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Advancing Care - August 2022

advancing care

Spot the warning signs of skin cancer

Summertime is sun time. We may spend our days soaking up the rays, but it’s important to learn to spot any potential problems on our skin. Skin cancer is the most common cancer in the U.S, and early detection can offer more treatment options.

There are three main types of skin cancer and each can look different. We turned to Mary Ann Bentz, MD, chief of dermatology at Lawrence + Memorial Hospital, and Jonathan Leventhal, MD, director of the Oncodermatology Clinic in the Melanoma Program at Smilow Cancer Hospital, to learn more.

Basal and squamous cell skin cancers are the most common, according to Dr. Bentz. “These cancers are most often found in areas exposed to the sun, such as the head, lips, ear, neck and arms, but they also can occur elsewhere,” she said. Added Dr. Leventhal, “Patients with sunburns are at increased risk for developing skin cancer.”

Warning signs of basal cell skin cancer can include a pink pimple-like growth on the skin, or a sore that doesn’t heal or bleeds. Squamous cells can be fast growing, painful to touch and look like a scaly, crusty or wart-like lesion. Dr. Bentz said it’s important to treat these types of skin cancers promptly. “Squamous cell cancers – particularly on the lips and ears -- can spread to the lymph nodes,” she said.

Melanoma, the third type of skin cancer, is less common. It accounts for approximately 1 percent of skin cancers (although studies indicate that the risk of melanoma seems to be increasing in people under 40, especially women. It can be more serious because it is more likely to spread to other parts of the body if not caught in the early stage, according to Dr. Leventhal.

Melanomas most often appear on areas that have been exposed to the sun, “especially your back, legs, arms and face,” Dr. Leventhal said. However, melanomas can also occur in areas that don't receive much sun exposure, such as the soles of your feet, palms of your hands and fingernail beds. Signs of melanomas include a dark spot that changes in size, shape or color or starts to bleed or itch. Risk factors include having many moles or a family history of skin cancer or certain genetic syndromes. Exposure to tanning beds also increases the risk of melanoma.

Dr. Bentz recommends regular skin self-exams to check for signs of skin cancer. “Look with intention,” Dr. Bentz said. “Get a hand mirror and use it to look at the places you can’t readily see – like your back and the backs of your legs and neck.” If you have risk factors, schedule an annual skin check with your dermatologist.

Dr. Leventhal and Dr. Bentz recommend these tips to protect your skin while outdoors:

  • Seek shade.
  • Wear protective clothing — including a long-sleeved shirt, pants, a wide-brimmed hat and sunglasses with UV (ultraviolet) protection.
  • Apply a broad-spectrum, water-resistant sunscreen with SPF 50 or higher to all skin not covered by clothing. Reapply sunscreen every three hours.

Being vigilant is the most important thing for your skin, said Dr. Bentz. “If you think you have reason to be worried – if you see something that isn’t healing or that looks unusual to you – call your doctor,” she said. “Is it new? Is it growing? Is it refusing to heal? Don’t wait too long. It can make a difference.”

Summer safety: Avoid a visit to the ED

Sprains, fractures, allergic reactions and heat-related illnesses all bring patients to the emergency department during the summer months. Proper prevention can help keep you out of the hospital.

Craig Mittleman, MD, chair of the Emergency Department at Lawrence + Memorial Hospital, offers tips for staying safe all summer. 

Symptoms of heat stroke

According to Dr. Mittleman, it’s important to pay attention to early warning signs of heat-related illnesses such as heat stroke. If you are thirsty, drink plenty of fluids and get out of the heat, he advises. Heat stroke happens when a person’s body temperature rises above a safe level and stays there. This is a very serious illness that can become deadly.

Signs of heat stroke can include:

  • Nausea
  • Vomiting
  • Dizziness
  • Confusion
  • Lack of sweat and skin that is dry to the touch

Someone who is experiencing heat stroke might not realize they need help. Don’t delay. Get them to the emergency room. Also, check on elderly neighbors during a heat wave to ensure their safety.

Sunburns

Sunburn often appears within a few hours of being in the sun too long. You can usually treat mild sunburns by yourself at home:

  • Cover your sunburned skin while it heals, especially when outside.
  • Drink water to avoid dehydration.
  • Leave blisters alone until they heal. Don’t peel skin — let it come off on its own.
  • Take a cool bath or shower. Try a bath with oatmeal or baking soda to soothe sore skin.
  • Take NSAIDs (non-steroidal anti-inflammatory drugs) for pain relief.
  • Use topical cooling and hydrating gels, creams and ointments, including hydrocortisone cream or aloe vera gel.

