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Welcome to Digestive Medical Services, Inc.
Digestive Medical Services, Inc.
   

Laurence K. Entsuah M.D.
Board Certified Gastroenterologist
Fellowship Training: Georgetown University Hospital and National Institutes of Health


What is Verruca-Freeze®?

Verruca Freeze® is one of the coldest portable cryosurgical systems available. A 3-6 second spray of cryogen, freezing for 20-30 seconds, makes it a quick, easy and effective form of cryosurgery. With 2 forms of application- disposable CryoBuds® and reusable CryoCones®, Verruca Freeze® is the clear choice for all your cryosurgical needs.

The most recent cryosurgery textbooks state that -50°C is adequate to treat most benign skin lesions. Verruca-Freeze® delivers freezing temperatures of -70°C, exceeding the minimum recommended freezing temperatures. The FDA has cleared Verruca-Freeze® for removal of 21 types of lesions including: warts, plantar warts, venereal warts (condyloma acuminatum), seborrheic and actinic keratoses, achrochordon (skin tags), molluscum contagiosum, age spots, dermatofibroma, small keloids, granuloma annulare, porokeratosis plantaris, angiomas, lentigo maligna, keratoacanthoma, lentigo discreta, chondrodermatitis, epithelial nevus, leukoplakia and pyogenic granuloma. Lesion Descriptions

 

Verruca-Freeze Treatable Lesions

Warts
A range of different types of wart has been identified, varying in shape and site affected, as well as the type of human papilloma virus involved. These include:

•Common wart (Verruca vulgaris): a raised wart with roughened surface, most common on hands and knees.
•Flat wart (Verruca plana): a small, smooth flattened wart, flesh colored, which can occur in large numbers; most common on the face, neck, hands, wrists and knees.
•Filiform or digitate wart: a thread- or finger-like wart, most common on the face, especially near the eyelids and lips.
Planter Warts
•Plantar wart (Verruca pedis): a hard sometimes painful lump, often with multiple black specks in the center; usually only found on pressure points on the soles of the feet.
•Mosaic wart: a group of tightly clustered Plantar-type warts, commonly on the hands or soles of the feet.
Actinic Keratoses
An actinic keratosis site may appear on any sun-exposed area, such as the face, ears, neck, scalp, chest, backs of hands, forearms or lips. Sites commonly range between 2 and 6 millimeters in size, and can be dark or light, tan, pink, red, a combination of all these, or have the same pigment as the surrounding skin.

Seborrheic Keratoses
A seborrheic keratosis (also known as Seborrheic Verruca)is a noncancerous benign skin growth that originates in keratinocytes. Like liver spots, seborrheic keratoses is seen more often as people age. S.K. appears in various colors, from light tan to black. They are round or oval in shape, feel flat or slightly elevated (like the scab from a healing wound) and range in size from very small to more than 2.5 centimeters (1.0 in) across. They can resemble warts, though they have no viral origins. They can also resemble melanoma skin cancer, though they are unrelated to melanoma.

Achrochordon (Skin Tags)
Achrochordon is a small benign tumor that forms primarily in areas where the skin forms creases, such as the neck, armpit and groin. They may also occur on the face, usually on the eyelids. Acrochorda are harmless and typically painless, and do not grow or change over time. Though tags up to a half-inch long have been seen, they are typically the size of a grain of rice. The surface of an acrochordon may be smooth or irregular in appearance and is often raised from the surface of the skin on a fleshy stalk called a peduncle.

Molluscum Contagiosum
Molluscum Contagiosu is a viral infection of the skin or occasionally of the mucous membranes. This common viral disease has a higher incidence in children, sexually active adults, and those who are immunodeficient, and the infection is most common in children aged one to ten years old. MC can affect any area of the skin but is most common on the trunk of the body, arms and legs. It is spread through direct contact or shared items such as clothing or towels. Molluscum contagiosum lesions are flesh-colored, dome-shaped and pearly in appearance. They are often 1–5 millimeters in diameter, with a dimpled center. They are generally not painful, but they may itch or become irritated. Picking or scratching the bumps may lead to further infection or scarring. In about 10% of the cases, eczema develops around the lesions. They may occasionally be complicated by secondary bacterial infections. In some cases the dimpled section may bleed once or twice.

Age Spots
Age spots are also known as sun spots, liver spots, Lentigos, or Lentigines. These lesions are flat, tan, brown or dark brown spots on sun-exposed skin. As people age, sun spots most commonly appear on the backs of the hands, the forearms, neck, chest and face. Sun spots are associated with cumulative sun exposure. The pigment producing cells in the skin (called melanocytes) are activated to produce more pigment (melanin) by ultraviolet rays. While these spots are not themselves cancerous, you may be at risk for skin cancer if you have them.

Condyloma
Condyloma (or Genital Warts) is a highly contagious sexually transmitted disease caused by some sub-types of human papillomavirus (HPV). It is spread through direct skin-to-skin contact during oral, genital, or anal sex with an infected partner. Warts are the most easily recognized symptom of genital HPV infection. Genital warts often occur in clusters and can be very tiny or can spread into large masses in the genital or penis area. In other cases they look like small stalks. In women they occur on the outside and inside of the vagina, on the cervix , the womb (uterus) or around (or inside) the anus. They are approximately as prevalent in men but the symptoms may be less obvious. When present, they usually are seen on the tip of the penis. They also may be found on the shaft of the penis, on the scrotum, or around (or inside) the anus. Rarely, genital warts also can develop in the mouth or throat of a person who has had oral sex with an infected person.

