Departments

The largest center for specialty dermatology in Connecticut, Yale’s Department of Dermatology is among the oldest in the United States. Our doctors and nurses provide safe, compassionate, and innovative care to all members of our community. We offer treatment for skin conditions, all of which can interfere with quality of life. Cutting-edge therapies are often the only hope for patients with resistant dermatologic illness, which affects the whole skin surface. Our physicians are deeply rooted in research, including the exploration of new technologies such as photopheresis for cutaneous T-cell lymphoma and graft-versus-host disease. Our patients often benefit from early access to new treatments and therapies discovered by researchers at Yale. Specialized clinics for organ transplant patients, photopheresis, ichthyosis, and inherited skin disease One of two centers in the state with a pigmented lesion clinic, phototherapy center, and cutaneous lymphoma clinic Cutting-edge microscopically controlled excision (Mohs technique) for recurrence of high-risk cancers Technically advanced referral center for expert diagnosis of benign and malignant skin disorders Large dermatopathology lab, which processes 75,000 patient biopsies annually

The Head and Neck Cancers Program at Smilow Cancer Hospital provides total care, as well as innovative and organ-sparing treatment options to patients with cancers of the head and neck. Our team sets the tone nationally and internationally for clinical trials and state-of-the-art cancer care. By carefully balancing treatment efficacy with quality-of-life, our collaborative approach to care personalizes treatment for tumors affecting the neck, larynx (voice box), pharynx (throat), oral cavity (mouth), ear, sinuses, tonsils, and salivary glands, as well as cervical (neck) lymph nodes or neck structures. Our multidisciplinary team includes head and neck surgeons, radiation oncologists, medical oncologists, pathologists, physical therapists, speech-language pathologists, nutritionists, a smoking cessation specialist, dentists, a physical/lymphedema therapist, advanced practice nurses, and social workers. Functional outcome is an important element in deciding which treatment approach is recommended. Our program offers a promising new surgical technique, transoral robotic surgery (TORS), that can be used to remove certain throat cancers while avoiding skin and bone incisions. This approach speeds healing and shortens a patient’s hospital stay. Likewise, patients with certain laryngeal cancers, who a few years ago would have lost their vocal cords and their voices, can often be treated with less invasive surgeries. Patients who undergo these treatments maintain their ability to speak, although they may need to alter their diet or learn new swallowing techniques. At Yale, rehabilitative specialists work with patients to help them adjust to and overcome some of these swallowing impairments. In many cases, radical neck dissections have been replaced by less radical surgeries that preserve the nerves, arteries, and muscles in the neck. Patients continue to move, speak, breathe, and eat normally after less radical surgeries, without sacrificing cure rates. Additionally, in recent years, the field of reconstructive surgery has achieved many breakthroughs, yielding previously unattainable cosmetic and functional outcomes. Medical Oncology Our medical oncologists have unique expertise in head and neck cancers and dedicate their practice entirely to cancers of the head and neck. The integration of chemotherapy with radiation has become very important for patients with head and neck cancers that involve the lymph nodes or is locally extensive, and this approach can lead to organ preservation and increase the chance of cure for many patients. Breakthroughs in targeted therapy and biomarkers allow a personalized approach that can avoid the toxicities of conventional chemotherapy in some cases, and new treatments to prevent recurrence in high-risk situations are also being studied. For patients with recurrent disease, new anti-cancer drugs and immunotherapies are also available. A study led by Yale Cancer Center revealed that the checkpoint inhibitor pembroli

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.