More severe sunburns may require medical attention. Seek immediate care if you are sunburned and you experience:

  • A fever over 103° F (39.4° C) with vomiting
  • Confusion
  • Signs of infection, such as blisters with pus or streaks
  • Dehydration
  • Cold skin, dizziness or faintness
  • Blisters on the face, hands or genitals
  • Severe swelling of the affected area
  • Worsening pain, headache, confusion, nausea, fever or chills
  • Symptoms that get worse despite home treatments
  • Eye pain or vision changes

Poison ivy

When it comes to poison ivy, remember the rhyme, “Leaves of three, let it be!” Avoidance is the best way to prevent a rash from this itch-inducing plant. Poison ivy grows as a vine or small shrub with compound leaves that occur in threes.

If you do get poison ivy:

  • Do not scratch the infected area
  • Wash your clothes and towels
  • Try over-the-counter lotions or steroid creams

Call your primary care doctor if the rash spreads to your face, eyes or groin.

Bee stings and bug bites

If you have a known allergy that has caused anaphylaxis or hospitalization, always keep an EpiPen nearby, said Dr. Mittleman. If you are not allergic to bee stings but get stung, remove the stinger by scraping over it with your fingernail or a piece of gauze. Don’t use tweezers. Squeezing the stinger can cause more venom to release into your skin. Clean the area with soap and water, apply ice to reduce swelling, and consider taking over-the-counter pain medication such as acetaminophen or ibuprofen.

“Remember that just because you’ve been stung by bees in the past and did not have a reaction, it doesn’t mean that you may not get a more severe reaction on a subsequent bee sting. There are many different types of bees and there are many different types of toxins,” Dr. Mittleman said.

Call 911 if you get:

  • Hives
  • Lip swelling
  • Tongue swelling

Don’t drive yourself to the hospital. Your reaction could intensify while you’re driving, and you could get into an accident.

The summer months also come with the risk of mosquito-borne illnesses, including eastern equine encephalitis virus (EEEV), a rare illness that can cause neurological issues. To protect yourself from mosquito bites, wear light, protective clothing, use bug spray and use more caution in the late afternoon and evening when bugs are more active.

Ticks are also very common in the Northeast. Use tick repellant for pets, wear protective clothing and always do a skin check after hiking or gardening.

ER, urgent care or video visit? How to know where to go

Need care right away? We can help with everything from allergies and sprains to emergency symptoms for heart attack and stroke. While emergency departments provide care for life-threatening injuries or illnesses, walk-in/urgent care centers offer convenient, professional medical attention for non-life-threatening conditions including the flu and common cold to broken bones, sprains, cuts, allergic reactions, and minor burns, and hundreds of other conditions. Avoid long wait times at the emergency department and get the care you need at one of our walk-in or urgent care centers located throughout Connecticut, including New London, Niantic, Stonington, Uncasville, Groton and Norwich.

For minor medical concerns, you can receive care online using Video Care OnDemand.

Not sure where to go? Explore your care options here

If you do choose to go to the Emergency Department, our wait time clocks help make sure you get the care you need as quickly as possible.

Share your story with us!

Yale New Haven Health recently launched Patient Story, a MyChart tool that gives patients the option of sharing information about their lives beyond what is in their medical record.

With Patient Story, you can complete a short questionnaire about your lifestyle, including hobbies and interests, religious or cultural traditions, and  any concerns you may have about your care. Patient Story offers your provider a more holistic view of who you are.

Participation in Patient Story is voluntary, and you do not have to answer every question.

To complete the Patient Story questionnaire, log into your MyChart account and choose “Patient Story” on your home page. Don’t have MyChart? Sign up here.

Questions about cancer? “Yale Cancer Answers”

“Yale Cancer Answers” is a weekly radio program produced by the Yale Cancer Center that provides listeners with the most up-to-date information on cancer screening, detection, treatment, and prevention. The program is hosted by Anees Chagpar, MD, professor, Department of Surgery, Yale School of Medicine. Each week guest cancer specialists talk about the most recent advances in cancer therapy, prevention and supportive care.

“Yale Cancer Answers” airs Sundays at 7:30 pm on WNPR. Tune in live online at wnpr.org, or browse the podcast episodes (Yale Cancer Answers < Yale Cancer Center) and listen to a specific topic. If you have a question for possible use during a show, email [email protected].

Find a Doc at L+M or WH

Are you looking for a physician? Call 833-346-3637 or visit our website’s Find a Doctor feature for information on physician specialties, office hours and locations as well as insurance plans accepted. Many of our physician practices offer telehealth video visits for your convenience.

Billing questions?

Yale New Haven Health offers financial counseling to patients and families. Spanish-speaking counselors are also available. To make an appointment with a financial counselor, call 855-547-4584.