Skin Health and Inflammation Demystified With Functional Medicine

Understand how functional medicine supports skin health and inflammation management for effective skin care solutions.

Educational Abstract: Integrative, Evidence-Based Skin Lesion Care with Functional and Chiropractic Perspectives

In this educational post, I, Dr. Alex Jimenez, DC, APRN, FNP-BC, CFMP, IFMCP, ATN, CCST, present a first-person, evidence-based walkthrough of evaluating and treating an inflamed seborrheic keratosis on the lateral hip of a middle-aged patient, including anesthesia, intradermal wheal formation, and shave biopsy technique. I explain how integrative chiropractic care fits into comprehensive dermatologic and musculoskeletal evaluation, especially in injury and functional medicine settings, where biomechanics, posture, and neuroimmune factors intersect with skin health.

I highlight our multidisciplinary collaboration at Injury Medical Clinic PA (Mission Plaza Injury Medical Clinic) in El Paso, Texas, where Dr. Maria Guadalupe Cardenas, MD (Board Certified in Internal Medicine; NPI #1164426749; Texas MD License #J2933), serves as Medical Director and Collaborative Physician, providing medical oversight and internal medicine expertise for diagnostics, procedural safety, and complex care. You will learn the physiological rationale behind local anesthesia choices, intradermal wheal mechanics, hemostasis with aluminum chloride, biopsy handling, differential diagnosis for pigmented and inflamed lesions, and follow-up care, all framed in an integrative model that includes functional medicine, rehabilitation, and personal injury.

The post emphasizes risk stratification, patient-centered safety, evidence-based decision-making, and the role of musculoskeletal and autonomic considerations in dermatologic presentations, ensuring practical insights for clinicians and clarity for patients.

Introduction to Our Integrative Clinical Approach

I am Dr. Alex Jimenez, DC, APRN, FNP-BC, CFMP, IFMCP, ATN, CCST, and I lead an integrative clinical team focused on comprehensive injury, functional health, and evidence-based care. Our practice, Injury Medical Clinic PA (also known as Mission Plaza Injury Medical Clinic) in El Paso, Texas, brings together chiropractic, internal medicine, functional medicine, and rehabilitation. At the heart of our model is a collaborative partnership with Dr. Maria Guadalupe Cardenas, MD, a Board-Certified Internist with over 40 years of experience (NPI #1164426749; Texas MD License #J2933), who serves as our Medical Director and Collaborative Physician. Her oversight enhances patient safety, diagnostic accuracy, and continuity of care.

In this post, I walk you through a real-world scenario of a middle-aged man with a painful, inflamed lesion on the lateral right hip. I explain each step—from initial assessment to shave biopsy—and why we choose specific techniques, and how integrative chiropractic care and functional medicine principles inform our clinical decisions. I will reference leading research in dermatology, pain science, neuroimmunology, and musculoskeletal medicine, and I will integrate insights from my clinical observations, available at the HealthCoach Clinic and my LinkedIn profile, to provide practical, evidence-based guidance.

Case Overview: A Painful, Inflamed Lesion on the Lateral Hip

A middle-aged man presented with a skin lesion on the lateral aspect of his right hip, noticeably enlarging over four weeks, accompanied by inflammation and pain. The lesion was clinically consistent with an inflamed seborrheic keratosis: a benign epidermal tumor often described as “stuck-on,” variably pigmented, and sometimes irritated or inflamed due to friction or secondary trauma. The lateral hip is a region prone to mechanical friction from clothing, belts, or activity-related contact, as well as postural and gait influences. These mechanical factors can aggravate superficial skin lesions, especially if underlying bony prominences and soft tissue dynamics increase localized shear forces.

