Minor skin surgery clinics are held at St. Michael’s Clinic, Much Wenlock and Donnington Practice sites.
We perform curettage (scraping off), shave excisions (slicing off), cryotherapy (freezing off) and full excision (cutting off) of lesions.
Lesions can either be completely removed, or a small sample taken, but are usually sent to the laboratory for testing to make an accurate diagnosis.
Biopsies are usually performed for rash or lesions that we need more information on prior to definitive treatment.
Sometimes we need to close a wound with a skin graft or move a piece of skin around (skin flap) to close the wound but this well be discussed before surgery.
It is important that you let your clinician know if you take warfarin or other blood thinning medications before the day of your surgery. If you have a pacemaker/LCD devise fitted, then please make your doctor/nurse aware of this also prior to the surgery date.
Photodynamic therapy (PDT) is a technique to treat skin cancers and sun-damaged skin, which might one day turn cancerous (precancers). In PDT, a special light activates a cream, which is applied to the affected area of skin. This treatment kills the abnormal cells in the skin.
PDT involved the use of a light-sensitive chemical (called a photosensitiser). This photosensitiser is by itself inactive.
When light of a certain wavelength (usually red light) shines onto the skin which the photosensitiser was applied before the reaction happens.
This caused changes within the sun-damaged skin cells to kill the abnormal cells. Only the area of skin exposed to the light source will be agented and inflamed. After the inflammation clears, it will be cured in most cases.
PDT van be use to treat various skin conditions including:
- Some types of basal cell carcinomas.
- Bowen's Disease (In situ squamous cell carcinoma), a pre-cancer
- Actinic (solar) keratoses - early sun damage, a pre-cancerous skin lesion.
The term phototherapy means the use of light to treat medical conditions. Natural sunlight has been to be beneficial in certain skin disorders for thousands of years, it is the ultraviolet part of the radiation produced by the sun that is used in phototherapy, the Ultraviolet A (UVA) and Ultraviolet B (UVB) wavelengths.
There are two main types of phototherapy:
- UVB in which the skin condition is treated a small part of the UVB spectrum to treat the condition.
- PUVA (Psoralen + UVA) also sometimes called photochemotherapy, in which UVA radiation is combined with sensitiser (a chemical that increases the effect of UVA on the skin) called a psoralen. The choice of the type of phototherapy to use is dependent on the type of skin condition, previous responses to treatment among other factors. UVB is available at both the St. Michael’s Clinic and Donnington sites. PUVA is currently available by referral onwards to hospital outpatient’s department.
The term 'cryotherapy' literally means treatment using low temperature and refers to the removal of skin lesions by freezing them. This is achieved using liquid nitrogen which is extremely cold, boiling at minus 196 °c. It is necessary to store and transport it in special flasks.
A wide variety of superficial benign lesions can be treat with cryotherapy, but it is most commonly used to remove actinic keratoses (an area of sun damaged skin found predominantly on sun exposed parts of the body), viral warts, seborrhoeic keratoes and other benign lesions. Occasionally, your dermatologist may suggest using cryotherapy to treat small skin cancers such as Basal Cell Carcinomas and Bowens Disease.
Patch testing is a specialist procedure carried out to find out whether your skin condition is caused or aggrevated by an allergy to substances which may have met it. This is called contact allergy. Substances that cause an allergic reaction are called allergens. They can be found at home, at work or in leisure activities.
There are many substances that you will be tested against which are most frequent in contact with the skin such as natural rubber latex, preservatives, metals, perfumes, cosmetics, leather chemicals, lanolin, and plants among others. Additional substance is sometimes added to this if it is thought they may trigger your skin condition. You may also be tested with some of your own work or home products such as personal toiletries.