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Mary Ruth Buchness, MD

Joined: 05/02/2011

Expert Profile:

Mary Ruth Buchness, MD is a board-certified Dermatologist with a private practice in medical, surgical, and cosmetic dermatology in Soho in NYC. She is a member of the American Academy of Dermatology, where she has chaired a committee responsible for continued medical education of members. She is the President-elect of the New York State Society of Dermatology and Dermatologic Surgery, and is a member of the President's Council of the National Psoriasis Foundation. She earned her undergraduate degree with honors from Harvard University, and her MD from Columbia University College of Physicians and Surgeons, where she is currently a faculty member. Dr. Buchness has also taught at New York University and at St. Vincent's Catholic Medical Center, where she was the Chief of Dermatology. She has been practicing dermatology and dermatologic surgery for 25 years in Manhattan.
For more information, visit Dr Buchness' website.

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Reply: Vitiligo

Hi, monikavega! Wow, there are a lot of questions here! First, let me...

Posted by Mary Ruth Buchness, MD

Hi, monikavega!
Wow, there are a lot of questions here! First, let me explain vitiligo. It is thought to be an autoimmune disease in which the body develops antibodies that destroy its own pigment cells. It usually develops first around orifices (the mouth, the eyes, the genitals) or on the hands. It has an unpredictable course-some people develop a single spot that never changes, and some people will develop more widespread spots that come and go. There are other situations in which the skin develops what looks like vitiligo, usually at the site of a splash with certain industrial cleaning fluids, or at the site of an itchy rash. In fact, if someone scratches an area for long and hard enough, they can scratch the pigmentation right out of the skin. A biopsy of this area would look exactly like vitiligo. From your description, it sounds like something was happening in the skin before the vitiligo was diagnosed, and I wonder what you mean when you describe "losing tissue at the site." Did the area become indented below the level of the normal skin?
Regarding the association with steroid injections, the pigmentation would disappear only at the site of the injection, because the cortisone temporarily kills the pigment cells. Steroid injections wouldn't activate or make vitiligo worse. If anything, they would help, because they would stop the immune reaction against the pigment cells.
The "Koebner phenomenon" happens when a skin disease localizes to an area of trauma. For example, if you cut yourself, a disease that has the Koebner phenomenon will develop in the scar. Vitiligo has this characteristic, as does psoriasis and several other skin diseases.
The bottom line is that if you have vitiligo, you have to wait and see whether it spreads. There is no predictability.
Regarding your recent surgery, you should be out of the woods as far as infection goes at 2 1/2 weeks, unless you re-injured the area. But if you have any spreading redness or if you see pus in the area, get back to the doctor right away. One reason that a scar becomes tender is if it is developing into a keloid, which is a large, purple scar. Since you mentioned that the area is raised and the podiatrist suggested steroid injections, this may be what is happening. You may want to try a scar gel that contains silicone on the area. Some brands are Kelocote or Bionect.
Good luck!View Thread

Posted byMary Ruth Buchness, MD

2 Replies | Reply | Watch This DiscussionReport This| Share this:Vitiligo Hi, monikavega! Wow, there are a lot of questions here! First, let me...

Reply: Hair vitamins

mstinamai, You won't notice a difference from taking Biotin for 6-12...

Posted by Mary Ruth Buchness, MD

30 Replies | Reply | Watch This DiscussionReport This| Share this:Hair vitamins mstinamai, You won't notice a difference from taking Biotin for 6-12...

Reply: epidurals during cosmetic surgery

Hi, candleinthewind56. The type of anesthesia used is going to be at the...

Posted by Mary Ruth Buchness, MD

1 Reply | Reply | Watch This DiscussionReport This| Share this:epidurals during cosmetic surgery Hi, candleinthewind56. The type of anesthesia used is going to be at the...

Reply: Help :( extremely uneven skin

Anon, I think that you need to see a specialist in pediatric dermatology....

Posted by Mary Ruth Buchness, MD

1 Reply | Reply | Watch This DiscussionReport This| Share this:Help :( extremely uneven skin Anon, I think that you need to see a specialist in pediatric dermatology....

Reply: please help!!!! terrible acne!

Dear Anon, The good news is that when you conceive, the acne may improve...

Posted by Mary Ruth Buchness, MD

4 Replies | Reply | Watch This DiscussionReport This| Share this:please help!!!! terrible acne! Dear Anon, The good news is that when you conceive, the acne may improve...

Reply: Dark spots on my face

Congratulations on your 4 babies! It sounds like you have a condition called...

Posted by Mary Ruth Buchness, MD

7 Replies | Reply | Watch This DiscussionReport This| Share this:Dark spots on my face Congratulations on your 4 babies! It sounds like you have a condition called...

Reply: Skin Tightening Options after Drastic Weight-Loss

There is a procedure called "SkinTyte" that is excellent for spot-firming...

Posted by Mary Ruth Buchness, MD

1 Reply | Reply | Watch This DiscussionReport This| Share this:Skin Tightening Options after Drastic Weight-Loss There is a procedure called "SkinTyte" that is excellent for spot-firming...

Reply: Help!! I really need to find answers.....

Hi, tncalhoon. I think you should take your daughter to see a...

Posted by Mary Ruth Buchness, MD

4 Replies | Reply | Watch This DiscussionReport This| Share this:Help!! I really need to find answers..... Hi, tncalhoon. I think you should take your daughter to see a...

Reply: purple blotchy skin?

Hi, Enelyak01. You mention that you always feel cold. Does the...

Posted by Mary Ruth Buchness, MD

1 Reply | Reply | Watch This DiscussionReport This| Share this:purple blotchy skin? Hi, Enelyak01. You mention that you always feel cold. Does the...

Reply: skin spots

Hi, magalene85. There are many causes of white spots on the skin. Your...

Posted by Mary Ruth Buchness, MD

1 Reply | Reply | Watch This DiscussionReport This| Share this:skin spots Hi, magalene85. There are many causes of white spots on the skin. Your...

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