Based on appearance, growth history, and symptom profile, the initial working diagnosis was inflamed seborrheic keratosis. However, because inflamed or atypical-appearing SKs can mimic other lesions, including basal cell carcinoma, squamous cell carcinoma, irritated melanocytic nevi, or, less commonly, melanoma, I planned a diagnostic shave biopsy to obtain histopathologic confirmation. My clinical objective was to provide a safe, efficient, minimally invasive biopsy; optimize patient comfort with local anesthesia; achieve hemostasis; and ensure appropriate tissue handling for pathology. Under our integrative framework, I coordinated with Dr. Cardenas for medical oversight, especially for peri-procedural safety, medication review, and follow-up planning.

Preparing the Field: Antisepsis and Sensory Modulation

I began by cleaning the area thoroughly with alcohol to reduce microbial load. Alcohol-based antiseptics rapidly denature proteins and disrupt bacterial membranes, offering broad-spectrum coverage and fast evaporation that supports procedural flow. For comfort, I used a brief cryo-analgesia technique with a pain ease mist (a vapocoolant spray). Short, controlled cooling can reduce nociceptive input by lowering the temperature of superficial nerve endings, diminishing pain perception at needle entry.

This initial sensory modulation primes the skin by providing immediate, short-lived analgesia, lowering the intensity of the first needle puncture. It is particularly useful in areas where patients expect high sensitivity, or when multiple intradermal passes are planned to raise a wheal. Integrative perspective: By acknowledging the neurophysiology of pain—specifically, the role of C fibers and A-delta fibers and the gating of nociception—simple measures like vapocoolant sprays can meaningfully enhance patient experience and reduce under-treatment of pain, without systemic effects. This aligns with non-pharmacologic pain strategies commonly used in musculoskeletal care.

Local Anesthesia: Choosing Lidocaine with Epinephrine

I selected a 30-gauge, half-inch needle to infiltrate local anesthetic—1% lidocaine with epinephrine—into the subcutaneous tissue. The small gauge reduces insertion pain and tissue trauma while providing adequate flow for infiltration. Lidocaine provides rapid-onset, intermediate-duration local anesthesia by blocking voltage-gated sodium channels in nerve membranes, preventing depolarization and pain signal conduction. Epinephrine, added at standard concentrations, causes localized vasoconstriction by activating alpha-1 adrenergic receptors. The rationale for including epinephrine is threefold: it prolongs the anesthetic effect by slowing systemic absorption, reduces bleeding by constricting superficial vessels, and improves the surgical field clarity. In a shave biopsy, reduced bleeding helps define the plane of resection and minimizes tissue distortion.

• Safety considerations: While epinephrine should be used cautiously in end-arterial fields (such as digits, nose tip, ear, penis), the lateral hip is not an end-arterial territory, making this combination safe and advantageous. Nevertheless, I confirmed the patient’s cardiovascular status, medication list, and any history of arrhythmias or adverse reactions—a step guided by Dr. Cardenas’s internal medicine oversight.

Intradermal Wheal Formation: Elevating the Lesion for Precision

After initial subcutaneous infiltration, I redirected the needle without fully withdrawing it and advanced intradermally beneath the lesion, gently creating an intradermal wheal. This raised the lesion toward the blade, improving access and allowing a more controlled and superficial shave. Mechanistically, intradermal infiltration slightly separates the epidermis and superficial dermis, creating a cushion that limits deeper blade penetration. This helps prevent removal of unnecessary dermal tissue, minimizes scarring, and supports a cosmetically favorable result. The wheal also aids hemostasis by providing mechanical tamponade and by dispersing anesthetic where free nerve endings are densest. Patient feedback during this step indicated minimal discomfort, suggesting adequate anesthesia and effective pain control.

• Evidence-based perspective: Intradermal tumescent techniques (mini-tumescent for shave biopsies) enhance precision and reduce complications. In research and practice, adequate wheal formation correlates with improved sampling adequacy and reduced need for repeat procedures, a critical consideration for diagnostic accuracy in pigmented or inflamed lesions.

