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Dermatologist (skin)
20 years of experience
Video profile
Accepting new patients

Education ?

Medical School Score Rankings
University of Pennsylvania (1990)
  • Currently 4 of 4 apples
Top 25%

Awards & Distinctions ?

Awards  
One of America's Leading Experts on:
Skin Cancer (Skin Neoplasms)
2006 Top Doctors, Philadelphia Magazine
Castle Connolly's Top Doctors™ (2012 - 2013)
Appointments
Thomas Jefferson University Jefferson Medical College
Associations
American Board of Dermatology
American Society for Dermatologic Surgery

Affiliations ?

Dr. Humphreys is affiliated with 11 hospitals.

Hospital Affilations

Score

Rankings

  • Bryn Mawr Rehabilitation Hospital
    414 Paoli Pike, Malvern, PA 19355
    • Currently 4 of 4 crosses
    Top 25%
  • Thomas Jefferson University Hospital *
    111 S 11th St, Philadelphia, PA 19107
    • Currently 4 of 4 crosses
    Top 25%
  • Main Line Hospital Lankenau
    100 E Lancaster Ave, Wynnewood, PA 19096
    • Currently 4 of 4 crosses
    Top 25%
  • Main Line Hospital - Bryn Mawr
    130 S Bryn Mawr Ave, Bryn Mawr, PA 19010
    • Currently 4 of 4 crosses
    Top 25%
  • Riddle Memorial Hospital
    1068 W Baltimore Pike, Media, PA 19063
    • Currently 3 of 4 crosses
    Top 50%
  • Methodist Hospital
    2301 S Broad St, Philadelphia, PA 19148
    • Currently 3 of 4 crosses
    Top 50%
  • Main Line Hospital Paoli
    255 W Lancaster Ave, Paoli, PA 19301
    • Currently 2 of 4 crosses
  • Paoli Hospital - On staff since
  • Lankenau Medical Center
  • Bryn Mawr Hospital - On staff since
  • Lankenau Medical Center - On staff since
  • * This information was reported to Vitals by the doctor or doctor's office.

    Publications & Research

    Dr. Humphreys has contributed to 27 publications.
    Title Ablative Laser Resurfacing: High-energy Pulsed Carbon Dioxide and Erbium:yttrium-aluminum-garnet.
    Date December 2007
    Journal Clinics in Dermatology
    Excerpt

    The development of the short-pulsed high-energy carbon dioxide laser in the mid 1990's led to the emergence of laser skin resurfacing. Used in the continuous mode, the CO(2) laser can cut and coagulate simultaneously. Used in the pulsed mode, the CO(2) laser is a powerful tool for epidermal ablation in many different contexts both therapeutic and cosmetic. Both the CO(2) and Erbium YAG lasers emit light in the infrared spectrum. Energy is preferentially absorbed by intracellular water creating rapid heating and vaporization of tissue. Because of the wavelength of the Er:YAG laser (2940 nm) more closely approximates the absorption peak of water (3000 nm) the target chromophore than the CO(2) laser (10,600 nm) nearly all of the energy is absorbed in the epidermis and papillary dermis yielding superficial ablation and less underlying thermal damage. The advantages, disadvantages, and applications of each type of laser resurfacing will be discussed. Despite proven efficacy, the public acceptance of laser resurfacing has declined with the emergence of new laser systems that cause dermal remodeling without ablating the overlying epidermis dramatically reducing recovery time. In the absence of blinded comparison studies, it remains unclear whether the clinical results of the newer 'nonablative' laser systems compare with their ablative predecessors.

    Title Pigmented Bowen's Disease Clinically Mimicking Melanoma of the Nail.
    Date January 2007
    Journal Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [et Al.]
    Title Laser-tissue Interactions.
    Date September 2006
    Journal Clinics in Dermatology
    Excerpt

    As new laser devices continue to emerge, it becomes increasingly important for the clinical dermatologist to understand the basic principles behind their operation. A fundamental understanding of how lasers interact with tissue will enable the physician to choose the most appropriate laser for a given clinical situation. Although the physical laws guiding laser design are vastly complex, the fundamental principles of laser-tissue interaction can be summarized as they are applicable to the clinician.

