The Stanford Blistering Disease Clinic is dedicated to the diagnosis and treatment of adult patients with inherited blistering disorders such as epidermolysis bullosa and Hailey-Hailey disease, as well as acquired blistering disorders such as, pemphigus subtypes, bullous and cicatricial pemphigoid, epidermolysis bullosa acquisita, porphyria cutanea tarda, linear IgA disease, dermatitis herpetiformis among others. The multidisciplinary clinic interfaces as needed with ophthalmology, gastroenterology, endocrinology, ENT, hematology and oral medicine to provide comprehensive care to its patients. The clinic has special expertise in difficult to diagnose and/or treat patients. Advanced diagnostic techniques include direct and indirect immunoflourescent microscopy of normal and salt split skin substrates. Additional tests such as immunoblotting, and ELISA assays are also performed. Advanced therapeutic techniques include photopheresis, plasmapheresis, IV cytoxan and IV immunoglobulin.
Multidisciplinary Cutaneous Lymphoma Clinic
The Stanford Multidsciplinary Cutaneous Lymphoma clinic (MCLC) offers expert treatment for patients with cutaneous lymphomas, including mycosis fungoides, Sezary syndrome, CD30+ lymphoproliferative disorders (lymphomatoid papulosis and anaplastic large cell lymphoma), subcutaneous panniculitis-like T-cell lymphoma, gamma-delta T-cell lymphoma, CD8+ aggressive epidermotropic T-cell lymphoma, NK/T-cell lymphoma, other unspecified cutaneous peripheral T-cell lymphomas, and cutaneous B-cell lymphomas. The physicians subspecialize in treating these types of cancers, and have extensive expertise in handling the most complicated cases. Care among specialists is tightly integrated. The MCLC is a national leader in clinical/translational research and treatment of patients with cutaneous lymphomas. In operation for over 30 years at Stanford, the MCLC (similar to a tumor board) is held twice weekly and patients are co-evaluated and co-managed by cutaneous, medical, and radiation oncologists, and pathologists who each have expertise in cutaneous lymphoma. Stanford is unique in offering this interdisciplinary care to provide the most comprehensive and optimal care for patients with this very rare group of lymphomas.
Mohs and Dermatologic Surgery
The Mohs and Dermatologic Surgery Clinic at Stanford is a nationally recognized leader in skin cancer management, Mohs micrographic surgery and other dermatologic procedures. The clinic features the latest research and approaches including techniques in basic excisional surgery as well as complex surgical closures such as flaps and grafts. Opportunities for extensive exposure to Mohs micrographic surgery are also provided as part of the surgical program.
The dermatopathology rotation is intended to build upon one’s fund of knowledge in dermatopathology through examination, clinical correlation, and interpretation of dermatopathologic material. The dermatology resident is expected to recognize the major patterns of inflammatory and neoplastic skin disease, construct a list of differential diagnostic possibilities, and arrive at a final diagnosis. Ancillary diagnostic techniques, as pertains to dermatopathology (including immunofluorescence, electron microscopy, immunophenotyping, and molecular diagnostics), are also reviewed.
Laser and Aesthetic Dermatology Clinic
The Laser and Aesthetic Dermatology Clinic at Stanford University provides cosmetic procedures including facial resurfacing and rejuvenation, acne scar treatment, botulinum toxin and filler injections, chemical peels, laser hair removal, laser and injectable vein treatments, intense pulsed light therapies, scar revisions, and other cosmetic skin surgeries. Residents participate in evaluation and treatment of patients both in the main (daily) laser and aesthetic clinic and in a dedicated weekly resident clinic.
The Pediatric Dermatology Clinic meets daily. Children are referred to our pediatric dermatologists for common skin conditions as well as complicated and rare skin diseases. The Pediatric Dermatology rotation includes experience in our regular Epidermolysis Bullosa Clinic, Vascular Anomalies Clinic, and Genetic Skin Disease Clinic. Each of these specialty clinics employs a multidisciplinary teamwork approach where the dermatology group facilitates care with a team of representatives from other subspecialties. There are multiple procedure clinics each month including excisions and ablative and non-ablative lasers. The pediatric dermatology consult resident and the pediatric dermatologist on-call also evaluate and treat pediatric inpatients at the Lucile Packard Children's Hospital at Stanford.
Pigmented Lesion and Melanoma Clinic
Stanford Dermatology has a longstanding commitment to providing multidisciplinary care for patients with pigmented lesions (atypical nevi) and melanoma of all stages, including cutaneous (skin) melanoma and metastatic disease.The Pigmented Lesion and Melanoma Program is housed in the Stanford Cancer Center in Palo Alto (900 Blake Wilbur, 3rd Floor Cancer Center Annex), with a satellite presence at the Cancer Center South Bay in San Jose. Simultaneously-run melanoma clinics in cutaneous, surgical, and medical oncology on Wednesdays in the Stanford Cancer Center, Blake-Wilbur-3 promote communication among specialists to provide a comprehensive, multidisciplinary “tumor board” approach for melanoma patients across the disease spectrum. Additional medical oncology clinics focusing on novel therapies and clinical trials for patients with advanced melanoma occur throughout the week.
The Pigmented Lesion and Cutaneous Melanoma Program employs photographic and dermoscopic imaging techniques to assist in the early detection of cutaneous melanoma and monitor individuals at increased risk based on their nevus phenotype. Stanford is an active participant in the Eastern Cooperative Oncology Group (ECOG)-ACRIN melanoma trials and in the melanoma prevention/chemoprevention efforts of the national Melanoma Prevention Working Group. The multidisciplinary melanoma clinic meets weekly and collaborates with other California-based academic melanoma centers in patient management and clinical trials.
