Dermatology and LaserCenter

We carry out treatments for acne, eczema, psoriasis, infections and many other skin diseases by means of local and systemic therapies, light therapy and photodynamic therapy. We often establish a specific therapy also partly using confirmed diagnostic skin and blood tests. Furthermore, we will provide you with our expert recommendation four your daily skincare regime.

Using modern reflected-light microscopy and computer-assisted analysis (DermoGenius), it is possible to digitally record moles that need to be checked, and to monitor them for progression. Most of the moles are benign, so-called nevus cell nevi. Frequent sunburns throughout childhood and adolescence are considered the main risk factors for the development of black skin cancer (malignant melanoma). Malignant melanoma can develop on moles or even on previously non-pigmented skin. Obvious changes should always be examined dermatologically. In older age, the forms of white skin cancer (basal cell carcinoma, spinocellular carcinoma) often occur, especially on skin areas exposed to UV light. These forms of skin cancer can be very inconspicuous – glassy nodule, rough redness and have a wart-like structure. It is important to Have yourself examined, even if the spot is only small and painless. We are also happy to advise you on sensible sun protection measures.

Essentially, a distinction is made between black (malignant melanoma) and white skin cancer (basal cell carcinoma, spinocellular carcinoma).

Preliminary stages of spinocellular carcinoma are the so-called actinic keratoses: rough, partly itchy redness – which occur mainly on UV light-exposed areas of the body such as the forehead, ears, nose, hairless scalp and the back of the hands. These precursors of white skin cancer can usually be successfully treated conservatively, although there is a known relatively high risk of recurrence. The forms of treatment include a local application of various active substances (e.g. diclofenac, 5-fluorouracil, imiquimod, etc.) in a solution, cream or ointment base, as well as the implementation of photodynamic therapy (PDT) with red light after prior local application of a photosensitizer (methyl aminolevulinic acid). In each case, the aim is to achieve a local inflammatory reaction and subsequent rejection of the altered skin cells. If left untreated, actinic keratoses can progress to spinocellular carcinoma, with a small risk of lymphogenic metastasis (development of offshoots). Therefore, spinocellular carcinoma must always be surgically and completely removed.
Basal cell carcinoma is the more benign variety of white skin cancer because they almost never metastasize. However, in situ they have a pronounced destructive potential and can spread to the surface and to the depth, without regard to muscle, cartilage, or bone. Depending on the type of basal cell carcinoma and the localization, various conservative (Imiquimod, etc.), photodynamic or surgical forms of therapy are indicated. The goal in each case is the complete removal of the tumor cells.
Malignant melanoma is the so-called black skin cancer and has a risk of metastasis to lymph nodes and organs depending on the tumor thickness. The flatter the malignant melanoma is at diagnosis, the lower the risk of developing offshoots. This in turn means, the earlier the diagnosis is clear, and the quicker the tumor is removed, the better the prognosis. The therapy occurs surgically and with safety margins, which exclude a recurrence on site. In case of larger tumor thickness, removal of the sentinel lymph node in the associated lymph drainage area (e.g. axilla or groin) may be recommended in order to have even more clarity.

Regular skin monitoring is particularly recommended if a white or black skin tumor has already occurred. Suspicious skin areas are observed over time, the images are compared with the previous reference images and a therapy decision is essentially made on the basis of this documentation.

This is the operative part on the large treatment spectrum of dermatology.

In our certified practice operating room we perform a wide variety of surgical techniques on the skin, under local anesthesia and under outpatient conditions:

Benign skin tumors (cysts, lipoma, congenital birthmark, dysplastic nevus, and many others).
Malignant skin tumors (malignant melanoma, spinocellular carcinoma, basal cell carcinoma, etc.)
Diagnostic tissue sampling
Abscess relief

In the operating room of the Hirslanden Klinik St. Anna in Meggen, we perform the following operations under outpatient or inpatient conditions, under local anesthesia or tumescent local anesthesia with accompanying analgesia (twilight sleep):

Sweat gland suction for axillary hyperhidrosis (excessive sweating)
Upper eyelid lifting (blepharoplasty) for sagging eyelid skin
Liposuction using vibration-assisted technique with microcannulas for lipedema or aesthetic indication

Liquid nitrogen (at -196 to -209 degrees Celsius) can be used to specifically „freeze“ small, benign neoplasms on the skin, such as cornifications, warts and hemangiomas. Icing therapy can be performed in an open spray method with a template, or contact method.

UVA and / or UVB radiation applied in a light cabin – under medically controlled conditions – has a healing effect on psoriasis, atopic eczema, sun allergy, white spot disease (vitiligo), and many other inflammatory diseases. In case of chronic hand and / or foot eczema, UV light can be used for partial body exposure.

For PDT therapy, a light-sensitizing cream (methyl-aminolevulinic acid) is applied to the skin area to be treated, light-proofed and exposed to red light after an absortion time of 3 hours. Indications for this therapy include actinic keratoses and superficial basal cell carcinomas.