Skin is an important protective barrier of human body, one of our largest organs. Skin makes up approximately 7% of the total body mass; its area in an adult is 1.5-2 square meters. Skin performs many important functions – protective, barrier, participates in water-salt, protein, carbohydrate, fat metabolism, as well as vitamin metabolism, performs respiratory, immune, excretory, thermoregulatory functions and many others. It is clear that skin is exposed to negative influence of various environmental factors every day, which can cause skin damage, including tumors development.

Dermatology in Israel has been actively developing in recent years. Due to warm, sunny climate and the large number of residents with fair skin, country ranks among the leaders in prevalence of skin cancer, so government spares no expense in introducing innovations in this area of medicine. Every day, modern and effective methods of treating skin diseases and methods for early diagnosis of skin cancerous lesions are introduced into practice.

The main advantages of skin diseases treating at TAMC:

We employ only the best specialists in the field of dermatology, who have excellent theoretical training and extensive practical experience.
Department is equipped with only modern medical equipment for diagnostics and treatment of dermatological pathologies.
Rapid implementation of all innovative therapy methods into practice immediately after their approval by relevant authorities, so TAMC patients can count on the most modern treatment.
Comfortable conditions in clinic, friendly medical staff, ready to answer all your questions.
Reasonable prices for treatment and diagnostics, payment upon completion of procedures.

Male doctor in white protective gloves hold magnifying glass. Examines patient with skin disease against office background. Allergy treatment concept

Departments

TAMC Dermatology Department operates several independent units (clinics) that specialize in specific disease:

General dermatology – specialists in this profile are the first to examine a patient with skin disease, determine a preliminary diagnosis, and develop a follow-up plan. At a follow-up consultation, a final diagnosis is made and treatment is prescribed. In the event that a patient requires complex specific therapy or surgery, patient is referred to appropriate specialist.
Dermatology Oncology – doctors in this field study, diagnose and treat benign and malignant skin lesions (fibromas, nevi, dermatofibromas, melanoma, basal cell and squamous cell carcinoma, etc.).
Pediatric dermatology – specialists in this area treat children with various dermatological problems (eczema, atopic dermatitis, ichthyosis, etc.).
Psoriasis Treatment Clinic – specialists in this unit provide comprehensive and modern treatment of psoriasis. The effectiveness of treatment programs for this disease in Israel is known far beyond the country’s borders, so thousands of adults and children with severe forms of psoriasis come here every year for treatment.
Clinic for Hair and Nail Diseases – dermatologists of this profile specialize in all problems related to damage to nails and hair (alopecia), and also successfully perform hair transplant procedures.
Acne treatment clinic – here patients with acne receive all the necessary help.

What diseases does Dermatology Department treat?

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Diagnostic methods in dermatology

As a rule, skin diseases diagnostics does not cause any particular difficulties. If a suspicious element is detected on skin, you should consult a dermatologist. Specialist will conduct an examination, dermatoscopy (examination of the element using a special dermatoscope apparatus that magnifies the image 20 times), collect and systematize patient’s complaints, medical history and life history. If, according to initial examination and dermatoscopy, the element on skin is classified as borderline or suspicious for malignancy, then patient will be offered a biopsy and referral to an oncodermatologist.

One of the modern types of biopsy for skin lesions is a punch biopsy, which makes it possible to establish the correct diagnosis in a short time with an accuracy of 99% and begin appropriate treatment. The procedure is a type of incisional (so-called puncture) biopsy, when tissue is collected from a suspicious area before any therapeutic interventions are performed. This allows us to accurately establish a diagnosis and create an appropriate comprehensive treatment program.

Important!

Biopsy is the main method for diagnosing malignant skin tumors. Technically, performing skin tumors biopsy is not difficult, because all the elements are located superficially.

After biopsy, we send all materials for revision to the best pathohistological laboratories in Israel. Thanks to such checks, we are sure that diagnosis is correct and treatment is appropriate to situation.

In case of a punch biopsy, biological material is collected not with an ordinary needle, but with a specially designed DERMO-PUNCH instrument (a hollow cylinder with a sharp cutting edge) designed for this purpose. It is a tubular scalpel with which doctor quickly, accurately and painlessly obtains a tissue sample for further histological examination.