Shave Biopsy Technique: Superficial Removal with Hemostatic Control

With the lesion elevated by the wheal, I initiated the shave biopsy approximately two millimeters lateral to the lesion margin to ensure an even, controlled entry. The blade traversed the superficial dermal plane, allowing complete removal of the lesion while preserving deeper dermal architecture. The goal in a shave biopsy for suspected seborrheic keratosis is complete superficial excision sufficient for histopathologic evaluation, recognizing that these lesions arise from the epidermis and typically do not require deep excision. Carefully controlling depth prevents unnecessary scarring and reduces the risk of post-inflammatory dyspigmentation. During the shave, I continuously monitored for patient discomfort and bleeding. After removing the lesion, I inspected the base for residual fragments or atypical features. Ensuring no visible residual tissue helps minimize recurrence and clarifies histologic interpretation.

• Integrative safety: Procedural efficiency and precision reduce cumulative nociception, lower stress responses (e.g., catecholamine surges), and support a smoother recovery. In our multidisciplinary clinic, such procedures are embedded within a broader patient-centered framework that values comfort, clarity, and continuity of care.

Achieving Hemostasis: Aluminum Chloride Application

Following excision, I applied aluminum chloride solution, saturated on a gauze pad, to the biopsy site. Aluminum chloride is a commonly used topical hemostatic agent that precipitates proteins and causes vasoconstriction at small vessels, providing quick hemostasis for superficial procedures. Compared with electrocautery, aluminum chloride avoids thermal injury, reduces scarring risk, and suits shave biopsies in areas like the hip where cosmetic outcomes matter, though less so than on the face. It also simplifies post-procedure care by reducing exudate and crusting. Bleeding ceased promptly, and the site was prepared for sterile dressing and specimen packaging for pathology. Tissue handling integrity was maintained to ensure accurate diagnosis.

• Functional rationale: Rapid hemostasis minimizes wound exposure to environmental contaminants and reduces inflammatory signaling that can increase nociception. In patients with autonomic dysregulation, careful hemostatic control can help avoid exaggerated vasomotor responses.

Differential Diagnosis: Why a Biopsy Matters in Inflamed Lesions

While inflamed seborrheic keratosis is common and benign, its variable presentations can overlap with other entities. The differential diagnosis includes irritated melanocytic nevus, basal cell carcinoma, squamous cell carcinoma (particularly keratoacanthoma-type lesions), and, in some cases, melanoma presenting with inflammation. Changes in size, color, borders, elevation, bleeding, pain, or pruritus guide the decision to biopsy. Rapid enlargement over weeks with inflammation and pain, as in this case, justifies histologic confirmation to exclude malignancy or atypical proliferations, especially in sun-exposed or high-friction zones. Histopathology clarifies features such as acanthosis, hyperkeratosis, pseudohorn cysts (characteristic of seborrheic keratosis), or atypical keratinocyte proliferation suggestive of squamous neoplasia. In pigmented lesions, pathology confirms whether melanin distribution or melanocytic proliferation warrants further excision.

• Clinical prudence: Evidence supports biopsy for changing or symptomatic SK-like lesions, particularly in older individuals, because misclassification can delay necessary oncologic management. We rely on pathology to calibrate follow-up, additional excision, and patient counseling.

Integrative Chiropractic Care: Where Musculoskeletal and Dermatologic Health Intersect

As a chiropractor and advanced practice clinician, I evaluate not only the lesion but also the surrounding biomechanics. The lateral hip region is subject to friction from clothing and movement patterns. Altered gait, pelvic tilt, or external rotation can increase contact stress at the iliotibial band-area skin, potentially aggravating superficial lesions. Integrative chiropractic care contributes by assessing posture, gait, and soft tissue dynamics. For example, addressing a tight iliotibial band, gluteal trigger points, or pelvic obliquity can reduce localized frictional forces against the skin, decreasing the risk of recurrent irritation of epidermal lesions in high-contact zones. Additionally, autonomic nervous system balance—a frequent focus in functional and chiropractic care—can influence skin vasomotor tone, sweating, and inflammatory responses. Techniques that modulate sympathetic-parasympathetic balance (e.g., diaphragmatic breathing, vagal tone strategies, gentle spinal mobilization) may improve local tissue resilience.

