Bruce P.Robinson, MD
Measles is an airborne, extremely infectious and potentially severe rash illness. It can be very serious for small children, but is easily preventable by a vaccine. Two doses of MMR vaccine are 97% effective at preventing measles, 1 dose is 93% effective. It is uncommon for someone fully vaccinated to develop measles. However, breakthrough infections (when someone becomes infected after they have been vaccinated) can occur, especially in communities experiencing an outbreak where high levels of measles virus are circulating. But the good news is, fully vaccinated people who get measles seem more likely to have a milder illness. Fully vaccinated people seem also less likely to spread the disease to other people, including people who can’t get vaccinated because they are too young or have weakened immune systems.
Measles was declared eliminated in the United States in 2000. This was thanks to a very high percentage of people receiving the safe and effective measles, mumps, and rubella (MMR) vaccine. In recent years, however: U.S. MMR coverage among kindergarteners is now below the 95% coverage target—much lower in some communities—and is decreasing. The unvaccinated individuals have been protected through community immunity (herd immunity), meaning the vaccinated community.
The disease spreads through the air by respiratory droplets produced from coughing or sneezing or touching an infected surface. The measles virus can linger in the air for several hours after an infected person coughs or sneezes.
Measles is not a seasonal virus. However, measles is often spread over times of high travel (like spring break) or in situations where unvaccinated persons are in close quarters (like summer camp).
Immediately call your healthcare provider and let them know that you have been exposed to someone who has measles. Your healthcare provider can:
Determine if you are immune to measles based on your vaccination record, age, or laboratory evidence.
Make special arrangements to evaluate you, if needed, without putting other patients and medical office staff at risk.
If you are not immune to measles, MMR vaccine or a medicine called immune globulin may help reduce your risk of developing measles. Your healthcare provider can advise you, and monitor you for signs and symptoms of measles.
If you are not immune and do not get MMR or immune globulin, you should stay away from settings where there are susceptible people (such as schools, hospitals, or childcare) until your healthcare provider says it's okay to return. This will help ensure that you do not spread it to others.
Measles symptoms don't appear until 10 to 14 days after exposure. They include:
If you have measles, you should stay home for four days after you develop the rash. Staying home is an important way to not spread measles to other people. Ask your healthcare provider when it is safe to be around other people again.
You should also:
CDC considers you protected from measles if you have written documentation (records) showing at least one of the following:
You received two doses of measles-containing vaccine, and you are:
No. CDC considers people who received two doses of measles vaccine as children according to the U.S. vaccination schedule protected for life, and they do not ever need a booster dose.
If you're not sure whether you are fully vaccinated, talk with your healthcare provider.
There's no treatment to get rid of an established measles infection, but over-the-counter fever reducers or vitamin A may help with symptoms. Measles usually goes away on its own after about 10 to 14 days.
Hand-Foot-Mouth Disease is a mild, contagious viral infection common in young children. It may causes a blister-like rash on your child's hands and feet and painful ogres in their mouth.The disease most often affects babies and children younger than 5 years old. HFMD is typically mild and usually clears up on it's own within 7-10 days.
Hand, foot and mouth disease symptoms typically appear in two stages. When the illness first starts, your child may have flu-like symptoms, such as
After a couple of days, these symptoms will go away and new symptoms will develop:
Viruses belonging to the coxsackievirus and enterovirus families. These viruses can be found in your child's digestive tract, including:
Yes, HFMD is contagious. Your child is most contagious during the first few days of the illness, often before the rash appears. Your child is less likely to spread it to others once the rash/blisters dry up. However, the virus can live in their stool (poop) for weeks after the rash goes away.
Your dermatologist or healthcare provider can diagnose HFMD by looking at your child's blisters. Occasionally, the will test for the virus by sending throat swab samples, or samples taken from blisters or stool (poop) to a lab
If you know your child has been exposed to the virus, alert their provider before scheduling an appointment to protect the health of others. You provider may suggest a virtual visit and make treatment suggestion over the phone.
