"Dermatology"

In April/May 2022, I approached my GP about concerns regarding red patches on my cheek that were present for over a year and had not disappeared. I was concerned about possible skin cancer given that they were new lesions, and that I had been diagnosed with actinic keratosis in the past. My GP examined the lesions under the dermatoscope, and was uncertain about diagnosis. She referred to Dermatology, sending pictures of my lesion to seek a more expert opinion. Dermatology responded to my GP by stating that they did not need to see me, and that the lesions were static red marks following previous skin treatment, recommending excellent sun protection and to return to GP if there were any changes. I was unclear what they meant by 'previous skin treatment'. I had had C02 laser on my entire face in 2018, but given the time that had elapsed and that I had no other lesions on my face, I was confused about how the Dermatologist who examined the photo had come to this conclusion. I continued to worry about these lesions, and decided to consult a private Dermatologist who recommended a biopsy of the lesions. The biopsy results concluded a more aggressive mixed subtype of basal cell carcinoma. At the same time, the Dermatologist advised a full body check, at which time he also discovered a nodular BCC on my scalp. He recommended surgery and referred me to the NHS plastics department for removal (I have written about my extremely positive experience with the plastics department at SJH in a separate story). 

Unfortunately, my experience with the Dermatology department has not been positive. I felt vulnerable and unsafe, and often think what might have happened if I had believed the initial opinion provided by my Dermatologist to my GP or had I not had the motivation or financial means to seek a second opinion privately. I am aware that BCC is a slow growing cancer, however the mixed subtype is more aggressive and can be particularly disfiguring and even metastasize in rare cases if left untreated.  I appreciate that the Dermatology department is under extreme pressure, with reduced staffing, resources and an increasing population of people with skin cancer. However I think it is important that patients know that there is a risk that these factors  lead to medical errors, misdiagnosis and mismanagement such as in my case, if assessment is not conducted thoroughly enough.