In addition to standard pathohistological examination, if malignant nature of neoplasm is confirmed (especially often with melanoma), material is also examined using modern immunohistochemical and molecular genetic techniques. This is necessary in order to find certain types of mutations in malignant cells and presence of specific receptors on their surface. In future, they become a target for innovative drugs created individually for each patient (targeted therapy, immunobiological drugs). One such test system for molecular genetic testing is Foundation One and Caris Molecular Testing panel.

Sometimes in-depth diagnostics may be necessary for dermatological patients, for example, if a malignant neoplasm is suspected or confirmed by biopsy. Using modern medical imaging methods, specialists assess the prevalence of malignant tumor, the presence of regional and distant metastases. For this purpose, a person is prescribed MRI, CT with or without contrast, ultrasound, PET-CT, PET-MRI, MSCT, and bone scintigraphy.

For etiological diagnostics (determining the cause) of allergic skin diseases, various provocative tests and skin tests are used, which make it possible to verify the causative factor of allergic rashes and get rid of the disease once and for all.

In Dermatology Department of TAMC, various molecular genetic tests are widely used to identify a specific genetic disease manifested by skin problems, or an infection and a specific causative agent of the disease (diagnosis by PCR of viral, bacterial, fungal and parasitic skin infections).

Based on obtained data, doctor formulates a detailed diagnosis indicating the stage of process. Depending on diagnosis, effective treatment is selected for each patient. All necessary diagnostic procedures can be completed directly in clinic.

Modern treatment methods in dermatology

Tel Aviv Medical Clinic patients have access to all traditional and innovative treatments for dermatological diseases. In addition, clinical studies are conducted at medical institution to study the effectiveness of the latest and experimental drugs, treatment methods, etc. Therefore, every person can become a participant in such study absolutely free of charge and receive the necessary help, and at the same time a chance for a healthy and fulfilling life.

Allergen-specific immunotherapy (ASIT) is the only method of effective treatment of allergic skin diseases when it is impossible to get rid of allergen influence, which is very common in practice. The technique is based on long-term introduction of causative allergen into the body, starting with minimal quantities, gradually increasing the dose to a high one. This kind of “vaccination” teaches the immune system to adequately respond to allergen without developing a hypersensitivity reaction (allergy). Over time, immune system becomes tolerant (patient) to allergen and allergic reactions stop. This is a long healing process that can last 6 months, and sometimes longer. All this time, our doctors are in touch with their patients, adjusting the dose of allergen, and if necessary, you can get an online consultation with a specialist.

To remove benign skin neoplasms, minimally invasive techniques are used, which are not accompanied by severe pain during the procedure and cosmetic defects (the wound heals without a scar). Such methods include cryodestruction, laser vaporization, radio wave coagulation of pathological element, and electrocoagulation. All our doctors master such interventions methods and effectively apply them in practice. Typically, this procedure does not require general anesthesia, but in case of very young children or severe fear, sedation or short-term drug-induced sleep may be used.

Electrocoagulation – lremoval of a tumor with high-intensity current, is widely used in Dermatology Oncology to remove various benign skin tumors. This technique allows us to remove malformation quickly (in one visit) and completely painlessly. Neoplasms that can be removed using this modern technique: viral papillomas, senile keratomas, condylomas, atheromas, warts, molluscum contagiosum, hemangiomas, post-acne, telangiectasia, rosacea, pigmented nevi.

Skin grafting can be performed at TAMC Dermatology Department. To do this, we use either patient’s own skin from undamaged areas of the body or transgenic skin grafts (from donors). More often, such surgeries are performed after burns, wide resection of malignant skin tumor, scalped wounds, large trophic ulcers, etc.

PUVA therapy is actively used to treat patients with severe forms of psoriasis. This is a combined phototherapy technique in which patient is given photoactive drugs (psoralens) orally and then irradiated with ultraviolet light. Psoralens increase the sensitivity of affected skin, due to which it actively absorbs ultraviolet radiation, which has a restorative effect on skin cells and contributes to onset of psoriasis remission. The department also uses conventional phototherapy for both therapeutic and cosmetic purposes.

