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November 18, 2019 / molehunter

International Dermoscopy Conference Winchester, England, 12th and 13th June 2020

International Dermoscopy 2 day Conference

CORONAVIRUS UPDATE 12TH MARCH

CONFERENCE CANCELLED DUE TO SPEAKER TRAVEL BAN

VERY, VERY SORRY

Friday 12th and Saturday 13th June, 2020, 09.00-18.00

Winchester Guildhall. Winchester, Hampshire, England.

(NB days can be booked separately-Friday more suitable for beginners/improvers, Saturday for improvers/experts, but best to come to both days)

On behalf of the newly founded British and Irish Dermoscopy Group and in association with the International Dermoscopy Society, in view of the continuing rise in work load, morbidity and mortality due to skin cancer including melanoma, we are delighted to offer clinicians the opportunity to study advanced modern skin cancer diagnostics with the world class faculty of Professor Cliff Rosendahl (Brisbane), Prof Harald Kittler (Vienna), Prof Bengu Nisa Akay (Ankara, Turkey),Prof Giuseppe Argenziano (Naples), Prof Luc Thomas (Lyons), Dr Agata Bulinska (Poland and UK) and Prof Beth Leocadia Fernandes from Sao Paulo, Brazil.

 

The programme is structured so that delegates attending the whole 2 days (recommended) will receive an outstanding and comprehensive refresher and update of modern best practice and theory concerning dermatoscopy/dermoscopy in skin lesion recognition. In order to accommodate delegates who may be only able to attend one day, the Friday will be more basic and the Saturday more advanced. Both days will run 09.00 to 18.00 with morning, lunch and afternoon breaks.

14 hours CPD has been granted by the Royal College of Physicians of London, reference

                 ‘International Dermoscopy 2 Day Conference 128388’

 

Friday 12th June
08.0-09.00 coffee and registration
09.00 Introduction and overview Stephen Hayes
09.10 Pattern analysis in dermatoscopy part 1 Harald Kittler
09.50 Dermatoscopy of common benign lesions (excluding naevi) Agata Bulinska
10.20 Dermatoscopy of melanocytic naevi Giuseppe Argenziano
11.00 break
11.30 Dermatoscopy of basal cell cancers Bengu Nisa Akay
12.00 Keratinocyte dysplasia (actinic keratosis, Bowen’s disease, squamous cell cancer) Cliff Rosendahl
12.30 lunch
13.30 Pattern analysis part 2 Harald Kittler
14.10 Dermatoscopy of melanoma Giuseppe Argenziano
14.45 Interesting and instructive cases from Turkey Bengu Nisa Akay
15.15 Break
15.45 Dermatoscopy of hands, feet and facial skin Luc Thomas
16.30 Lessons in community based skin cancer diagnostics and screening from an Australian sabbatical Stephen Hayes
17.00 Interactive case discussions Faculty
18.00 Close
Saturday
09.00 Global state of skin cancer diagnostics, work of the International Dermoscopy Society, new developments. Giuseppe Argenziano, Secretary of the International Dermoscopy Society
09.30 Dermatoscopy in skin cancer surgery including nail biopsy Luc Thomas
10.00 Interesting and instructive cases from Brazil Beth Leocadia Fernandes
10.30 Lentigo maligna Luc Thomas
11.00 Break
11.30 Slow growing melanomas and other instructive curiosities Giuseppe Argenziano
12.00 The Queensland skin check-how we pick up very early melanomas in badly sun damaged skin. Use of Fotofinder, the SCARD skin cancer database Cliff Rosendahl
12.30 Lunch
13.30 Artificial intelligence skin lesion diagnosis machines-what, why, how and when? Cliff Rosendahl and Harald Kittler
14.15 Prediction without pigment-dermatoscopic clues to diagnosis in non-pigmented lesions of interest Agata Bulinska
15.00 The atypical (or dysplastic) naevus syndrome-what is it, what does it mean, and how should it be managed? Harald Kittler
15.30 break
16.00 Inflammoscopy (dermatoscopy in general dermatology) Beth Leocadia Fernandes
16.450 tips for taking better dermoscopic photographs Stephen Hayes
17.00 case discussions faculty
18.00 close of conference

 

Delegates will receive a memory drive which will have as many as possible of the presentations in PDF format for private study, plus other learning material including references and links to on-line resources, and also a substantial collection of my personal high quality plain and dermoscopic digital lesion images (including over 130 melanoma cases, 100 basal cell cancers, many other cases including dysplastic naevi, lichenoid keratoses etc, with dermoscopic images and teaching notes) which may be freely used in presentations-a ‘teach the teachers’ resource pack.