There is no medication for HFMD. Antibiotics won't work because they don't treat viruses. Fortunately, symptoms are usually mild. Over the counter (OTC) pain relievers such as acetaminophen (Tylenol) and ibuprofen (Advil, Motrin) for fever and pain. Do not give your child aspirin, w which may cause Reye's syndrome.
The viruses that cause Hand, foot and mouth disease are highly contagious. The infection often spreads before a person realizes they're sick. You can slow or stop the spread of the illness through these good hygiene habits.
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Dr. Robinson is improving skin cancer prognosis and treatment with little to no-downtime, scarring, or bleeding and functional & cosmetic results that are superior to cold steel excision & MOHS.
Patients on anticoagulant therapy do not have to stop their medication before treatment, therefore not increasing their risk for stroke and/or heart attack, quick healing, & no risk of post-operative complications!
This treatment is especially great for actors/actresses or professionals in the public eye who can't afford downtime or a scar, athletes or weekend warriors who want to continue their workouts unencumbered and helpful with infirm or older patients who are not able to perform extensive wound care and withstand the rigors of a skin flap or graft.
Using non-ablative fractional laser therapy, at adaptive settings, offers a gentle approach to treating pre-cancerous skin growths and therefore help prevent future skin cancer by 60-70%. Given that skin cancer is the most prevalent cancer in the United States, affecting more than 3 million Americans a year, just two using non-ablative fractional laser therapy. Treatments 2-4 weeks apart provides a major advancement in skin cancer prevention. In addition, given the likelihood of future basal or squamous cell carcinomas in individuals with a history of a prior skin cancer, using non-ablative fractional laser therapy. Treatment dramatically reduces the risk of subsequent skin cancer and skin cancer recurrence.
Non-ablative fractional laser already demonstrated remarkable success with minimal downtime & discomfort as a gentle yet effective treatment of actinic keratosis (AK), the most common type of pre-cancerous skin conditions. Other benefits to using non-ablative fractional laser therapy is it's ability @ ameliorating photo damage, utilizing precise photothermolysis to stimulate collagen and elastin production, promote dermal wound healing, improving hyperpigmentation (brown spots) skin tone, skin laxity, and roughness. Now we can add the using non-ablative fractional laser therapy as the up and coming gold standard to the treatment of certain skin cancers!
Shingles causes a painful, blistering rash on your skin. If you get shingles, you may notice the following three stages:
Before the rash appears: For 1 to 2 days before the rash appears, you may have pain, burning, or tingling on an area of skin where the rash will develop. Some people have described an “electrical sensation” on their skin before getting the rash.
Rash appears: A painful, blistering rash appears. It usually appears on one side of your body, often on the torso; however, it can appear anywhere on your skin. Some people get more blisters after the rash appears, so it can seem that the rash is spreading.
Rash starts to clear: As the rash clears, the blisters may crack open, bleed, and scab over. For most people, the rash will clear within 2 to 4 weeks.
If you have a rash of blisters on your skin or a rash that looks like those shown below, schedule an appointment immediately for a diagnosis. If you have shingles, it’s important to get treatment, preferably within 1 to 3 days.
If you’ve had the rash for longer than 2 to 3 days, it’s still important to schedule an appointment!
Along with a painful, blistering rash, some people can also have one or more of the following:
Rash: PLEASE call our office to schedule an appointment immediately or other health-care provider within 3 days of getting the rash. When treatment is started within 3 days, treatment can prevent possible complications, such as long-lasting nerve pain.
Receiving treatment after 3 days still has benefits, so you should still schedule an appoointment to see your doctor if you’ve had the rash for longer than 3 days.
Before taking any medication, it’s important to make sure that you have shingles.We will prescribe an antiviral medication. One of three antiviral medications is usually prescribed—acyclovir, famciclovir, or valacyclovi to:
Pain: Over-the-counter medication(s) can help, such as:
If you have severe pain, we may prescribe a medication that reduces inflammation, such as a corticosteroid.
Talk with your doctor about getting the shingles vaccine, Shingrix. You can get shingles again. A shingles vaccine that the U.S. Food and Drug Administration (FDA) approved in 2017 can greatly reduce your risk of developing shingles again. You can learn more about this vaccine at, Shingles Vaccine, CDC.