• Practical application: I often integrate gentle soft tissue work, targeted corrective exercises, and ergonomic coaching to limit mechanical aggravators. This is especially relevant in personal injury contexts, where altered movement patterns post-injury can exacerbate friction-sensitive skin areas.

Medical Oversight and Collaborative Care: Dr. Cardenas’s Role

Our internal medicine partner, Dr. Maria Guadalupe Cardenas, MD, provides essential medical direction. She reviews patient histories for comorbidities (e.g., diabetes, anticoagulation status, vascular conditions), evaluates medication interactions (e.g., anticoagulants, antiplatelets, beta-blockers affecting response to epinephrine), and ensures adherence to procedural safety standards. In this case, Dr. Cardenas’s oversight contributed to risk stratification for bleeding, infection, and anesthetic tolerance. She also coordinates follow-up for pathology results and guides systemic evaluations if pathology warrants further investigation or if lesions reflect underlying systemic conditions. This multidisciplinary setup—chiropractic care integrated with medical direction—exemplifies modern injury and functional clinics. It expands scope safely while maintaining high standards of evidence-based practice, ensuring that when musculoskeletal and dermatologic issues intersect, patients receive cohesive, comprehensive care.

• Organizational benefit: Patients gain a streamlined experience—one clinic, multiple perspectives—reducing fragmentation and improving outcomes.

Functional Medicine Lens: Inflammation, Immunity, and Skin

Functional medicine emphasizes systems biology. In skin health, we consider the immune microenvironment, barrier integrity, microbiome, and systemic inflammatory load. Factors like chronic stress, poor glycemic control, micronutrient deficiencies, and metabolic syndrome can exacerbate inflamed lesions. We evaluate diet quality, glycemic variability, sleep, stress, and environmental exposures. Nutritional strategies to support skin health include adequate omega-3 fatty acids, vitamin D sufficiency, polyphenol-rich foods, and protein adequacy to support keratinocyte turnover and wound healing.

• Gut-skin axis: Dysbiosis and increased intestinal permeability can upregulate systemic inflammatory mediators that influence skin reactivity. While a seborrheic keratosis is not an inflammatory disease per se, a pro-inflammatory milieu can heighten symptom perception and delay healing from minor procedures.
• Personalized plans: We integrate nutrition counseling, movement prescriptions, stress modulation, and targeted supplementation when appropriate to optimize the terrain for recovery and resilience.

Post-Procedure Care: Healing, Scar Minimization, and Recurrence Prevention

After hemostasis, I placed a sterile dressing. I provided clear wound care instructions: keep the area clean and dry for 24 hours, then gently cleanse and apply a thin film of petrolatum or a modern occlusive dressing to support moist wound healing, which reduces scar formation and accelerates re-epithelialization. Sun protection is crucial to prevent post-inflammatory hyperpigmentation, particularly in individuals with higher Fitzpatrick skin types. We advise a broad-spectrum SPF on exposed areas and protective clothing when feasible.

Patients are instructed to monitor for signs of infection (increasing redness, warmth, discharge, fever), persistent bleeding, or unexpected pain. We schedule a follow-up to review pathology and assess healing. Recurrence prevention includes minimizing mechanical friction through clothing choices, posture and gait corrections, and addressing repetitive activities that could irritate the area. In integrative practice, these practical steps complement the procedural success.

Evidence Behind Shave Biopsy: Efficacy and Safety

Shave biopsy is widely accepted for diagnosing superficial epidermal lesions such as seborrheic keratoses and many keratinocytic neoplasms. Studies show high diagnostic yield with low complication rates when performed with appropriate technique, anesthesia, and hemostasis. Advantages include rapid execution, minimal invasiveness, and often favorable cosmetic outcomes. Potential limitations include the risk of partial sampling in deeper lesions or in melanocytic lesions where full-thickness assessment may be preferable; clinical judgment therefore directs technique choice.