The venue is the Winchester Guildhall, close to the historic town centre, cathedral, city mill, pleasant riverside walks, gardens, restaurants and shops. Southampton airport (flights from all over UK plus Paris, Amsterdam, Dublin, Bordeaux, Verona, Geneva and other European destinations) is 15 minutes by direct train. London Waterloo is just over an hour by train, Heathrow 90 minutes by coach.

Cost is £300 both days, £165 either day (early bird discount now ended). As a goodwill gesture in the light of Brexit, delegates from mainland Europe or the island of Ireland may pay the above prices in Euros, which is about a 15% reduction. I am glad to say that of the 150 plus delegates booked to  date (3rd February) some are from Romania, Germany, Holland, Sweden, France, Ireland and Australia-there will be plenty of chance to socialise with colleagues. Refreshments and lunch included.

 

HOW TO REGISTER

Make payment by BACS to Molehunter Diagnostics Ltd

sort code                               20-79-31

account number                 13540294

IBAN GB31 BUKB 2079 3103 8214 98

SWIFTBIC = BUKBGB22 (for bookings from outside the UK) 

or by cheque to Molehunter Diagnostics c/o Dr Stephen Hayes, 96 Winchester Street, Botley, Hampshire, SO30 2AA.

Please email on stevehayes272@gmail.com once you have paid and on receipt of funds a confirmation and receipt will be emailed to you. Please state whether the full conference or Friday only or Saturday only. Please also mention if there are any skin cancer diagnostics issues you would particularly like the faculty to address if not covered above.

 

Refunds minus a £50 admin fee can be made on request up to a month before the event. Places are transferable (i.e. a colleague can come in your place if you let us know).

14 hours CME from the Royal College of Physicians of London is approved.

Further details, will appear on my blog, see below. Delegates are responsible for organising their own accommodation, early booking is advised as Winchester is a popular tourist destination in June.

This conference is highly commended to qualified and trainee dermatologists, plastic surgeons, GPs and GPwSIs, specialist dermatology nurses, occupational health and elderly care doctors, general physicians and all clinicians working in the NHS or private sector whose work involves the evaluation of suspicious skin lesions or offering skin checks.

Dr Stephen Hayes (**) course organiser

GMC 2482404

Associate Specialist in Dermatology, University Hospital Southampton

Life member of Primary Care Dermatology Society

Director, Molehunter Diagnostics Ltd (***)

Chair, British and Irish Dermoscopy Group

UK board member, International Dermoscopy Society

 

(*) The programme will cover the triage and diagnosis of common and important skin lesions with an emphasis on advanced pattern analysis and the ‘chaos and clues’ and ‘prediction without pigment’ algorithms. This evidence based and readily teachable approach to skin lesion recognition is widely accepted by the international dermoscopy/dermatoscopy community and covered in best-selling books by Professors Kittler and Rosendahl which will be on sale.

The conference will teach all aspects of skin lesion diagnosis from basic to advanced, with hundreds of cases. Subjects such as artificial intelligence, digital monitoring, the Australian experience, screening, dermoscopic features of very early melanoma, dermatoscopy in darker skin types and inflammoscopy will also be considered, with an emphasis on safe and efficient clinical decision making and  learning how to teach others.

Level of difficulty- Friday will be suitable for clinicians with some familiarity with skin lesions who have done pre-course work on dermoscopy (for links to free on-line resources see Dr Hayes’ blog at www.dermoscopy.wordpress.com .) Saturday is more for the confident and experienced dermatoscopy practitioner, but they will benefit more to attend the whole conference. Beginners who do a bit of pre-course on line study and attend Friday should be well prepared for Saturday!

