Departments

Our dermatologists are here to help improve the health and appearance of patients’ skin, and to diagnose and treat both benign and malignant skin conditions. We provide specialized care for the full spectrum of skin disorders, including acne, alopecia areata, psoriasis, inherited skin disease, and skin issues arising after organ transplant and during cancer treatment. We are one of two centers in the state with a pigmented lesion clinic, phototherapy center, and cutaneous lymphoma clinic. The clinical research efforts of our dermatologists have contributed significantly to the treatment of skin tumors such as melanomas and cutaneous T-cell lymphomas. We are actively exploring the uses of advanced technologies such as photopheresis, a therapy for life-threatening and debilitating diseases like cutaneous T-cell lymphoma and graft-versus-host disease. A large portion of the department's research is performed through two separate research entities—the Yale SPORE in Skin Cancer Center and the Spitzoid Neoplasm Repository.

Patients with moderate-to-severe psoriasis often require a host of medications to manage their disease. One type in particular—biologics—are highly effective, but they can be complicated to administer. They are also expensive, which means navigating insurance coverage can be difficult and result in treatment delays. The Psoriasis Treatment Program brings together a board-certified medical dermatologist who specializes in psoriasis and a pharmacist from Yale New Haven Hospital Ambulatory Clinical Pharmacy Services who is an expert in psoriasis medication management and coordinating insurance coverage. Together, this dedicated team can manage patients’ care in a seamless fashion, which ensures prompt care. One medical professional focuses on the disease process and treatment selection; the other medication management. In this collaborative model, patients meet with their physician first to discuss a treatment plan and talk separately with the pharmacist. The pharmacist talks in depth with the patient, obtaining a complete medical history and answering all questions related to potential laboratory tests and prescribed medications, which can include injections they self-administer at home, as well as oral and topical treatments. The two points of access mean that patients aren’t condensing all of their questions about their treatment plan into one appointment, and the two medical professionals communicate closely about their psoriasis patients. If one is not available to help, the other can. Patients can work directly with their pharmacist on all issues related to medications, side effects, and insurance coverage in between follow-up appointments with their physician. Having two points of contact allows patients timely access to their medical team as well as their prescribed medications. The program brings together a physician who has expertise in treating psoriasis and a pharmacist with additional training in outpatient care and in dermatologic medications, including those for psoriasis. Managing medications for dermatologic patients is the pharmacist’s full-time job. The pharmacist educates patients about the medications and can obtain insurance coverage and set up home delivery of the medications, taking many hassles and obstacles out of the patient’s hands.

The Skin & Kidney Cancer Program at Smilow Cancer Hospital brings together an extensive, multidisciplinary team to diagnose, treat, and care for patients with all types of skin cancers, including melanoma, as well as kidney cancers. Established over 30 years ago, our program includes experts in surgery, medical oncology, dermatology, urology, pathology, dermatopathology, radiology, genetics, and radiation oncology. Members of the team are national and international leaders in clinical and laboratory research focusing on improving treatment and outcomes for our patients. From patients who present with an early-stage diagnosis or more complex, metastatic disease, our team is prepared to provide each patient with the most comprehensive and cutting-edge treatment available. Each patient’s care is reviewed by our multidisciplinary care team to develop a personalized treatment plan. Clinical trials are also available to patients through Yale Cancer Center, bringing the latest treatment options to our clinics to benefit patients. Our doctors are at the forefront of melanoma and kidney cancer treatment and research, including novel immunotherapy approaches and the genetic characterization of kidney cancers. Smilow Cancer Hospital places great emphasis on taking care of all of our patients’ needs through a network of supportive care services. Nurses with dedicated knowledge and skills care for our patients through the continuum of their treatment. Patients and their families also have access to social workers to provide psychosocial support, as well as pastoral support, nutritional counseling, physical therapy, palliative care, and integrative medicine. After the initial diagnosis—and depending on the presentation of the disease—each patient is evaluated by our dermatologists, surgeons, urologists, and/or medical oncologists. For some presentations of melanoma and other skin cancers, particularly in the early stages in which disease has not spread beyond the primary site or lymph nodes close to the primary site, surgery may the preferred initial treatment. Specialized surgical expertise is essential for the management of melanoma and other skin cancers, which can occur on any skin site and even in areas not exposed to the sun. Some skin cancers appear in delicate areas such as the face, nose, ear, or hand and often require the expertise of a plastic surgeon. For certain regions of the body, our team collaborates with other highly trained surgical subspecialties, including thoracic surgery and neurosurgery. To care for kidney cancer, we work closely with oncologists and urologic surgeons. In the early stages of melanoma, pathology results from the tumor will determine the risk of developing metastases (spread to distant organs) in the future. If the results indicate a high risk for melanoma metastases, treatments are available to reduce the risk and possibly prevent or delay melanoma recurrence. Adjuvant therapies (or therapies given after surgery