Cancer Screening strategies are used to identify cancers at their earliest stage, before the onset of signs and symptoms, when the disease is most easily treated or cured. Cancer Prevention strategies are used to minimize the risk of cancer occurring. The Smilow Screening & Prevention Program brings together doctors and researchers at Smilow Cancer Hospital and Yale Cancer Center who are focused on merging the best science with the best cancer prevention and screening programs. Our goal is to provide patients in Connecticut with the tools they need to stay healthy. Screening Our Program offers many different screening tests for cancer of many types. Cancer screening tests are for patients who do not have symptoms. The goal of these tests is to find cancer as early as possible, and before any symptoms appear. Some, but not all, cancer screening tests detect potential problems and allow the doctor to remove the suspicious tissue at the time of the screening. This is important as it means that patients are less likely to develop cancer later in life. Sometimes the screening test results in a finding that requires more follow-up testing. Cancer screening offers the most protection when it is done on a regular basis as recommended by physicians. Patients should consult with their primary care physicians to determine which tests they recommend based on factors including gender, age, family history, and possibly race or ethnicity. Prevention Our program offers information to help patients make choices that can maintain their health and potentially reduce their risk of cancer. It is usually not possible to know why one person develops cancer and another does not. Healthy choices help all people--whether they have a family history of cancer or not--reduce their risk of developing cancer and many other chronic diseases. Avoiding smoking or chewing tobacco, choosing a diet that is rich in fruits and vegetables, exercising regularly, avoiding sitting for long periods, limiting alcohol, protecting skin and eyes from the sun and tanning beds are all key elements of healthy living. Following physician advice on regular cancer screening is also critical to long-term health. Types of cancer screening Click on the links below for more information on these specific cancer screening tests at Smilow Cancer Hospital: Lung Cancer Colorectal Cancer Breast Cancer Prostate Cancer Cervical Cancer Skin Cancer Head & Neck Cancer

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.

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 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.

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

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.

Through laser surgery and other cutting-edge techniques, our board-certified dermatologists can help brighten and rejuvenate our patients’ skin. Our range of expertise includes removal of benign growths such as skin tags and cysts; laser treatment of facial telangiectasias; and the precise placement of fillers to enhance appearance. Laser Treatments For the treatment of broken capillaries on the face due to sun damage, aging, and rosacea, we use a pulsed dye laser to specifically target and destroy these blood vessels. This laser is also used for the treatment of port-wine stains and hemangiomas. For unwanted hair growth, we offer two types of lasers that work either in light or dark skin tones with medium- to dark-colored hair. Over a series of treatments, depending on the site, a significant reduction in hair growth is achieved. Fillers There are a variety of injectable materials that can be placed in the skin to replace volume loss that leads to an aged appearance, or to fill in crevices caused by wrinkles. Common places to use fillers include the lips, smile lines, smoker’s lines, and in the cheeks. We currently offer a range of hyaluronic acid fillers, including Juvéderm®, Restylane®, and Perlane®, which each lasts up to six months. More permanent fillers, such as Sculptra™ and Radiesse®, are also available. Prior to injection of any filler, we perform a cosmetic consultation to assess patients’ expectations and areas of concern to provide the best correction possible. Botulinum Toxin A (Botox) Our physicians are experts in facial anatomy, and perform Botulinum Toxin A injections to minimize the appearance of wrinkles that naturally occur through facial expression. The result is a softening of creases and an overall more “relaxed” appearance. These injections can also be placed on the neck and used to decrease excessive sweating in the armpits, hands, or feet.