(**) Dr Stephen Hayes, course organiser, qualified from Southampton University Medical School in 1979, worked as a GP from 1985-2012, developed a special interest in dermatology from 1995 and helped found one of the first UK community dermatology services in Southampton from 2000. He has been active in the Primary Care Dermatology Society since 2000, sat on the skin cancer services committee of the British Association of Dermatologists, and with consultant colleagues Drs Catriona Henderson and Birgit Pees,  set up South Coast Dermoscopy Associates which has run 10 integrated skin lesion recognition and dermoscopy courses in Hampshire, Sussex, Jersey and London since 2011. He recently spent 7 weeks on sabbatical in Australia and New Zealand learning with expert skin cancer GPs there. He is a UK board member of the International Dermoscopy Society and regularly contributes case discussions to its Facebook page, and also blogs at http://www.dermoscopy.wordpress.com.  He is currently working with other dermoscopy enthusiasts to establish a British and Irish Dermoscopy Group, in order to advocate for better skin lesion recognition skills and co-ordinate occasional conferences of this kind with visiting top world speakers.

 

(***) Molehunter Diagnostics Ltd was set up to manage the economics of this conference.

SH 3rd February 2020 contact me on stevehayes272@gmail.com

May 8, 2019 / molehunter

Funny looking mole on the chest

This lesion appeared on a holiday photo from 2 years ago. It had got a bit bigger since then. It wasn’t itching or bleeding, and as you can see does not look very dramatic to the naked eye.

case for IDS (1)

When the dermatoscope is applied, the appearance changes radically.

case for IDS (2)

Using the ‘chaos and clues’ algorithm this is clearly chaotic. As I often say to learners in my clinic, even if you cannot put a name to the structures seen through the dermatoscope, you can count the number of structures and clearly there are many structures here. Chaos on dermoscopy is defined as multiple colours, multiple structures, and lack of symmetry.

I can see 4 four colours (brown, blue, red, black) arranged asymmetrically, plus irregular dots and clods, featureless blue and red areas, and angulated lines (slightly easier to see if you squint at the picture). Too many colours, too many structures.

The lesion was removed immediately and proved to be a melanoma, 0.35mm thick, so a 99% or better chance of a cure.

 

May 20, 2020 / molehunter

Little pink mole on shoulder was a skin cancer

This was a new lesion on the upper arm of an older white female. It had been scabbing. This history is suggestive of a basal cell cancer.

BCC shoulder (1)

It’s not very impressive, but it’s new and has been scabbing, so should not be ignored. Always look at the background, and here we see pale white skin with many small flat brown marks (technically these are solar lentigines, lentigines being the plural of lentigo), you can call them freckles or sun spots. They are harmless, and not precursors to malignancy, however they are an indication of past sun exposure, so where we find them, we may find skin cancers also.

There is a dark spot in the top left quadrant of this. What could it be? Let’s ask the dermatoscope.

BCC shoulder (2)

Now we have much more information to assist us with a diagnosis. The dark spot (in dermatoscopy, we call this shape a clod) we could see with the unassisted eye is much more prominent, and we can now see that there are many other smaller dark clods, scattered around the lesion. They vary in size and distribution, the colour being very deep brown with maybe a touch of blue.

We also see some sharply focused vessels, these used to be called arborising (tree-like) but are now more accurately described as serpentine (snake-like) which is a somewhat better metaphor, since tree branches vary considerably in shape, whereas all snakes have a very similar shape (if their colour and size vary).

The irregular clods are a clue to malignancy. You see irregular clods in melanomas and also basal cell cancers (BCCs). In BCCs the clods are more likely to be blue/grey in colour, but this is not specific. The sharply focused serpentine vessels are typical of BCCs, vessels in melanoma are less prominent and often dotted, linear/irregular and helical (corkscrew shaped). The vessels seen here are much more like a BCC than a melanoma, but even experts can’t always reliably distinguish between a pigmented BCC and a hypopigmented or non pigmented (amelanotic) melanoma, so this lesion should be excised without delay and not put on a non-urgent waiting list, which in an under funded health system like the British NHS could mean  wait of up to 5 months for surgery, which might be barely acceptable for a BCC but highly dangerous for a melanoma.