Hemostasis with aluminum chloride and anesthesia with lidocaine-epinephrine are well-supported in dermatologic literature for such procedures, offering a balance of efficacy and safety in non-end-arterial fields. Our protocols align with dermatologic best practices, and our multidisciplinary oversight further enhances patient safety, especially in those with comorbidities.

Neurophysiology of Pain and Comfort Strategies

Pain arises from nociceptor activation in the epidermis and dermis, transmitted via A-delta and C fibers. Needle entry and tissue infiltration trigger mechanosensitive and chemosensitive pathways. Vapocoolant spray temporarily reduces pain by cooling and modulating these fibers. Lidocaine interrupts action potentials by blocking sodium channels, while epinephrine reduces perfusion, lowering washout. Intradermal buffering (sometimes with bicarbonate, though not used here) can reduce sting by equalizing pH; wheal creation distributes anesthetic where free nerve endings are dense.

Psychological factors—anticipation, anxiety—amplify pain via cortical modulation. Clear communication, step narration, and patient involvement reduce uncertainty, lowering sympathetic arousal and perceived pain. Integrative care: We often incorporate breathing techniques or brief mindfulness cues before procedures to lower sympathetic tone and improve the overall experience.

Biomechanics and Skin: Friction, Shear, and Lesion Irritation

The lateral hip overlies the greater trochanter region, with soft tissue layers including subcutaneous fat and fascia (iliotibial band) subjected to shear during walking, side-lying sleep, and clothing contact. Repetitive microtrauma can irritate superficial lesions. A chiropractic assessment identifies contributors such as pelvic obliquity, leg length discrepancy, gluteal weakness, or IT band tightness. We can address these with targeted mobilization, soft tissue release, neuromuscular re-education, and home exercises.

By reducing friction and improving movement efficiency, we reduce the risk of cutaneous irritation and enhance comfort. This is particularly valuable in individuals with occupations or sports that stress the lateral hip region. Patient education includes ergonomic suggestions, garment selection, and activity modifications, demonstrating how musculoskeletal care supports dermatologic comfort and healing.

Safety, Risk, and Contraindications: Internal Medicine Support

Under Dr. Cardenas’s guidance, we screen for bleeding risks (anticoagulants, thrombocytopenia), infection risks (immunosuppression, poorly controlled diabetes), and anesthetic contraindications (allergies, history of arrhythmia). Documentation includes informed consent, detailed procedural notes, and post-care instructions. For patients on anticoagulants, we weigh risks and benefits; shave biopsies often proceed with careful local hemostasis, but coordination with prescribing providers may be necessary. For patients with keloid tendencies, we discuss scar risks and preventive strategies. Silicone gels, pressure therapy, and careful avoidance of tension across healing skin can reduce hypertrophic responses. This structured approach aligns with evidence-based peri-procedural safety and underscores the value of multidisciplinary oversight in outpatient procedures.

Pathology and Communication: Closing the Loop

Accurate labeling, prompt transport, and clear clinical notes to the pathologist improve diagnostic yield. We include lesion description, location, clinical impression, duration, and prior treatments. This clinical-pathologic correlation is vital. We contact patients with results and arrange follow-up when needed. If the lesion is benign and fully removed, reassurance and routine surveillance suffice. If atypia or malignancy is found, we escalate care—potentially involving dermatology or surgery—within our network. Patient-centered communication reduces anxiety and improves adherence to follow-up recommendations, contributing to better outcomes.

The Healing Diet: Combat Inflammation, Embrace Wellness- Video

The Role of Integrative Chiropractic in Personal Injury and Skin Care

In personal injury contexts, patients often present with altered movement patterns that increase friction on certain skin areas. Our chiropractic interventions target these patterns, reducing cutaneous irritation and promoting comfort during recovery. Integrative care also addresses the stress response associated with injury. Chronic sympathetic activation can impair wound healing and increase inflammatory reactivity. We incorporate stress reduction, sleep optimization, and gentle movement to support recovery.

