Conditions We TreatConditions We Treat

Wall Street Dermatology evaluates and treats the conditions below at its Financial District office. Dr. Julia Tzu is triple board-certified in dermatology, dermatopathology and Mohs micrographic surgery. Each page sets out the condition’s presentation, its causes, how it is diagnosed, and what treatment involves.

Skin cancer is the most common cancer in the United States, and nearly all of it is curable when caught early. Dr. Tzu is board certified in dermatopathology and in Mohs micrographic surgery, so a lesion biopsied here is read, and where indicated excised, by the same physician.

• Cutaneous malignancy Skin Cancer Abnormal growth of skin cells, most often on skin exposed to ultraviolet radiation over many years. The most common cancer of any kind. Common signs New growth or spot that changes in size, shape, or color · A sore that does not heal or heals and returns · Pearly or waxy… Learn more →
• Keratinocyte carcinoma Basal Cell Carcinoma The most common skin cancer, roughly 3.6 million US cases a year. It arises in the basal layer and rarely metastasizes. Common signs Pearly or waxy bump, often with visible blood vessels · Flat, flesh-colored, pink, or brown scar-like lesion · Open sore that… Learn more →
• Keratinocyte carcinoma Squamous Cell Carcinoma The second most common skin cancer. Unlike basal cell carcinoma it can invade deeper structures and reach the lymph nodes. Common signs Red, scaly patch that may crust or bleed · Raised, firm bump with rough or scaly surface · Open sore that doesn’t heal or… Learn more →
• Melanocytic malignancy Melanoma The most serious skin cancer, arising from melanocytes. Detected before it spreads, five-year survival is 99 percent. Common signs Asymmetrical mole (one half differs from the other) · Border irregularity (ragged, notched, or blurred edges) · Color… Learn more →

Cutaneous malignancy

Abnormal growth of skin cells, most often on skin exposed to ultraviolet radiation over many years. The most common cancer of any kind.

Common signs New growth or spot that changes in size, shape, or color · A sore that does not heal or heals and returns · Pearly or waxy…

Keratinocyte carcinoma

The most common skin cancer, roughly 3.6 million US cases a year. It arises in the basal layer and rarely metastasizes.

Common signs Pearly or waxy bump, often with visible blood vessels · Flat, flesh-colored, pink, or brown scar-like lesion · Open sore that…

The second most common skin cancer. Unlike basal cell carcinoma it can invade deeper structures and reach the lymph nodes.

Common signs Red, scaly patch that may crust or bleed · Raised, firm bump with rough or scaly surface · Open sore that doesn’t heal or…

Melanocytic malignancy

The most serious skin cancer, arising from melanocytes. Detected before it spreads, five-year survival is 99 percent.

Common signs Asymmetrical mole (one half differs from the other) · Border irregularity (ragged, notched, or blurred edges) · Color…

Facial lines begin as dynamic rhytides produced by repeated muscle contraction, and become static as dermal collagen and elastin decline. Treatment differs depending on which stage a line has reached.

• Cutaneous photoaging Wrinkles The creases, folds and ridges that develop in skin over time. Fine wrinkles measure under a millimeter; coarse wrinkles a millimeter or more. Common signs Fine lines appearing around the eyes (crow’s feet) · Horizontal lines across the forehead · Vertical lines between the… Learn more →
• Dynamic rhytides Forehead Wrinkles Horizontal forehead lines and vertical glabellar lines, produced by the frontalis, corrugator and procerus muscles. Common signs Horizontal lines running across the forehead · Vertical lines between the eyebrows (glabellar region) · Lines that deepen… Learn more →
• Dynamic rhytides Crow’s Feet Lateral canthal lines radiating from the outer corners of the eyes, produced by repeated orbicularis oculi contraction. Common signs Fine lines radiating from outer eye corners · Lines that fan outward when smiling or squinting · Creases visible even when… Learn more →

Cutaneous photoaging

The creases, folds and ridges that develop in skin over time. Fine wrinkles measure under a millimeter; coarse wrinkles a millimeter or more.

Common signs Fine lines appearing around the eyes (crow’s feet) · Horizontal lines across the forehead · Vertical lines between the…

Dynamic rhytides

Horizontal forehead lines and vertical glabellar lines, produced by the frontalis, corrugator and procerus muscles.

Common signs Horizontal lines running across the forehead · Vertical lines between the eyebrows (glabellar region) · Lines that deepen…

Lateral canthal lines radiating from the outer corners of the eyes, produced by repeated orbicularis oculi contraction.

Common signs Fine lines radiating from outer eye corners · Lines that fan outward when smiling or squinting · Creases visible even when…

Discoloration results from melanocytes depositing excess melanin in a localized area. Ultraviolet exposure and hormonal signaling are the usual drivers, and both recur without photoprotection.

• Pigmentary disorder Melasma Brown or gray-brown patches across the cheeks, forehead and upper lip, driven by hormonal signaling combined with light exposure. Common signs Brown or gray-brown patches on the face · Symmetric pattern on both sides of the face · Patches with well-defined or blurry… Learn more →
• Pigmentary disorder Hyperpigmentation Any patch darker than surrounding skin, where melanocytes have deposited excess melanin. Occurs in every skin type. Common signs Patches or spots darker than surrounding skin · Flat, darkened areas of various sizes · Brown, tan, or gray-brown… Learn more →

Pigmentary disorder

Brown or gray-brown patches across the cheeks, forehead and upper lip, driven by hormonal signaling combined with light exposure.

Common signs Brown or gray-brown patches on the face · Symmetric pattern on both sides of the face · Patches with well-defined or blurry…

Any patch darker than surrounding skin, where melanocytes have deposited excess melanin. Occurs in every skin type.