Autoimmune Skin Disease Clinic
The Autoimmune Skin Diseases Clinic at Stanford provides multidisciplinary expertise in the care of patients with dermatomyositis, scleroderma, lupus and other autoimmune diseases affecting the skin and/or internal organs. All patients are evaluated concurrently by both our dermatology and rheumatology physicians who have a particular expertise in rheumatic skin diseases. Our physicians work closely with other Stanford services such as pulmonary medicine, gastroenterology, cardiology, physical therapy, and pain services, as appropriate, to provide comprehensive systemic care for our patients. We employ advanced serologic testing to provide up to date information for our patients regarding their diagnosis and prognosis. Our physicians employ all modes of topical and systemic therapy treatment, and we serve as a large referral center of expertise for scleroderma and dermatomyositis. Our clinic operates in the setting of an active research program. Patients are evaluated and, if appropriate, are given opportunity to participate in cutting-edge clinical trials in scleroderma, dermatomyositis, lupus, and other diseases.
The mission of the Stanford Supportive Dermato-Oncology Clinic is to serve the dermatologic needs of cancer patients. Located within the Stanford Cancer Center, the clinic runs daily, in parallel with multiple oncology specialty clinics, to deliver timely and efficient access for patients who develop skin conditions while undergoing cancer treatment. Prompt recognition and treatment of cutaneous complications of cancer therapy is critical in order to minimize skin-related interference to a patient's treatment course and to increase the quality of life of a cancer patient. The Supportive Dermato-Oncology Clinic aims to provide accurate diagnosis and prompt management of cutaneous complications of cancer therapy, including but not limited to:
Chemotherapy-related skin rashes
Skin infections arising in the immunocompromised state of cancer diagnosis and cancer therapy
Involvement of the skin by systemic cancer
Hair and nail changes due to cancer therapy
Graft-versus-host-disease secondary to hematopoietic stem cell transplantation
Skin Cancer Genetics Clinic
The Stanford Skin Cancer Genetics clinic is focused on evaluating and managing patients with a high risk of skin cancer due to a strong family history of positive genetic test results. When applicable, diagnostic testing is performed to identify germline mutations and patient education provided on prevention and screening. Examples of inherited syndromes evaluated in our clinic include Basal Cell Nevus Syndrome, Li-Fraumeni, Familial Atypical Mole-Melanoma Syndrome, BAP1 tumor predisposition syndrome, PTEN hamartoma syndrome.
High Risk Non-Melanoma Skin Cancer Clinic
Patients at high risk of relapse and/or development of subsequent malignancies due to solid organ transplantation or other reasons (history of chronic lymphocytic leukemia, lymphoma, immunosuppressive medication, history of radiation therapy, genetic predisposition to skin cancer, etc.) are followed closely in the Stanford High Risk Non-melanoma Skin Cancer Clinic where frequent skin examination, early intervention and prevention, and advanced treatments such as chemowraps, cyclical photodynamic therapy, systemic chemoprevention, and other novel therapies are employed. Locally advanced squamous cell carcinoma may be co-managed through the High Risk Tumor Board. Patients with metastatic squamous cell carcinoma may be seen in a multispecialty fashion with dermatology, medical oncology, radiation oncology, and other providers as deemed necessary. We also now see patients with Merkel Cell Carcinoma, a rare, aggressive non-melanoma skin cancer.
Nail Disorders Clinic
The Stanford Nail Disorders clinic specializes in evaluation and management of tumors of the nail apparatus, longitudinal melanonychia, brittle nail disease, and inflammatory nail disorders as well as the performance of nail surgery.
Hair Loss Clinic
The Stanford Dermatology Hair Loss clinic focuses on the diagnosis and treatment of disorders of the hair and scalp including hair loss, which can be caused by a variety of conditions. Diseases managed include alopecia areata, anagen and telogen effluvium, male/female pattern baldness, scarring alopecias and infections of the scalp.
Genital Dermatology Clinic
The Stanford Genital Dermatology Clinic provides a unique service in Northern California and combines elements of dermatology, gynecology and urology to provide expert dermatologic care for both men and women with genital dermatoses.
Advanced Basal Cell Carcinoma Clinic
The Stanford Advanced Basal Cell Carcinoma Clinic offers multidisciplinary cancer specialty care for patients with aggressive basal cell skin cancer. Stanford Clinical-investigators and basic scientists conducted pivotal research in the use of the recently FDA-approved drug, Vismodegib, for patients with advanced basal cell carcinoma, including those with inoperable tumors and metastatic disease. Stanford Dermatology researchers have pioneered study of this agent in patients with basal cell nevus syndrome, a genetic disorder that results in the formation of hundreds of skin cancers. Ongoing research involving this class of drugs, termed hedgehog pathway inhibitors, is in progress.
Skin Allergies and Contact Dermatitis Clinic
The Contact Dermatitis Clinic at Stanford offers comprehensive evaluation of patients with eczematous skin eruptions, contact dermatitis, systemic hypersensitivities, photosensitivity, and occupational dermatoses. Contact dermatitis occurs as a result of skin contact with irritating or sensitizing substances in the environment. The Stanford Contact Dermatitis Clinic offers diagnostic patch testing and photo-patch testing using standard and customized allergen panels according to each individual patient’s exposures and unique history. Patch testing is conducted at the Stanford Medicine Outpatient Center. A consultation visit prior to undergoing patch testing is recommended.