Collaboration with internal medicine ensures we address systemic issues—like uncontrolled hypertension, diabetes, or medication interactions—while we manage musculoskeletal and dermatologic needs. This model exemplifies whole-person care, where procedures like shave biopsies occur within a broader therapeutic context.

Clinical Observations from Practice

In my practice, patients with lateral hip lesions often report increased discomfort during prolonged sitting, side-lying sleep, or after specific activities like long walks or runs. Addressing IT band tightness and conditioning the gluteus medius reduces symptom recurrence. Patients with metabolic syndrome frequently experience slower healing and greater inflammation after minor procedures. Nutritional counseling to improve insulin sensitivity and reduce systemic inflammation correlates with better healing trajectories. Anxiety reduction through education and transparent process narration consistently yields lower perceived pain and better patient satisfaction during minor procedures. These observations align with published evidence linking biomechanical, metabolic, and psychosocial factors with dermatologic symptom burden and healing outcomes.

Integrative Protocol Summary for Inflamed Seborrheic Keratosis

• Assessment: Careful examination, dermoscopic evaluation if available, and risk stratification for malignancy. If features are atypical or symptomatic, proceed to biopsy.
• Preparation: Antisepsis with alcohol, optional vapocoolant for initial analgesia, informed consent, and positioning to optimize access and comfort.
• Anesthesia: 1% lidocaine with epinephrine via 30-gauge needle; initial subcutaneous infiltration followed by intradermal wheal creation to elevate the lesion and distribute anesthetic evenly.
• Shave: Controlled, superficial plane resection beginning slightly lateral to the lesion; ensure complete removal and inspect base.
• Hemostasis: Aluminum chloride application for rapid bleeding control; dress and provide wound care instructions.
• Follow-up: Pathology review, communication, and plan adjustments; consider integrative measures to reduce irritation and support healing.

Why Integrative Care Matters for Dermatologic Procedures

Combining chiropractic insights with medical oversight bridges a gap between biomechanics and dermatology. It reduces irritation recurrence and supports a better healing environment. Functional medicine expands the lens to systemic contributors, ensuring that local procedures benefit from global health improvements. Patients benefit from a cohesive, coordinated approach that respects safety, comfort, and long-term well-being.

A Personal Note on Patient Experience and Education

I prioritize clear communication and patient empowerment. When patients understand each step—what I am doing and why—they often relax, report less pain, and recover more smoothly. Education extends beyond the procedure: we discuss posture, clothing choices, activity modifications, and nutrition to prevent irritation and support skin health. Our team’s synergy—chiropractic, internal medicine, rehab, and functional medicine—creates an environment where patients feel supported, informed, and confident in their care.

Conclusion: Evidence-Based, Patient-Centered, Integrative Dermatologic Care

This case illustrates how a straightforward dermatologic procedure benefits from a comprehensive, integrative approach. From anesthesia choices to post-procedure care and biomechanical adjustments, each element is purposeful and evidence-based. Working with Dr. Maria Guadalupe Cardenas, MD, we ensure safety, precision, and continuity of care. Our integrative chiropractic care, functional strategies, and rehabilitation support not only resolve the immediate problem but also reduce recurrence and enhance overall health. Patients deserve care that is technically sound and human-centered. Our multidisciplinary clinic delivers on both.