The CDC recommends that adults 50 years and older get two doses of the shingles vaccine called Shingrix (recombinant zoster vaccine) to prevent shingles and the complications from the disease. Adults 19 years and older who have weakened immune systems because of disease or therapy should also get two doses of Shingrix, as they have a higher risk of getting shingles and related complications.
Until the shingles rash clears, you are contagious.
Anyone who has not had chickenpox (or the vaccine for chickenpox) can catch the virus. This could cause chickenpox. To avoid infecting others, who could get chickenpox and later shingles, dermatologists recommend that you do the following until the rash clears:
Having a shingles rash on your face is a medical emergency.
Even if the rash isn’t on your eye, it could still affect your eyesight. Immediately seeing a doctor for treatment could save your eyesight.
We are pleased to introduce ProNox™ in our practice, a patient controlled, inhaled analgesia for in-office use. We want our patients to achieve their cosmetic goals worry-free. Patients say that it has made all the difference in moving forward with many cosmetic procedures.
The use of nitrous oxide in Medical, Cosmetic & Laser Dermatologic procedures is becoming more common. Our goal is to provide each patient with a pain-free experience and to work with their varied anxiety levels. While we have excellent topical numbing options for pain control, nitrous oxide can help calm the patient who is nervous or anxious and also help with pain relief.
Dr. Robinson was a pediatric resident @ NYU / NYC Health & Hospitals / Bellevue prior to pursuing dermatology. He enjoys seeing pediatric patients and specializes in difficult to diagnose rashes, birthmarks, acne, warts, molluscum and eczema.
We recommend annual skin cancer screenings for almost everyone. Essentially all skin cancer can be cured if detected early, and an annual skin cancer screening is the best way to find them at this early stage. Patients with a skin cancer history usually require screening every 3 to 6 months. Skin cancer screenings are truly life saving! Don’t be shy—make your appointment today! Contact us today to schedule an appointment.
Dr. Robinson offers a full 20-30 minute thorough skin exam. You'll be given a gown and asked to take off everything but your undergarments. The gown and undergarments can be moved in ways to keep areas of your body covered during the exam and to protect your privacy. Your appointment will involve a thorough examination of your skin — from the top of your scalp to the bottoms of your feet — by a board-certified dermatologist. Remove any nail polish, this will allow us to fully examine your fingers, nails, and nail beds. We will look for suspicious spots that could be cancerous.
Warts are non-cancerous skin growths caused by a viral infection in the top layer of the skin. Viruses that cause warts are called human papillomavirus (HPV). The types of HPV that cause common warts, plantar warts, or flat warts are usually different from the types of HPV that cause genital warts. A vaccine is available to help protect against the types of HPV that cause genital warts (and increase a person's risk of certain types of cancer).
There are several different kinds of warts including:
Common warts usually grow on the fingers, around the nails and on the backs of the hands. They are more common where skin has been broken, for example where fingernails are bitten or hangnails picked. These are often called "seed" warts because the blood vessels to the wart produce black dots that look like seeds.
Foot warts usually appear on the soles (plantar area) of the feet and are called plantar warts. When plantar warts grow in clusters they are known as mosaic warts. Most plantar warts do not stick up above the surface like common warts because the pressure of walking flattens them and pushes them back into the skin. Like common warts, these warts may have black dots. Plantar warts are uncomfortable and painful, feeling like a stone in the shoe.
Flat warts appear as small, smooth usually skin colored, pink or brown bumps on the skin. Common places for flat warts are the face, top of the hands, top of the feet, arms, and legs.
Genital warts (warts in the genital area, also called "condyloma acuminatum"
To prevent warts from spreading, dermatologists recommend the following:
While you can often clear a wart at home, some warts can be stubborn. If the person has a weakened immune system, it can be difficult to get rid of warts. Sometimes, what looks like a wart turns out to be a callus or another type of growth.
A board-certified dermatologist can help by:
Sometimes, warts can be stubborn, so they don’t clear with treatment that you can buy without a prescription. A dermatologist can create an effective treatment plan.