If, after the diagnostic program, patient is diagnosed with a malignant skin neoplasm, treatment program will certainly expand. If tumor is in the early stages of its development and no metastases are detected, then the main treatment is surgical tumor removal using wide excision (within healthy tissue). Malignant neoplasms are not recommended to be removed using minimally invasive methods, but only by wide surgical excision. This prevents relapse development of the disease. Often, after such interventions, a significant skin defect is formed, so the immediate or second stage of surgical intervention is reconstructive plastic surgery, especially if tumor is localized on face or other open area of the body.

MOHS dermatosurgery (Mohs method) is a modern technique for malignant skin tumors removal. The main difference between Mohs surgery and classical surgical excision of tumor is that the removal of tumor occurs sequentially in several stages, with mandatory histological control of boundaries after each stage (histological analysis for presence of cancer cells) and spread determination of the tumor deep into the tissue with reference to 3D spatial orientation. Thanks to this special technique, Mohs dermatosurgery ensures complete removal of malignant neoplasm with minimal involvement of surrounding healthy tissue, which can significantly reduce postoperative tissue defects and obtain the best cosmetic result.

If disease is diagnosed at stages 3-4 of oncological process, then treatment program is necessarily complemented by other complex treatment methods – radiation therapy, chemotherapy, targeted and immunobiological therapy.

Radiation therapy is used in complex treatment after surgery. As a rule, remote irradiation is used using modern linear accelerators. Modern radiological equipment in TAMC allows for targeted irradiation of tumor, minimizing the dose to other healthy tissues. Modern linear accelerators available to our patients enable intensity modulated radiation therapy (IMRT), beam intensity modulated rotational (VMAT) radiation therapy, as well as stereotactic radiation therapy (SRT) and stereotactic radiosurgery (SRS). Such equipment allows us to effectively fight cancer diseases that were previously considered incurable. Also, for skin tumors, contact radiation therapy (brachytherapy) is used, when a radiation source is placed directly into the tumor tissue.

Chemotherapy is also used in complex treatment of common stages of malignant skin tumors. Unfortunately, such tumor as melanoma is resistant to standard chemotherapy (both systemic and contact). Therefore, in such patients, treatment is supplemented with modern methods – targeted drugs, immunobiological drugs.

Immunotherapies using programmed cell death receptor 1 (PD-1) antibodies – pembrolizumab and nivolumab – prolong the lives of melanoma patients. Ipilimumab (monoclonal antibody to cytotoxic T-lymphocyte-associated antigen 4 [CTLA-4]) is another form of immunotherapy that can also increase the life expectancy of these severely ill patients.

Molecularly targeted therapies include application of vemurafenib, dobrafenib and encorafenib, which work by inhibiting the BRAF gene, thereby slowing or stopping the proliferation of tumor cells. These drugs prolong patients’ life of with metastatic melanoma.

Progressive medical centers in Israel, including TAMC, use the latest methods for treating melanoma – application of drugs based on T-vec. Patients of our clinic can receive such help if necessary. This medicine is based on live viruses of T-vec group. They penetrate specifically into melanoma, due to which tumor is destroyed from the inside by body’s own immune system, since administration of such drugs causes a strong immune response in patient.

TIL therapy is a personalized cell therapy based on application of tumor-infiltrating lymphocytes (TIL – tumor-infiltrating lymphocyte). This innovative method of immunotherapy for malignant diseases is now actively used to treat skin melanoma in Israel. Even patients with distant metastases have an excellent positive result after a course of treatment. With TIL therapy, cells are not genetically modified; they are simply extracted from tissue of malignant tumor itself. Then they are cloned to produce large quantities and reintroduced to patient by infusion. Action mechanism is that these TIL cells are able to independently “seek out” and destroy not only tumor tissues, but also individual tumor cells circulating in blood.

The progressive approach to treatment of skin diseases and the favorable climatic conditions of Israel’s sunny climate are the main reasons why Israeli medical institutions have become the “number one place” for patients with dermatological pathologies. Proof of this is the thousands of patients who got rid of psoriasis and other skin problems once and for all after a trip to Israel.