Common signs Patches or spots darker than surrounding skin · Flat, darkened areas of various sizes · Brown, tan, or gray-brown…

Most growths in this group are benign and need no treatment at all. Excision is indicated for symptomatic irritation, recurrent inflammation, or appearance, and is performed under local anesthesia. Moles are the exception that is watched rather than removed: a nevus that changes in size, shape, or color should be examined promptly.

• Benign melanocytic lesion Moles Melanocytic nevi: benign growths where pigment cells cluster. Most adults carry between 10 and 40 of them. Common signs Round or oval shape with smooth, distinct edges · Uniform color ranging from pink, tan, brown, to black · Flat or raised… Learn more →
• Benign soft-tissue tumor Lipomas A benign growth of fatty tissue under the skin, affecting roughly one person in a thousand. Common signs Soft, doughy lump under the skin · Easily movable with slight finger pressure · Rubbery texture (not hard) Learn more →
• Epidermal inclusion cyst Sebaceous Cyst A sac beneath the skin filled with keratin and dead skin cells, producing a firm, slow-growing lump. Common signs Small, round, movable bump under the skin · Slow-growing lump · Skin-colored, whitish, or yellowish appearance Learn more →
• Epidermal inclusion cyst Epidermoid Cyst The same lesion under its more accurate name: epidermal cells trapped below the surface, filling a sac with keratin. Common signs Round, dome-shaped bump under the skin · Firm but movable lump · Skin-colored, whitish, or yellowish color Learn more →
• Benign epidermal growth Seborrheic Keratosis Among the most common benign skin growths, appearing from middle age onward. Waxy and stuck-on in appearance. Common signs Round or oval waxy or rough bump · Stuck-on or pasted-on appearance · Flat or slightly raised with warty surface Learn more →

Benign melanocytic lesion

Melanocytic nevi: benign growths where pigment cells cluster. Most adults carry between 10 and 40 of them.

Common signs Round or oval shape with smooth, distinct edges · Uniform color ranging from pink, tan, brown, to black · Flat or raised…

Benign soft-tissue tumor

A benign growth of fatty tissue under the skin, affecting roughly one person in a thousand.

Common signs Soft, doughy lump under the skin · Easily movable with slight finger pressure · Rubbery texture (not hard)

Epidermal inclusion cyst

A sac beneath the skin filled with keratin and dead skin cells, producing a firm, slow-growing lump.

Common signs Small, round, movable bump under the skin · Slow-growing lump · Skin-colored, whitish, or yellowish appearance

The same lesion under its more accurate name: epidermal cells trapped below the surface, filling a sac with keratin.

Common signs Round, dome-shaped bump under the skin · Firm but movable lump · Skin-colored, whitish, or yellowish color

Benign epidermal growth

Among the most common benign skin growths, appearing from middle age onward. Waxy and stuck-on in appearance.

Common signs Round or oval waxy or rough bump · Stuck-on or pasted-on appearance · Flat or slightly raised with warty surface

Superficial vessels become visible when they weaken and dilate. On the face they cluster around the nose, cheeks and chin; on the legs they follow venous pressure.

• Telangiectasia Broken Blood Vessels Telangiectasias: small vessels beneath the skin that have become visible. On the face they cluster around the nose, cheeks and chin. Common signs Thin red, blue, or purple visible lines on skin · Spider web or tree branch-like patterns · Clusters of small visible blood… Learn more →
• Telangiectasia Spider Veins Small damaged vessels visible below the skin surface as thin red, blue or purple lines, often branching into a web-like pattern. Common signs Thin red, blue, or purple visible lines · Web-like or branching patterns under skin · Flat appearance (not raised like… Learn more →

Telangiectasia

Telangiectasias: small vessels beneath the skin that have become visible. On the face they cluster around the nose, cheeks and chin.

Common signs Thin red, blue, or purple visible lines on skin · Spider web or tree branch-like patterns · Clusters of small visible blood…

Small damaged vessels visible below the skin surface as thin red, blue or purple lines, often branching into a web-like pattern.

Common signs Thin red, blue, or purple visible lines · Web-like or branching patterns under skin · Flat appearance (not raised like…

Three conditions that sit outside the categories above. Each is evaluated and treated at the Financial District office.

• Benign epidermal growth Dermatosis Papulosa Nigra Benign papules across the face and neck, reaching 35 percent prevalence among Black Americans. Common signs Small, round or oval light brown to black papules (bumps) · Smooth or slightly rough texture · Typically 1-5 millimeters in… Learn more →
• Acquired soft-tissue defect Split Earlobe A tear or separation through earlobe tissue, nearly always at a piercing, from gradual stretching or a sudden pull. Common signs Complete or partial tear through the earlobe · Elongated or stretched piercing hole · Inability to wear earrings securely Learn more →
• Alopecia Hair Loss Alopecia. Androgenetic alopecia is by far the most common form, affecting an estimated 80 million people in the United States. Common signs Gradual thinning on top of head · Receding hairline (common in men) · Widening part (common in women) Learn more →

Benign papules across the face and neck, reaching 35 percent prevalence among Black Americans.

Common signs Small, round or oval light brown to black papules (bumps) · Smooth or slightly rough texture · Typically 1-5 millimeters in…

Acquired soft-tissue defect

A tear or separation through earlobe tissue, nearly always at a piercing, from gradual stretching or a sudden pull.

Common signs Complete or partial tear through the earlobe · Elongated or stretched piercing hole · Inability to wear earrings securely

Alopecia

Alopecia. Androgenetic alopecia is by far the most common form, affecting an estimated 80 million people in the United States.

Common signs Gradual thinning on top of head · Receding hairline (common in men) · Widening part (common in women)

If a lesion has changed, an in-person examination is the fastest way to establish what it is.