Histology confirmed the strong impression of a BCC. These lesions almost never kill anyone, unless they are on the face and are seriously neglected, but they never stop growing and can produce unpleasant ulcers. It is still worth diagnosing them earlier, since the surgery will be easier and cheaper and leave a smaller scar, besides which, a lesion presenting like this MIGHT be a melanoma, which can be fatal if not caught early enough.

May 12, 2020 / molehunter

Screening for melanoma skin cancer

I recently had this opinion article published in the PMFA (Plastic, Maxillo-Facial and Aesthetics) magazine. It’s basically an argument for regular skin screening/mole checks, at least for higher risk groups (e.g. older white people with sun damaged skin and a personal history of skin cancer).Long term routine skin screening is not offered in the British NHS except for the most at-risk, and even the short to medium term skin checks offered to post-melanoma patients (1 year for less than 1mm thick, 5 years if more than 1mm) that does happen has been indefinitely postponed during the Covid-19 crisis.

I have made several arguments…

  • Screening for melanoma is not generally calculated to be cost effective, and so is not offered in publicly funded health care systems such as the NHS,  but the calculations that say screening is not cost effective may be seriously out, for the following reasons

(a) Melanoma incidence is rising,

(b) we now have better tools for early detection,

(c) due to new therapeutic agents such as ipilimumab, dabrafenib, trametinib etc, the cost of treating advanced melanoma has risen to a catastrophic level, up to £500,000 per patient.

  • I have seen screening work well in Australia, in affordable, community settings.
  • Since I returned from a short trip there, I have been picking up more very early melanomas and other skin cancers using the skills and techniques I learned.

Basically, I’m saying that if the State won’t pay for skin checks, even for the at risk, many people would pay themselves, if the right service at the right price was offered. Click on the link to see these arguments developed.

I’m 64 with a few other obligations, so it’s unlikely that I will strike out on my own and set up a private (non-NHS) screening clinic, but, my goodness, there is a need and an opportunity! There is no reason why British and other GPs should not skill up and set up shop offering full dermoscopic and photographic full skin checks to concerned patients, and earn a fair fee for doing so. There is no point waiting for either the NHS or the Dermatologist community to lead on this, they never will.

https://www.thepmfajournal.com/features/features/post/melanoma-skin-cancer-how-can-we-improve-early-detection-in-the-uk

 

 

 

 

May 11, 2020 / molehunter

A new video about how to recognise melanoma skin cancer

A new video about recognising melanoma

I have previously put 2 short videos about how to recognise melanoma skin cancers on Vimeo. These are aimed at the general public, medical and other health care students, anyone who works with skin (e.g. hairdressers, masseurs, tattoo artists etc) and health care professionals who would like a basic refresher.

This is a new video created and posted for World Melanoma Day. Covid 19 is not the only killer, and many doctors are afraid that non-Covid health issues are currently being neglected.

Feel free to share. They are quite basic and many of the lesions are fairly advanced, therefore obvious, bot they were all on real people and had all got as big as they were before being diagnosed and treated. It’s all about earlier diagnosis, and most melanomas will still be diagnosed by the person on whose skin they occur. However skilled a doctor is with a dermatoscope, its no good until the patients come to be seen.

April 29, 2020 / molehunter

Small new mole on the foot was a cancer

This mole on a middle aged white woman’s foot was reported as it was new and changing.

0.4 mm melanoma dorsum of foot 1Not a very large mole, but it is irregular in outline. We need a closer look.

0.4 mm melanoma dorsum of foot 2

The greater part of the lesion is medium to dark brown with some variability of shade, and maybe some angulated lines. On the right we see an eccentrically located featureless area-this is one of the nine clues to melanoma. This does not look very dramatic, but as it is a new, changing lesion on sun exposed skin (40% of all women’s melanomas are on the lower limb) there was no safe choice but to remove.

Histology confirmed a very thin melanoma. Cure is almost guaranteed due to early diagnosis.

Always be careful of a new, changing mole on adult white skin (under the age of 25, not so much).