Dermatofibroma
A dermatofibroma is a round, brownish to red-purple growth commonly found on the legs. It is also called a histiocytoma. It can occur anywhere, but seems to favor exposed areas. Dermatofibromas feel like hard lumps under the skin. They're like an iceberg in that there is more under the skin than seen on the surface. Often these start out as red, turning later to brown, and sometimes itch. They probably are a reaction to a minor injury, such as insect bites or thorn pricks. Most commonly found on the leg.

Small Keloids
A keloid (aka keloidal scar), is a type of scar, which depending on its maturity, is composed of mainly either type III (early) or type I (late) collagen. It is a result of an overgrowth of granulation tissue (collagen type III) at the site of a healed skin injury which is then slowly replaced by collagen type I. Keloids are firm, rubbery lesions or shiny, fibrous nodules and can vary from pink to flesh-colored or red to dark brown in color. A keloid scar is benign, non-contagious, and sometimes accompanied by severe itchiness and pain, or changes in texture. In severe cases, it can affect movement of the surrounding skin.

Granuloma Annulare
Granuloma annulare may be pearly white, skin-colored, red or purple. It is most often in an isolated area, but may appear as several "bumps" spread over the body. Beginning as a round, firm, smooth bump, the lesion becomes a circular ring with a clear center, which resembles the shape of a doughnut. While granuloma annulare can develop on any part of the skin it appears most often on the tops of the hands and feet, elbows and knees. It usually does not peel or itch and for that reason, can often go unnoticed.

Porokeratosis Plantaris
Porokeratosis plantaris, palmaris, et disseminata: A very rare disorder involving progressive skin thickening that starts with the palms and soles.

Angiomas
An angioma is any benign growth that consists of small blood vessels. These tumors can be located anywhere on the body, and some of the different types include spider angiomas, cherry angiomas and angiokeratomas. Cherry angiomas and are due to aging and do not have any known significance. Spider angiomas are more common in childhood and during pregnancy, and a few can appear on anyone. When present in large numbers, they may warn of liver damage. Angiokeratomas are an overgrowth of blood vessels and skin cells.

Lentigo Maligna
Lentigo maligna is the non-invasive skin growth that some pathologists consider to be a melanoma-in-situ. A few pathologists do not consider lentigo maligna to be a melanoma at all, but a precursor to melanomas. Once a lentigo maligna becomes a lentigo maligna melanoma, it is treated as if it were an invasive melanoma.

Keratoacanthoma
Keratoacanthoma (KA) is a growth that is relatively common, benign and most commonly found in elderly light-skinned individuals. It is more common with individuals having an increased degree of sun exposure and is often found at sites of previous injury or trauma. It is not associated with internal malignancy, except in rare instances where multiple keratoacanthomas are associated with a disease process called Muir-Torre syndrome. KA is a rapidly growing growth on the skin that expands from 1-2mm to 1-3cm over a few weeks, and develops into a smooth dome-shaped growth with a central keratin core. If untreated, KA's usually stop growing around 6-8 weeks, stay dormant and unchanging for 2-6 weeks and then finally spontaneously regress slowly over 2 to 12 months frequently healing with scarring. KA's are most commonly found in the hands, arms, trunk and face.

Lentigo
A lentigo is a small, sharply circumscribed, pigmented macule surrounded by normal-appearing skin. Histologic findings may include hyperplasia of the epidermis and increased pigmentation of the basal layer. A variable number of melanocytes are present; these melanocytes may be increased in number, but they do not form nests. Lentigines may evolve slowly over years, or they may be eruptive and appear rather suddenly. Pigmentation may be homogeneous or variegated, with a color ranging from brown to black.

Chondrodermatitis
Is a small, nodular, tender, chronic inflammatory lesion occurring on the helix of the ear, occurring most often in men.

Epithelial Nevus
Epidermal nevi are hamartomas arising from the embryonic ectoderm whose pluri potentialcells differentiate not only into keratinocytes but also into the cell forming epidermal appendages. The lesions may be deeply or slightly pigmented, have either a unilateral or bilateral distribution, and often favour the extremities in what appears to be a dermatomal distribution. They may also appear on the oral mucosa and ocular conjunctiva. Onset is usually at birth but may also occur in the second or third decade.

Leukoplakia
Leukoplakia is a clinical term used to describe patches of keratosis. It is visible as adherent white plaques or patches on the mucous membranes of the oral cavity, including the tongue. The clinical appearance is highly variable. Leukoplakia is not a specific disease entity, but is diagnosis of exclusion.

Pyogenic Granuloma
Pyogenic granuloma is a relatively common skin growth. It is usually a small red, oozing and bleeding bump that looks like raw hamburger meat. It often seems to follows a minor injury and grows rapidly over a period of a few weeks to an average size of a half an inch. The head, neck, upper trunk and hands and feet are the most commonly sites; It can also be found on the lips, tongue and inner cheek. Poor oral hygiene or trauma are usually precipitating factors. It is seen most often in children, pregnant women and those taking the drugs Indinavir, Soriatane, Accutane and oral contraceptives.

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COLON CANCER SCREENING

Laurence K. Entsuah M.D. Board Certified Gastroenterologist
Fellowship Training: Georgetown University Hospital and National Institutes of Health
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