Our expert pathologists are key players in all health care provided by Yale Medicine. By studying bodily fluids and tissues, we help other physicians make diagnoses. We offer highly specialized diagnostic and consultation services in all major specialty and subspecialty areas of pathology. Our subspecialists attend all regular meetings in which a number of doctors from various specialties review and discuss a patient's medical condition and treatment options.They are on call around the clock, ensuring that doctors working in oncology, surgery, transplantation, and other service areas always have access to our expert knowledge. Our internationally recognized physicians offer specialized expertise in breast, cytopathology (cell), dermatologic, endocrine, gastrointestinal and liver, gynecological, head and neck, hematologic (blood), neurologic, ophthalmologic, pediatric, kidney, soft-tissue and bone, transplant, thoracic and urologic pathology, molecular and genomic pathology, and autopsy pathology. Specialized care is offered in the following areas: Accredited PD-LI testing Autopsy Cytopathology Intraoperative frozen section and tumor triaging service Molecular diagnostics and tumor genomics profiling Pediatric pathology Support laboratories: histology, immunohistochemistry, translational pathology, and electron microscopy and quantitative immunofluorescence analysis of multiplexed tumor markers Surgical pathology with subspecialty expertise in gastrointestinal tract and liver; prostate; bladder; kidney; gynecological tract; endocrine system; head, neck, and oropharynx; bone and soft tissue; hematologic and lymphoid system; brain, muscle and eye; pulmonary system; and transplantation

When skin diseases affect infants, children, and adolescents, our pediatric dermatologists are ready to help. As childhood skin conditions bring not only physical but also psychological challenges, we make it our priority to help prevent permanent scarring and disfigurement. Laser therapy is one tool we use for certain hemangiomas, port-wine stains, and other vascular lesions of the skin. Our pediatric dermatologists also offer expertise in diagnosing and treating a variety of skin conditions, including psoriasis, alopecia areata, atopic dermatitis, vitiligo, acne, and genetic skin diseases. In addition, we conduct advanced research and clinical trials to find breakthrough treatments for childhood skin diseases.

The Yale Onco-Dermatology Program at Smilow Cancer Hospital serves the dermatologic needs of cancer patients in Connecticut and beyond. We treat concerns including very dry skin, itching, and skin changes that arise as side effects from chemotherapy. We also treat rashes, nail and hair changes, skin infections, cancer involvement of the skin, radiation dermatitis, and other changes due to radiation. We also provide dedicated care for patients with skin cancer, including melanoma and non-melanoma skin cancer, ranging from rigorous skin screening examinations to optimized prevention and therapy.

We provide preventive and urgent health care to children and adolescents in the greater New Haven community. Our pediatricians work in the Yale New Haven Hospital Pediatric Primary Care Centers at three locations: York Street, St. Raphael campus, and at Chapel Pediatrics in Hamden. We offer routine vaccinations and wellness exams, screening for childhood illness, and positive parenting support and programs. We also have particular expertise in handling conditions that occur during adolescence. Our physicians are highly trained and committed to advocating for children. In our offices, we see children with Husky or commercial insurance, and offer a sliding scale for those without insurance. In our specialty programs, we treat infants and children with a broad range of childhood problems, including: Developmental and behavioral disorders Physical and sexual abuse Rheumatologic conditions, such as arthritis and lupus

Our internationally recognized team of clinicians focuses on treating a wide array of viral, bacterial, and parasitic infections. Through our outpatient clinical services, we diagnose and treat infectious diseases in children from throughout New England and the Mid-Atlantic states. In addition to HIV/AIDS, tuberculosis, and Lyme disease, our doctors are experts in: Acquired and congenital infections in newborns Infections in immunocompromised patients Fungal infections Respiratory tract infections Tropical medicine and parasitology

The Yale Allergy & Immunology Contact Dermatitis Program serves patients affected by one of the most common causes of both personal and occupational allergic skin diseases: allergic contact dermatitis (ACD). ACD is an immune reaction that typically causes a rash in response to a substance in personal care products, medications, or even diet. Other potential allergic sources include occupational exposures and biomedical implants, all of which can result in chronic and sometimes debilitating symptoms. Identification of the offending allergen is key to the rapid diagnosis and resolution of ACD. Patch testing, in which allergens are placed in chambers held in place with adhesive patches on the back, is the gold standard for the diagnosis of ACD. The testing usually takes place during three visits over the course of a week after the initial consultation is completed. At the first visit, the patches are placed, and a second visit occurs 48 hours later for patch removal. Between 72-96 hours after the initial patch placement, a third visit occurs with a final diagnosis and a physician follow-up. Occasionally, a fourth visit is needed for delayed reads of certain allergens. We have the ability to test to multiple extended allergen series, medications, occupational and healthcare-specific substances, as well as some product brought in by patients. We take a personalized approach to the diagnosis and care of patients with contact dermatitis. From the initial consultation and testing phase, where potential allergens will be determined, a custom patch test prescription is prepared, and, ultimately, allergen identification/avoidance strategies and a treatment plan are formulated.