    Title Epidermotropically Metastatic Pancreatic Adenocarcinoma.
    Date July 2006
    Journal The American Journal of Dermatopathology
    Excerpt

    We describe an epidermotropically metastatic pancreatic mucinous ductal adenocarcinoma on the scalp. Neoplastic glandular structures that varied in size and shape containing abundant mucin within the lumens and in the neoplastic cells were present within a seborrheic keratosis and adjacent normal epidermis. Similar neoplastic glandular structures were present in the dermis, some within adnexal epithelium and lymphatic vessels. The patient's history of pancreatic mucinous ductal adenocarcinoma and immunohistochemical staining pattern of carbohydrate antigen 19-9 (CA 19-9) confirmed the diagnosis.

    Title Mohs Micrographic Surgery for Squamous Cell Carcinoma Associated with Epidermolysis Bullosa.
    Date April 2006
    Journal Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [et Al.]
    Title Perioperative Management of Patient Expectations.
    Date March 2006
    Journal Skinmed
    Title Mohs Surgery for Malignant Eccrine Neoplasms.
    Date January 2005
    Journal Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [et Al.]
    Excerpt

    BACKGROUND: Eccrine carcinomas (ECs) are rare tumors with potentially aggressive clinical behavior and a high recurrence rate following conventional surgical excision. With the exception of microcystic adnexal carcinoma (MAC), there have been few reports on the use of Mohs micrographic surgery (MMS) as a primary treatment for EC. OBJECTIVE: To review the use of MMS for EC and compare treatment outcomes with those of conventional surgical excision. METHODS: We report our use of MMS in 7 cases of EC and review the literature regarding the use of MMS for EC excluding microcystic adnexal carcinoma (MAC), which has been described elsewhere. RESULTS: A total of 19 case reports describing MMS for non-MAS malignant eccrine neoplasms were reviewed. There were no reported recurrences over an average follow-up period of 29 months, whereas the local recurrence rate following conventional surgical excision of these neoplasms from 10-70%. CONCLUSIONS: While the clinical experience is limited, the use of MMS appears to decrease recurrence rates when compared to conventional surgical excision. Further experience and longer follow-up intervals will be necessary to demonstrate superior efficacy and recommended surgical margins.

    Title Superficial Leiomyosarcoma Treated with Mohs Micrographic Surgery.
    Date March 2004
    Journal Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [et Al.]
    Excerpt

    BACKGROUND: Leiomyosarcoma (LMS) is a rare cutaneous malignancy with an infiltrative growth pattern and high risk of local recurrence (30-45%) with conventional wide excision. Mohs micrographic surgery (MMS) may offer an improved cure. OBJECTIVE: To illustrate by case reports the spectrum of clinical presentation of this rare neoplasm and management with MMS. METHODS: The outcomes of three cases of LMS treated by Mohs micrographic are described and compared with other cases in the medical literature. RESULTS: Three cases of LMS were excised using MMS. Two cutaneous tumors located on the trunk and arm were easily removed and have not recurred. The third tumor on the leg of an immunosuppressed patient demonstrated deep soft-tissue invasion that developed subsequent cutaneous metastases but no recurrence adjacent to the primary site. The patient remains disease free at 36 months after amputation below the knee. A total of 15 cases of LMS treated by MMS are reported in the literature, including these cases, with an aggregate recurrence rate of 13%. CONCLUSIONS: The overall cure rate of leiomyosarcoma treated by MMS is 87%, which compares favorably to wide excision and offers the advantage of tissue sparing. Immunosuppression may promote aggressive tumor behavior. Deeply invasive tumors may result in cutaneous or distant metastases regardless of the method of excision.

    Title Surgical Pearl: Immobilization of the Helical Rim for Postauricular Procedures.
    Date February 2004
    Journal Journal of the American Academy of Dermatology
    Title A Case of Extraskeletal Osteosarcoma with Metastasis to the Skin.
    Date July 2003
    Journal Journal of the American Academy of Dermatology
    Excerpt

    We present an 83-year-old woman with extraskeletal osteosarcoma (ESOS) of the breast who developed metastasis to the scalp. Skeletal osteosarcoma is the most common primary malignant neoplasm of the bone, predominantly occurring in the metaphysis of the long bones of adolescents and young adults. ESOS, in contrast, occurs primarily in the fifth and sixth decades of life, most commonly in the soft tissue of the thigh. Although the lung is overwhelmingly the most common site of metastasis for both skeletal osteosarcoma and ESOS, the skin is an uncommon metastatic site with only a few reported cases. Metastasis of ESOS to the skin is an exceedingly infrequent phenomenon, which may be a sign of widespread metastases foreboding a grim prognosis.