References

• Jones, S., Henry, V., Strong, E., Sheriff, S. A., Wanat, K., Kasprzak, J., Clark, M., Shukla, M., Zenga, J., Stadler, M., Dzwierzynski, W., Harker-Murray, A., Young, K., Kothari, A. N., & Clarke, C. N. (2023). Clinical Impact and Accuracy of Shave Biopsy for Initial Diagnosis of Cutaneous Melanoma. The Journal of Surgical Research, 286, 35–40. doi.org/10.1016/j.jss.2022.12.042
• AMurthy AB, Palaniappan V, Karthikeyan K. Aluminum in dermatology – Inside story of an innocuous metal. Indian J Dermatol Venereol Leprol. 2024;90:755-62. doi: 10.25259/IJDVL_188_2023
• Ammad, S., Licata, G., Brancaccio, G., Moscarella, E., & Argenziano, G. (2023). Clinical and Dermatoscopic Features of Seborrheic Keratoses According to Skin Types: A Retrospective Study. Dermatology Practical & conceptual, 13(4), e2023253. doi.org/10.5826/dpc.1304a253
• Work Group, Invited Reviewers, Kim, J. Y. S., Kozlow, J. H., Mittal, B., Moyer, J., Olenecki, T., & Rodgers, P. (2018). Guidelines of care for the management of cutaneous squamous cell carcinoma. Journal of the American Academy of Dermatology, 78(3), 560–578. doi.org/10.1016/j.jaad.2017.10.007
• Saco, M., & Golda, N. (2019). Postoperative Pain Management in Dermatologic Surgery: A Systematic Review. Dermatologic Clinics, 37(3), 341–348. doi.org/10.1016/j.det.2019.03.004
• Gulseren, D., Bostan, E., & Ersoy-Evans, S. (2021). The dermoscopic features of seborrheic keratoses according to patient age and anatomic localization. Journal of Cosmetic Dermatology, 20(8), 2675–2677. doi.org/10.1111/jocd.13910
• Pickett, H. (2011). Shave and punch biopsy for skin lesions. American Family Physician, 84(9), 995–1002. pubmed.ncbi.nlm.nih.gov/22046939/
• Islam, R. K., Tong, V. T., Robicheaux, C., Tageant, H., Haas, C. J., Kline, R. J., & Islam, K. N. (2024). The Impact of Anesthesia on Dermatological Outcomes: A Narrative Review. Cureus, 16(10), e72321. doi.org/10.7759/cureus.72321
• Griffith, R. J., Jordan, V., Herd, D., Reed, P. W., & Dalziel, S. R. (2016). Vapocoolants (cold spray) for pain treatment during intravenous cannulation. The Cochrane database of systematic reviews, 4(4), CD009484. doi.org/10.1002/14651858.CD009484.pub2
• Greco MJ, Bhutta BS. Seborrheic Keratosis. [Updated 2024 May 6]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Available from: www.ncbi.nlm.nih.gov/books/NBK545285/
• Xie, F & Wang, R & Chen, Y & Jia, Y & Jia, X & Chen, M & Yang, L & Lan, X. (2015). A Case of Seborrheic Keratosis and Family Survey. West Indian Medical Journal. 10.7727/wimj.2014.221.
• Chu, C. Y., Yang, C. H., & Chiu, H. C. (2001). Inflammation of seborrheic keratoses due to docetaxel treatment. Acta Dermato-Venereologica, 81(4), 316–317. doi.org/10.1080/00015550152573092
• Tschandl, P., et al. (2018). Dermoscopy of pigmented lesions: Differentials and clues. International Journal of Dermatology, 57(1), 3–14.
• Nuutila, K., & Eriksson, E. (2021). Moist Wound Healing with Commonly Available Dressings. Advances in wound care, 10(12), 685–698. doi.org/10.1089/wound.2020.1232
• Bailey, J., Schwehr, M., & Beattie, A. (2024). Management of Keloids and Hypertrophic Scars. American Family Physician, 110(6), 605–611. pubmed.ncbi.nlm.nih.gov/39700364/

SEO tags: integrative dermatology, shave biopsy, seborrheic keratosis, intradermal wheal, lidocaine with epinephrine, aluminum chloride hemostasis, chiropractic care, functional medicine, internal medicine collaboration, Injury Medical Clinic PA, Mission Plaza Injury Medical Clinic, El Paso, Texas, Dr Alex Jimenez, Dr Maria Guadalupe Cardenas, personal injury care, wound healing, pain management, biomechanics and skin, evidence-based dermatology, multidisciplinary clinic