April 18, 2020 / molehunter

An update on dermoscopy I wrote a few years ago

www.thepmfajournal.com/media/9819/pmfaam18-dermoscopy-v4.pdf

March 16, 2020 / molehunter

International dermoscopy conference Winchester CANCELLED

With immense disappointment, I am forced to announce the unavoidable cancellation of the international dermoscopy conference which was to have been held in Winchester, England, on 12th and 13th June 2020. This is due to the following effects of the coronavirus emergency.

  1. My overseas expert speakers are subject to travel bans, by their employers, their countries, or both.
  2. My own employing hospital group has cancelled all study leave and forbidden all doctors and nurses in it’s employ from attending any meetings or conferences whatever. So I am forbidden to attend my own conference. This has been done for the very understandable reason that if clinical staff become sick, they are then not available to care for sick patients. I would have done the same in their place.
  3. Delegates are also subject to similar travel bans, so cannot attend.
  4. The situation in Britain and the rest of Europe is evidently deteriorating and likely to get worse before it gets better. It is likely that within 2 weeks we may see complete travel shutdown, school closures (which means parents will have to drop everything else) and people will be worrying about elderly relatives, friends and neighbours.

 

This is a huge disappointment, and economic hit, for me personally, but also a big blow to skin cancer diagnostics in the UK. Bookings were going excellently, it is a comfort to know that there is a strong demand for excellent skin cancer diagnostics education. Over 200 delegates from 6 countries were confirmed and the economic targets had been met with 12 weeks to go. This would have been the largest number of top world skin cancer diagnostics experts to have presented together for 2 days in the British Isles so far, and delegates were going to receive 6 GB of images and case discussions to enable them to reinforce their learning and teach others. I know that delegates are sorry to miss out.

Postponement is not viable in the circumstances, firstly we don’ know when normality will be restored, then there is the problem of clashing with major international International Dermoscopy Society events in Warsaw this autumn and Buenos Aires next June. The idea of running the event via teleconferencing has been suggested, but since delegates most likely can’t come to the venue, it won’t work even if the technology does (and I have my doubts). doing webinar/podcasts direct to delegates’ homes might be possible, but that is an entirely different concept and if I were to go that way, I would want to re-design the whole event. There isn’t time for a major redesign, especially not in this atmosphere of fear and uncertainty. If the coronavirus forecasts are even half true, we will all have other things on our minds very soon-such as caring for our kids when the schools are closed, and trying to keep elderly parents and grandparents alive-or palliating and then burying them with as much dignity as possible.

There is a small possibility that I might run a much reduced one-day conference at the venue, which could be held open tentatively until a month before (May 10th). That will depend on negotiations with the venue and might be of some use to people who would like a basic introduction to Chaos and Clues.

PS all delegates will be able to get a refund. I will contact them individually. 

Stephen Hayes 16th March 2020

March 9, 2020 / molehunter

Coronavirus emergency and Winchester dermoscopy conference

International dermoscopy conference 12/13th June, Winchester.

 

Booked and potential delegates of the above conference will be aware of the ongoing coronavirus (Covid-19) emergency. The situation as of today (9/3/20) is very fluid and uncertain. Over 400 have died in Italy and there is a panic on.

I cannot exclude the possibility that the emergency may affect the conference. If one or more of the advertised speakers is not allowed to travel, as is possible, substitutes will be arranged as far as possible. If an acceptable minimum number of speakers are able to attend, we will recruit some UK based teachers and modify the programme.

In the event of forcible cancellation (e.g. if the government bans public meetings or the venue cancels), paid up delegates will receive a full refund of the conference fee paid to Molehunter Diagnostics Ltd.  I cannot however refund any other expenses delegates may have incurred such as booked travel or accommodation, they will have to try to claim on their own insurance, as will I for the £10,000 or so I have already spent on hotels, web hosting, advertising, accountancy etc.  Miserable, but such things happen-who could have predicted this virus outbreak at this time?

Having said that, I fully intend to deliver this conference unless forcibly  prevented e.g. by government cancellation of free movement and/or public meetings. I am hopeful as I am sure we all are that the coronavirus problem will have settled and life returned to normal by June.

4 people have died in Britain from coronavirus so far, melanoma skin cancer continues to kill 6 or 7 a day, every day.

Kind regards, Stephen Hayes.

 

 

 

 

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