The Cutaneous Granulomatous Disorders Program brings together dermatologists, dermatopathologists, and researchers with expertise in the evaluation and treatment of granulomatous disorders of the skin. Granulomatous disorders of the skin include the following diagnoses: Sarcoidosis Granuloma annulare Necrobiosis lipoidica Reactive granulomatous dermatitis Interstitial granulomatous dermatitis Interstitial granulomatous drug (medication) reaction Palisaded neutrophilic and granulomatous dermatitis Necrobiotic xanthogranuloma Rubella granulomas Granulomatous dermatitis, not otherwise specified These conditions lead to skin rashes, which can be very problematic and are frequently life-altering. Individuals affected by these disorders may experience frustration due to the lack of Food and Drug Administration (FDA)-approved treatment modalities. Yale’s Cutaneous Granulomatous Disorders Program recognizes this and works individually with each patient to find the treatment approach that is most suited to their particular situation and individual goals. The program also strives to identify and evaluate new therapies for these disorders. The primary goal of the Cutaneous Granulomatous Disorders Program is to provide optimal care for each patient seen in our specialty clinic, where we take an individualized approach to each patient’s diagnosis and their goals, pairing these with the best treatment options. The program also has several active clinical trials; patients who are interested may have the ability to participate, potentially providing access to some of the latest molecular therapies undergoing evaluation for the treatment of these disorders. Patients may also have an opportunity to participate in other research projects designed to better understand the molecular pathogenesis of these diseases and their effect on patient well-being. Our team was assembled with the goal of bringing together leading experts in cutaneous granulomatous disorders. The physicians in the program include internationally recognized leaders in medical education on cutaneous granulomatous disorders, scientists that have deciphered the underlying immunology of these disorders, individuals that have developed consensus diagnostic criteria for necrobiotic xanthogranuloma, and physicians that have led the evaluation of new treatment approaches for patients with sarcoidosis, granuloma annulare, and necrobiosis lipoidica. Our team also includes dedicated pharmacists with specialized training in the practical and safe use of cutting-edge dermatologic medications, including those used to treat cutaneous granulomatous disorders. The pharmacists have vast expertise in effectively coordinating insurance coverage and are another important point of contact for our patients as they navigate coverage of specialty medications. For patients with sarcoidosis involving the skin, our dermatologists will work closely with their other specialists to identify the optimal treatment approach. Ya

At the Yale Pediatric Infectious Diseases Consultation Program, our internationally recognized team of clinicians focuses on treating a wide array of viral, bacterial, and parasitic infections. Through our outpatient clinical services, we diagnose and treat infectious diseases in children. In addition to HIV/AIDS, tuberculosis, and Lyme disease, our doctors are experts in: Acquired and congenital infections in newborns Infections in immunocompromised patients Fungal infections Respiratory tract infections Tropical medicine and parasitology Transplant ID Outpatient consultations in Infectious Diseases are provided at The Children's Hospital at Yale New Haven, the major teaching hospital of the Yale School of Medicine. Appointments require a referral from a Primary care provider. To schedule a consultation, physicians should call the YM CARE Center at 1-877-925-3637 (1-877-YALE MDS).

We offer sophisticated approaches for the management of skin cancers, ranging from the most common to the most complicated or rare. At the heart of our program is microscopically controlled excision, known asMohs surgery, the most successful treatment to cure recurrent or other high-risk skin cancers. We have been offering the procedure since 1998, and today, our physicians perform 3,500 Mohs surgeries each year. Mohs surgery has revolutionized the treatment of such skin cancers as basal cell carcinoma and squamous cell carcinoma, and the chances of lasting, disfiguring scars are minimized. In this procedure, the cancer is removed layer by layer, and, after each step, the tissue is examined under a microscope, allowing our dermatologists to confirm that all of the cancer cells have been eliminated as the surgery progresses. This maximizes the chances of removing all of the abnormal cells while still preserving as much of the normal skin tissue as possible.