Cancer can have a profound impact on someone’s life. From the very beginning, most patients have many questions about the road ahead. Working in collaboration with medical and radiation oncologists at Yale Cancer Center, our world-renowned oncology surgeons are committed to providing compassionate and personalized care, offering comfort and support. We understand that the thought of undergoing surgery can be overwhelming. An integral part of our approach is to provide support, in part, through detailed answers and by thoroughly explaining treatment options and what to expect before, during, and after the surgery. Our innovative methods enable our surgeons to address even the most complex cancerous and noncancerous conditions. Our surgeons provide the most comprehensive and advanced care available, collaborating with other internationally recognized cancer care specialists at Smilow Cancer Hospital at Yale New Haven, including diagnostic and interventional radiologists, gastroenterologists, hepatologists, imaging specialists, and pathologists. Whether patients are newly diagnosed with cancer or their cancer has not responded to traditional treatment therapies, our team of surgeons and specialists will create a personalized plan based on the latest research, technologies, evidence-based medicine, and the possibility of clinical trials. During the first visit, patients will meet with a surgical oncologist, medical oncologist, and a radiation oncologist who will create a personalized treatment. Our goal is to begin treatment as soon as possible. Because our surgeons treat patients at theSmilow Cancer Hospital at Yale New Haven, patients will have access to a multitude of medical and supportive services to help improve their quality of life while living with cancer, and after. We treat the following cancers and cysts: Breast cancer Gastrointestinal cancers, including gastric bile duct, gallbladder, liver, colon, stomach, pancreas, and colorectal cancers Intra-abdominal cancers and tumors Melanoma Pancreatic cysts (noncancerous) Sarcoma Minimally invasive surgery. Our emphasis is on the most successful surgery with the least pain, scarring, and recovery time. Our highly-skilled surgeons are leaders in minimally invasive procedures, even for complex cases that would otherwise require traditional open surgery. During minimally invasive surgery, also known as laparoscopic surgery, only a few small incisions are necessary. Surgeons use small video cameras to view the affected area and use special surgical instruments to perform the surgery. Recovery time and postsurgical discomfort are significantly reduced because the incisions are smaller than with open surgery. Surgical wounds tend to heal more quickly and with less scarring. Whipple Procedure. The pancreas, which is the largest gland of the endocrine system, is difficult to treat surgically because of its position behind major organs. The Whipple procedure is an innovative approach that allows surgeons

The Center for Breast Cancer at Smilow Cancer Hospital and Yale Cancer Center provides coordinated, state-of-the-art care for patients with benign and malignant diseases of the breast. For patients diagnosed with breast cancer , we offer dedicated care, innovative treatment options, and cutting-edge research. A great deal of progress in the detection and treatment of breast cancer has been made in recent years, and our physicians are on the leading edge of finding even better solutions. Women with a diagnosis of breast cancer are cared for by a multidisciplinary team of physician specialists, including radiologists, breast surgeons, medical oncologists, radiation oncologists, pathologists, and plastic surgeons. From the tranquility of the building, to our complementary therapy services, to the most sophisticated personalized therapies and equipment available, Yale is committed to tailoring treatment to our patients to ensure they have the best experiences possible during their time in our care. Breast Surgery Although many general surgeons perform breast surgery, dedicated breast surgeons have the experience and knowledge to handle difficult or unusual cases, and are generally more likely to understand the complexities of breast diagnosis and treatment. The surgeons at the Center for Breast Cancer at Smilow Cancer Hospital and Yale Cancer Center perform breast surgery exclusively, and are nationally known as leaders in their field. Yale surgeons were among the first to perform a lumpectomy instead of a mastectomy, and were instrumental in the development of noninvasive procedures like sentinel lymph node biopsy, intraoperative guidance by ultrasound, and advanced oncoplastic procedures. Our surgeons are experienced in cutting-edge techniques, such as skin-sparing and nipple-sparing mastectomy, and often work hand-in-hand with our plastic surgeons to offer women a variety of options for breast reconstruction. Medical Oncology Many patients with breast cancer also need medical therapy, such as chemotherapy and/or endocrine therapy. Our team of experts utilizes both standard chemotherapies and novel targeted therapies to attack the cancer precisely while minimizing harm to normal tissues. Our medical oncologists are nationally recognized for their contributions to breast cancer research. For example, investigators at Yale helped to elucidate the biology of a cellular receptor called HER2. As a result, our medical oncologists have been successful in developing treatment strategies for HER2-positive breast cancer, and have extended this expertise to provide effective therapies for triple-negative/basal-like and hormone receptor-positive breast cancer. They continue to study new treatments, and patients at Smilow Cancer Hospital have the opportunity to receive such novel therapies through clinical trials, many of which are not available elsewhere in Connecticut. New and complicated patient cases are discussed weekly by the entire team so that