Skin Cancer

  You can now submit smartphone dermoscopy photographs of 'lesions of concern' for assessment and triage to know if an appointment is required or recommended. This is a great option for people who live or work in rural areas and find it difficult to make an appointment during our business hours. You will need to purchase a Skin Scope and attach it to your phone. Information on how the scope works and to purchase one online visit FirstCheckMe. Scopes are also available for sale in our Clinic. How does it work? Watch this video. By clicking on this link you can create a user account with FirstCheck.me and upload your images and relevant clinical history. There is a $40.00 fee for the virtual check assessment and triage through this platform. There is no Medicare rebate. Dr. Basson will receive your images and will respond with a written report. A telehealth consultation may be suitable to discuss your case if needed, or we will make an appointment for you to come into our Clinic situated on Invermay Road. Our fee schedule applies to these consults and a Medicare rebate is available.

Why Mole Photography? The most important clinical distinguishing feature between a melanoma and a normal mole is that a melanoma changes in appearance over time. Early detection of this change helps to diagnose a melanoma at an early, curable stage. It can be difficult for patients and doctors to say with confidence whether change has occurred, and photography provides a baseline reference that can be used to detect early change (Hanraham, 1997). Melanoma Consensus Conferences have recommended the use of photography in melanoma surveillance for high-risk groups (1984). The current National Health & Medical Research Council (NHMRC) guidelines also recommend baseline body photography in high risk individuals. Who Will Most Benefit? Patients with:

• More than 100 moles
• 4 or more abnormal moles
• A personal history of melanoma
• A family history of melanoma

Also, patients with :  A family history of melanoma

• Red hair, blue eyes and skin that burns easily
• A history of multiple severe sunburns in childhood
• Frequent solarium use in the past 
• Anxiety about their moles

How does it work? Skin photography is a complete record of your skin and moles. We use a system call Dermengine which is the most advanced, web-based system for capturing, storing and analysing total body images. Photographs are designed to help self-monitoring and also to help your doctor track any changes over time.    Full skin examination by the doctor remains essential. The Process

• You will be required to remove your outer clothing but usually underwear is kept on. The consultation room is private and room temperature is monitored for your comfort.
• A registered nurse trained in the technique takes the photos
• The photographic session takes around 30 to 40 minutes
• If you are willing to provide your email address, you will be given an access code to view your file. You will need to download a free app to make this possible.

30 Standard Views A standard set includes 30 views to provide full cover of the body. A basic set of 10 may be all that is needed depending on a doctor's recommendation. Additional views may also be included. References Hanrahan, P 1997, Early Detection of Melanoma in Older People, PhD Thesis, University of New South Wales. Kelly, J, Yeatman, J, Regalia, C, Mason, g & Henham, A 1997, 'A high incidence of melanoma found in patients with multiple dysplastic naevi', Medical Journal of Australia, vol. 167, pp. 191 – 194. Malignant Melanoma – Consensus Conference 1984, JAMA, April 13, Vol. 251, no. 1, pp. 1864 – 1866. National Health and Medical Research Council (NHMRC) Guidelines.

Dermoscopy ‘suboptimal’ for diagnosing tiny melanomas

Sometimes your doctor will need to take a specimen for close examination in the laboratory to aide diagnosis of suspicious lesions. This may be a small core sample of the lesion or it may involve removal of the entire lesion through a shave biopsy or surgical removal. This can usually be done on the same day as your examination but may require a separate appointment depending on room availability. A small amount of local anaesthetic is injected into the skin below the lesion. Once the sample is taken. a dressing will be applied. If the lesion was removed in its entirety surgically, a few stitches may be needed to speed healing. These will need to be removed approximately 10-days later. All biopsy results are reviewed by your doctor and you will be notified of abnormal results and a plan made for treatment and follow up.

• Cryotherapy - commonly used for pre-cancerous lesions and some superficial skin cancers. This involves freezing the lesion and a margin of surrounding skin. Swelling and blistering is common but will heal spontaneously over about 14 days with no special attention. Treated skin cancers may take longer to heal - anything from 2-4 weeks.
• Photodynamic Therapy (PDT) - Photodynamic Therapy is a non-surgical procedure involving the application of a product called 5-Aminolevulinic Acid (5-ALA) to the skin. Skin Cells which have been damaged by the sun undergo a reaction when the ALA is applied, causing them to become sensitive to a particular wavelength of light. When the area is exposed to this light the damaged cells begin to die, allowing healthy, new skin to form.
• Topical treatments: there are a range of creams and gels available on prescription that can help with:
  • Solar keratoses, also kno wn as actinic keratoses or sunspots
  • Bowen's disease (type of superficial skin cancer)
  • Superficial basal cell carcinoma
  • Genital/perianal warts

• Complete removal of the skin cancer with an appropriate margin of normal skin.
• Simple ellipses through to the more complex (graft, flaps) as is needed to repair the skin after your skin cancer has been removed.

• The removal of more annoying lesions including skin tags, senile warts, viral warts, and benign moles.
• Use of Radiofrequency surgery – Surgitron – is an option to minimise scarring.

Tamar Skin Clinic provides skin cancer checks for workers either in the workplace or at our Clinic on Invermay Road. Please contact the Practice Manager to discuss this service for your staff.