    Title Skin Cancer: Recognition and Management.
    Date May 2003
    Journal Clinical Cornerstone
    Excerpt

    Skin cancer is the most common malignancy in humans and accounts for one third of newly diagnosed cancers--it will be diagnosed in approximately 1 in 5 Americans in their lifetime and > 1 million cases are diagnosed each year. Skin cancer can cause local tissue destruction, disfigurement, and even death if left untreated; therefore, timely recognition, treatment, and appropriate referral are critical to reducing morbidity. As the incidence of skin cancer rises each year, the primary care physician needs to be familiar with the clinical presentation, treatment options, and means of prevention of the most common skin cancers: basal cell carcinoma, squamous cell carcinoma, and malignant melanoma.

    Title Use of the "spiral" Flap for Closure of Small Defects of the Nasal Ala.
    Date May 2001
    Journal Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [et Al.]
    Excerpt

    BACKGROUND: Multiple wound closure options exist for cutaneous defects of the nasal ala. The best option depends on the depth, size, and location of the defect. OBJECTIVE: To demonstrate a modification of the traditional rotation flap for closure of small alar defects. METHODS: The design and execution of the "spiral" flap for closure of a representative defect are described. RESULTS: Immediate and delayed postoperative views demonstrate expected outcome. CONCLUSION: The spiral flap modification of the rotation flap is a simple and elegant closure option for small nasal alar defects.

    Title Mast Cells and Dendritic Cells in Basal Cell Carcinoma Stroma.
    Date August 2000
    Journal Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [et Al.]
    Excerpt

    BACKGROUND: The interaction of tumors with the surrounding stroma has become an important topic in tumor biology. Basal cell carcinoma (BCC) stroma has been characterized as hypervascular and rich in mast cells. The presence of dermal dendrocytes thought to have both antigen presenting and wound healing functions has recently been reported in BCC stroma. GP1b-alpha is a newly described vascular adhesion molecule with potential significance in tumor biology. OBJECTIVE: To further characterize the cellular phenotype of BCC stroma. METHODS: Eleven BCCs (8 nodular, 2 sclerosing, 1 adenoid-cystic) were examined using immunohistochemical techniques for the presence of antigens specific to vascular endothelium, mast cells, and dermal dendrocytes. RESULTS: The stroma of all BCCs demonstrated increased vascularity, increased numbers of mast cells, and increased numbers of dermal dendrocytes expressing both CD34 and GP1b-alpha adjacent to tumor nests. No differences in antigen expression were observed between histologic subtypes of BCC. CONCLUSION: The close proximity of stromal mast cells and dermal dendrocytes surrounding BCC nests suggests a biologically significant interaction. The pattern observed is similar to that observed in healing wounds.

    Title Cutaneous Metastasis of Chordoma.
    Date August 2000
    Journal Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [et Al.]
    Excerpt

    BACKGROUND: Chordomas are rare neoplasms that arise from the notochord remnant. They develop in the sacrococcygeal (50%) or cervical (15%) region and are generally regarded as a locally aggressive tumor with a slow progressive growth rate and a metastatic incidence ranging from 3 to 48%. Skin involvement by chordoma is rare, but can occur by direct extension, by local recurrence and by metastases. OBJECTIVE: To illustrate by a case report the clinical presentation and management of this disease. METHODS: We present a case of sacral chordoma with metastases over a 10-year period to the lungs, the soft tissue of the chest wall, the triceps tendon, and distant cutaneous metastases to the back and the nose. RESULTS: The cutaneous metastases were treated by excision. CONCLUSION: Chordoma is a slow growing tumor of the notochord remnant that may metastasize to the skin. Physicians and pathologists should be aware of this entity.

    Title Treatment of Superficial Basal Cell Carcinoma and Squamous Cell Carcinoma in Situ with a High-energy Pulsed Carbon Dioxide Laser.
    Date November 1998
    Journal Archives of Dermatology
    Excerpt

