raptiva and Remicade. Sometimes it is advisable to combine or rotate these treatments to obtain maximal benefit for the patient.

MOHS MICROGRAFIC SURGERY

Mohs micrographic surgery is named for Frederick Mohs, a surgeon that developed the procedure in the 1950's. It is the most effective technique available to treat skin cancer. Performed as an out-patient procedure, Mohs Micrographic surgery entirely removes the affected area while sparing the surrounding healthy skin.

Mohs micrographic surgery is commonly used to remove large tumors, tumors in hard-to-treat places, recurrent tumors, and those occurring in areas where preservation of normal skin is essential (such as the tissue surrounding the eyes or nose). It is most commonly performed on basal cell and squamous cell carcinomas, and is useful on melanomas in some cases.

The University of Miami School of Medicine, Department of Dermatology and Cutaneous Surgery offers a state-of-the-art Mohs surgical unit at the Sylvester Comprehensive Cancer Center . Dr. Keyvan Nouri is the Director of Mohs Surgery and Director of the Mohs/Laser Center at the Sylvester Comprehensive Cancer Center .

MULTIDISCIPLINARY MELANOMA PROGRAM

The department has an active melanoma and cutaneous oncology program. Multidisciplinary monthly staff conferences and tumor board has representation from oncology, surgical oncology, pathology and all facets of dermatology. The tumor board is available as a service to the community and is at no charge. Dr. Elgart is the dermatology leader of this group and Dr. Lynn Feun of oncology serves as site disease group leader at the Sylvester Research Cancer Center . Dr. Robert Johr offers a computerized surveillance service for those at high risk for melanoma.

PHOTOTHERAPY

Phototherapy is the use of ultraviolet light, which is found in sunlight, for the treatment of skin disease. Although natural sunlight is sometimes used for certain diseases, artificially produced ultraviolet light is generally used as it is easily controlled, is available and is convenient and less time consuming for patients. The phototherapy equipment available in the department has capability of producing UVB and UVA. UVB is short wavelength UV that is often used in the hospital to treat psoriasis. UVA is longer wavelength UV used with the drug psoralen in the treatment referred to as PUVA and is generally used in an outpatient setting. In addition, narrow band UVB is now available.

Phototherapy is most frequently used to manage psoriasis. It is also helpful in the treatment of a multitude of other skin problems, including: cutaneous T cell lymphoma, vitiligo, lichen planus, granuloma annulare, pityriasis rosea, acne, generalized itching from various causes, diseases of the hands and feet, atopic and other types of eczema.

Phototherapy equipment is available at our private offices, the Miami Veterans Affairs Medical Center , Jackson Memorial Hospital Outpatient Clinics, and Cedars Medical Center . Treatment may be UV light alone or in-combination with other forms of treatment and must be individualized for each patient. George Elgart, M.D. oversees the phototherapy services.

Any of our faculty are available to discuss this program with interested patients. Please contact us at 305-243-6704.

DERMATOPATHOLOGY DIVISION

The University of Miami , School of Medicine has one of the longest standing dermatopathology programs in the country. Since March of 1965, at least one and frequently many faculty have participated in daily evaluation and sign out of dermatology cases. The division as currently has an approved dermatopathology training program and receives more than 25,000 specimens annually for review.

George W. Elgart, M.D., director of the dermatopathology program at the University of Miami , School of Medicine , is certified in dermatology, dermatopathology and immunodermatology. He has led this program since 1993 and has worked with residents, students, and dermatopathology fellows. Paolo Romanelli, M.D. is board certified in dermatology and dermatopathology and participates in daily evaluation and sign out of dermatology cases, as well as being actively involved in resident education.

Cases may be submitted for evaluation with routine cases usually completed in 24 hours.

TELEMEDICINE

Teledermatology consultations are provided to patients at Project Outreach, a comprehensive HIV+/AIDS University of Miami Clinic in Florida City, FL., sponsored by the University of Miami, School of Medicine's Comprehensive AIDS Program. The project outreach nurse takes digital camera still images of patients' skin problems. These images, along with the patient's history are sent to Dr. Anne Burdick via ISDN telephone lines to a dedicated computer for her review. Both the physicians and patients have found these "store and forward" tele-consultations to be very helpful clinically as well as being time and cost saving since patients can be spared the long trip to Jackson Memorial Hospital 's Dermatology Clinic.

HANSEN'S DISEASE

The University of Miami / Jackson Memorial Hospital Hansen's Disease Program is one of 11 federally funded programs in the United States . The Medical Director, Anne E. Burdick, M.D., M.P.H. treats patients with leprosy including those who do not have insurance. Collaborative research on the immunologic basis of this infectious disease is being conducted.