By Chris Motola
New dermatologist in Fayetteville happy to be a solo practitioner. “My patients appreciate it because they know who they’re getting when they come in,” he says
Q: I understand you’ve recently started a private dermatology practice in Fayetteville.
A: So I took over the practice from a dermatologist who had been there since the 1980s. I had been talking to him about joining his practice, but everything changed once he passed away. So I took it over. I opened last August. I see all types of dermatology patients, all ages, all conditions. I do a lot of skin checks, a lot of surgeries. So I pretty much see it all. A lot of my patients were patients from the previous owner and I’ve also been working on getting referrals from local primary care and urgent care. So I pretty much do everything related to the skin, including a small amount of cosmetic surgery. I usually keep two appointment slots open each day for any urgent issues, which patients seem to appreciate. But, yes, right now I’m a solo dermatologist. One of the few in the area, I think. So every time patients come in, they’re seeing me.
Q: Have you been in the area long?
A: I did my medical schooling at Upstate. I was here for four years and really enjoyed the area. I’m from Rochester originally. I did my residency over at the University of Rochester. And right after residency I came back and took over this practice.
Q: How has the experience of being in private practice been? You’re going against the trends.
A: It’s definitely not the norm. I was reading about it in journals over the last month. Dermatologist graduates from the year 2000 or 2010, something like only 1% of dermatology graduates were in solo practice. So it’s very unusual now, but I really enjoy it. And I think my patients appreciate it because they know who they’re getting when they come in. I don’t know if that will be the case forever, but it’s been going well. I think there’s still a place for private practice.
Q: How hard has it been to handle the business aspects of the practice?
A: There’s a steep learning curve in the beginning, but I was able to manage it. I’ve had a number of friends and mentors around Upstate New York who were able to advise and help me through the process.
Q: Are dermatological issues in Upstate New York typical compared to the rest of the country? I remember reading a while back that the Pacific Northwest actually had a very high rate of melanomas despite the reputation for cloudy weather.
A: We do see a good amount of skin cancers here in Syracuse. We see a lot of melanoma. I don’t know if there’s a specific reason why that is. If you look at us on a map, we’re still about the same latitude as Italy. When we do get the sun it’s pretty strong. So I do see skin cancers every day, including melanoma every week.
Q: Do you think the cloudiness gives people a false sense of security?
A: Yeah, it could be because you still get UV-A rays through the clouds. But also people here sometimes hibernate half the year and then, once it gets sunny, they’ll overdo it and get burnt, which can lead to skin cancers down the road.
Q: You also treat hair and nail issues. What would that include?
A: Yes, I also take care of hair and nail conditions. I see a good amount of alopecias. One extremely common subtype that we’re seeing a lot of is something called telogen effluvium. It’s secondary to COVID-19. Many people, after recovering from COVID-19, have a temporary hair loss or shedding event.
Q: I’m one of them.
A: I’m seeing it almost every day. You don’t hear about it so much in the media, but in dermatology we see it all the time.
Q: How do you go about talking to your patients about it?
A: The good thing about it is it’s a nonscarring, nonpermanent hair loss, so it will all come back. The key is just to have faith that it will come back and wait it out. There’s not really anything you can do to speed it up.
Q: What kinds of nail-based conditions do you treat?
A: Probably the most common is fungal infections of the nails. So I see those. They’re pretty common, but not the easiest to treat. And very rarely I see skin cancers under the nails.
Q: What makes fungal nail infections so hard to treat?
A: They very frequently get reinfected after you treat them, and you have to treat them for a very long period of time—six months to a year. And the treatment is not very effective, so not everyone gets better.
Q: What makes nails so prone to fungal infections?
A: It’s not so much that they’re more prone to fungal infections as they become more atypical from fungal infection and are more difficult to treat than a fungal infection on, say, the skin.
Q: How frequently should patients have their skin checked for abnormal growths?
A: There are no set guidelines. For people with a history of skin cancer, I’d recommend a full skin exam at least once a year. For people without a history of skin cancer, it’s not a bad idea to do a baseline skin check, and then you can establish how often it makes sense to get follow-up checks, whether yearly or every few years. If you have lighter skin or a lot of moles, oftentimes more frequent exams are a good idea. If you have darker skin and fewer moles, then you probably need less frequent exams. But a baseline check is a good idea for anyone.
Name: James Prezzano, M.D.
Position: Dermatologist and owner of Fayetteville Dermatology
Education: SUNY Upstate Medical University
Affiliations: St. Joseph’s Health Hospital
Organizations: American Academy of Dermatology; American Society of Dermatologic Surgery; American Board of Dermatology
Family: Married, one daughter
Hobbies: Hiking, skiing, travel