    BACKGROUND: High-energy pulsed carbon dioxide (CO2) lasers have been used extensively to resurface wrinkled and photodamaged skin with a low risk of scarring. Results of histological studies demonstrate precise ablation depths in treated skin with minimal thermal damage to underlying tissue. Our objective was to determine if a pulsed CO2 laser could effectively ablate superficial malignant cutaneous neoplasms (superficial multifocal basal cell carcinoma [BCC] and squamous cell carcinoma [SCC] in situ). OBSERVATIONS: Thirty superficial neoplasms (17 BCCs and 13 SCCs) and their surrounding 3-mm margins were treated with either 2 or 3 passes of a pulsed CO2 laser (500 mJ, 2-4 W) using a 3-mm collimated handpiece. The treated areas were subsequently excised and evaluated histologically by serial sectioning at 5-micron intervals for residual tumor at the deep and lateral margins. Average patient age was greater for those with SCCs than for those with BCCs (76.5 vs 56.7 years; P = .001). The average tumor thickness of SCC in situ was significantly greater than that of superficial BCC (0.57 vs 0.34 mm; P = .01). All (9 of 9 patients) BCCs were completely ablated with 3 passes, and residual tumor in the deep margins was seen in 5 of 8 patients treated with 2 passes of the pulsed CO2 laser (P = .005). Incomplete vaporization of the SCC depth was seen in 3 of 7 patients treated with 3 passes and in 2 of 6 patients treated with 2 passes. Those SCCs incompletely treated were significantly thicker than those completely ablated (0.65 vs 0.41 mm; P = .01). Positive lateral margins were seen in 1 BCC and 3 SCC specimens. CONCLUSIONS: Pulsed CO2 laser treatment can be effective in ablating superficial BCC. Treatment of the neoplasm and a minimum of 4-mm margins with 3 passes (500 mJ, 2-4 W) is recommended for complete vaporization using this laser system. Because 3 passes did not completely ablate all SCC in situ, use of this modality alone is not recommended for treatment of thick or keratotic lesions. No direct comparison of efficacy can be made with other destructive modalities that have not been evaluated with comparably sensitive histological techniques. Further study is needed to establish any cosmetic advantage of pulsed CO2 lasers over other destructive modalities for treatment of superficial malignant neoplasms and long-term cure rates.

    Title Peritumoral B Cell Infiltrate Associated with Chronic Lymphocytic Leukemia Obscuring Margin Evaluation During Mohs Micrographic Surgery.
    Date August 1997
    Journal Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [et Al.]
    Title Repair of Defects of the Nasal Ala.
    Date July 1997
    Journal Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [et Al.]
    Excerpt

    BACKGROUND: Alar defects present a reconstructive challenge. OBJECTIVE: To define closure options for alar defects of variable thickness and location. METHODS: The repair options for closure of alar defects are reviewed and discussed with regard to depth of defect and complexity of reconstruction. CONCLUSION: Surgeons repairing defects of the nose should develop a variety of reconstructive approaches for the ala including but not limited to those presented here.

    Title Stump the Experts. Eccrine Acrospiroma, Clear Cell Type.
    Date April 1997
    Journal Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [et Al.]
    Title A Pilot Study Comparing Toluidine Blue and Hematoxylin and Eosin Staining of Basal Cell and Squamous Cell Carcinoma During Mohs Surgery.
    Date October 1996
    Journal Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [et Al.]
    Excerpt

    BACKGROUND: Hematoxylin and Eosin (H&E) is the most common stain used for Mohs frozen sections. Toluidine blue (T-blue) is a metachromatic stain that has been frequently utilized for this purpose. OBJECTIVE: To compare the cytologic and stromal staining patterns of each stain for Mohs frozen sections of squamous cell carcinoma (SCC) and basal cell carcinoma (BCC), and to identify the advantages and disadvantages of each technique. RESULTS: T-blue revealed stromal change associated with the presence of BCC and SCC. H&E provided more prominent visibility of individual cell keratinization and necrosis, which are common features seen in SCC. CONCLUSION: We found T-blue to be fast and effective in identifying mucopolysaccharides in stroma associated with basal cell carcinoma. For this reason, T-blue is our preferred stain for BCCs, while H&E can provide greater ease of identification of histologic features of SCCs.

    Title Surgical Pearl: Using the Liposuction Cannula/syringe Apparatus for Conservative Evacuation of Postoperative Hematomas.
    Date July 1996
    Journal Journal of the American Academy of Dermatology
    Title The Postauricular (revolving Door) Island Pedicle Flap Revisited.
    Date May 1996
    Journal Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [et Al.]
    Excerpt

    BACKGROUND. Few satisfactory closure options exist for large anterior auricular defects. OBJECTIVE. To describe the use of the postauricular (revolving door) island pedicle flap for closure of large defects on the scapha, antihelix, and helix. METHODS. Mohs micrographic surgery for excision of basal cell carcinoma was performed on the anterior auricular surface of two patients. Both defects were closed using a posterior auricular island flap that was advanced through cartilage with excellent cosmetic results. Other closure options are discussed for this region. CONCLUSION. The postauricular (revolving door) island pedicle flap is a good closure option for large anterior auricular defects lacking perichondrium and not easily repaired by other methods.

    Title Treatment of Photodamaged Skin with Trichloroacetic Acid and Topical Tretinoin.
    Date May 1996
    Journal Journal of the American Academy of Dermatology
    Excerpt

    BACKGROUND: Photodamaged skin typically displays lentigines, actinic keratoses, wrinkles, and textural alteration. Chemical peeling has been used to treat these, but few controlled studies have been performed to determine its efficacy. OBJECTIVE: Our purpose was to compare the efficacy of a medium-depth chemical peel with and without tretinoin before and after treatment. METHODS: Sixteen men with actinic damage including actinic keratoses were treated with a 40% trichloroacetic acid(TCA) chemical peel. Half were pretreated for 6 weeks with topical tretinoin; they also used tretinoin after the peel. Photographs were obtained at baseline and at 6 weeks and 6 months after treatment. Changes in specific features were rated by a panel of three examiners. RESULTS: Some improvement was noted in all patients. More rapid and even frosting was observed in the patients pretreated with tretinoin. Solar lentigines, actinic keratoses, and skin texture were the features of photoaging most affected; wrinkles were least affected. No statistically significant difference was found between patients treated with TCA and tretinoin (before and after peel) and those with TCA alone. CONCLUSION: A medium-depth chemical peel with 40% TCA alone produced moderate improvement in some manifestations of actinic damage but had little effect on wrinkles. Treatment with tretinoin before and after TCA did not significantly enhance the efficacy of the peel.

    Title The Postauricular Cutaneous Advancement Flap for Repairing Ear Rim Defects.
    Date February 1996
    Journal Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [et Al.]
    Excerpt

    BACKGROUND. Due to the ear's complicated anatomy and closely adherent anterior skin, repairing ear rim defects is often difficult. OBJECTIVE. We describe a simple postauricular cutaneous advancement flap for correcting ear rim defects of varying sizes. METHODS. Skin tumors involving the ear rims of 12 patients were excised. A postauricular cutaneous advancement flap was designed to correct the resulting defects. RESULTS. The postauricular cutaneous advancement flap provided excellent cosmetic results in our 12 patients. Minimal superficial necrosis of the flap was observed in one patient. CONCLUSION. Utilizing relatively loose postauricular skin, this postauricular advancement flap can cover helical rim defects of varying sizes with excellent cosmetic results and low complication rates.

    Title A Persistent Dermal Nodule in an African-american Patient.
    Date November 1995
    Journal Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [et Al.]
    Title Familial Occurrence of Multiple Cutaneous Chondromas.
    Date May 1994
    Journal The American Journal of Dermatopathology
    Excerpt

    True cutaneous chondromas are rare lesions with an uncertain pathogenesis. We report an unusual case of a patient with multiple cutaneous chondromas of the face. One of the patient's siblings, a brother, and that brother's son had similar facial lesions. We conclude that this familial pattern suggests an autosomal dominant mode of transmission.

    Title Acute Reversible Central Nervous System Toxicity Associated with Low-dose Oral Cyclosporine Therapy.
    Date September 1993
    Journal Journal of the American Academy of Dermatology
    Title Massive Bilateral Diaphragmatic Rupture After an Apparently Minor Automobile Accident.
    Date May 1991
    Journal The American Journal of Emergency Medicine
    Excerpt

    A case of massive bilateral diaphragmatic rupture following a low impact motor vehicle accident is described. The patient experienced herniation of intraabdominal contents into the thoracic cavity, but suffered no additional injuries. Few cases of bilateral diaphragmatic rupture have been reported and no cases of acute bilateral rupture have been described as an isolated injury. Diaphragmatic rupture in general may be a difficult injury to recognize. Based on our review of recent cases of diaphragmatic rupture (1979-1990), most patients presenting acutely have additional trauma (89.9%) but only vague symptoms related to their diaphragmatic insult. A chest roentgenogram may be a useful diagnostic tool, although many patients with diaphragmatic rupture have only nonspecific findings. A nasogastric tube placed prior to chest roentgenogram may enable the physician to recognize the injury more readily. A high index of suspicion is required to recognize diaphragmatic rupture and should be maintained for all victims of motor vehicle accidents with abnormal but nondiagnostic chest roentgenograms.

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