Hi all
just saying I have negotiated a slightly larger room at the Leonard Royal so there are now a handful of extra places available. Secured by payment and emailing me on stevehayes272 at gmail dot com, see below.
Stephen Hayes
Thanks to all who have booked, if you are interested in coming to a course like this in the autumn, please let me know, if there is demand we will do it twice a year at different locations in central southern England. SH 27th May 2023
Thursday 8th June 2023 09.00-17.00
Leonardo Royal Hotel, Southampton SO15 1AG
Skin lesion diagnostics has become more important with the rising number of skin cancers including melanoma (which kills more people in Britain annually that road traffic accidents, cervical cancer and meningitis combined). Patients worried about a mole or other skin lesion are advised to first see their GP, but many GPs lack confidence due to limited training. Britain has too few dermatologists and skin lesion clinics are under extreme pressure, so quite clearly the initial triage of skin lesions at first medical contact should be as efficient as reasonably possible.
The Dermoscope (dermatoscope) is a hand held skin microscope which has been proven over 20 years to greatly improve skin lesion recognition skills. Trials have shown that GPs perform much better after only one day’s training. GPs and community nurses do not need to be experts in skin lesion recognition, they just need to be able to safely and efficiently screen out benign lesions and recognise danger signs. Dermoscopy, with a little training, vastly improves their ability to do this, so community based dermoscopy for lesion triage is a highly cost-effective addition to the local health economy.
Dr Stephen Hayes is a recently retired Associate Specialist in dermatology, and a member of the Executive Committee of the International Dermoscopy Society. He has practiced and studied diagnostic dermoscopy in various NHS settings as a GP, GPwSI and hospital specialist since 2002 and has travelled to international conferences in Vienna, Paris, Madrid, Thessaloniki and Milan- learning from the top world experts. He spent 6 weeks studying with Professor Cliff Rosendahl and other experts in Australia and New Zealand, and has taught skin lesion diagnostics all over the British Isles from Jersey to Belfast and from Galway to Norwich, by lecture, blog, conference and book. He has a huge collection of consented plain and dermoscopic skin images which he shares to educate others.
Dr Birgit Pees is a senior consultant dermatologist in Southampton working at the University Hospital
Southampton (UHS).She has a keen interest in skin cancer and dermoscopy, which began during the
1990 early in her career in Dermatology. She is a member of the IDS and has attended many courses,
updates and 2 world conferences of Dermoscopy herself.
Since 2003 she has been a core member of Southampton’s skin cancer team and the South coasts
skin cancer network. She runs a weekly high volume skin cancer clinic at UHS. She introduced digital
dermoscopy at UHS and is part of the team who run the serial digital mole monitoring clinic using
Fotofinder for at MM high-risk patients.
She has been teaching dermoscopy and skin lesion recognition skills to undergraduates, Registrars, GPs and Consultants for many years in her role as consultant at UHS, as part of the South Coast Dermoscopy Associates team and nationally under the
auspices of the BAD for Registrars. Her motivation is to improve on early skin cancer diagnosis by promoting “integrated dermoscopy ” which focuses on clinical context, examination and dermoscopy.
Dr Chloe Angwin is a dermatology trainee who regularly uses dermoscopy in skin lesion recognition in a busy NHS clinic.
The Euroderm Skin Diagnostics team of Dr Hayes, Dr Birgit Pees and Dr Chloe Angwin will assume little to no prior knowledge, and, with hundreds of images (*), present delegates with a simple, integrated diagnostic system that will enable them to safely and efficiently decide which patients can be reassured and advised, which can be best treated in the community, and who needs urgent or routine referral. Dermoscopy teaching will mainly use the pattern analysis (chaos and clues) system, which is the easiest method to learn and is well validated by top world experts such as Professor Harald Kittler.
The course is designed for GPs and community based or skin specialist nurses but will also be of value to clinicians working in occupational health, elderly care, plastic surgery or any other area where skin lesions are seen.
(*) Delegates will receive PDFs of the presentations with colour images plus other digital learning tools for their private study.
Coffee and refreshments will be available through the day and a hot meal with vegan options will be served at lunchtime. The Leonardo Royal Hotel is situated close to the West Quay shopping centre and the cruise ship port area. There is ample hotel parking (vehicle registration necessary), Southampton Central station is 10 minutes walk and Southampton (Eastleigh) airport is a 20 minute taxi ride away.
09.00 Introduction and overview of skin lesion diagnostics in the UK-Stephen Hayes
09.15 Melanoma and other skin cancer stats Dr Chloe Angwin
09.30 The approach to the patient with a skin lesion Dr Birgit Pees
10.00 What is dermoscopy? Dr Chloe Angwin
10.30 ‘One algorithm to rule them all’ (Chaos and Clues.) Dr Stephen Hayes
11.00 Coffee
11.30 Diagnosing BCC with confidence-Dr Birgit Pees
12.00 Diagnosing SCC with confidence Dr Stephen Hayes
12.30 Premalignant skin lesions (AK and Bowen’s) Dr Chloe Angwin
13.00 Lunch
14.00 Diagnosing melanoma and lentigo melanoma Dr Stephen Hayes
14.30 Diagnosis of common benign lesions Dr Chloe Angwin
15.00 Prediction without pigment Dr Birgit Pees
15.30 Coffee
15.45 Interactive quiz and case discussions-the team
16.30 Skin checks-why, who, when and where? Dr Stephen Hayes
16.45 Question time -the team
15.00 Close
Delegates will receive a certificate by email and a memory drive with the presentations plus additional learning material amounting to a virtual text book of skin lesion diagnostics for their private study.
| Early bird price for bookings received with payment before 1st April 2023 | Standard price for bookings received with payment after 1st April | |
| Thursday 8th June 2023 Skin lesion diagnostics covering basic principles of history, examination, dermoscopy of all common and important skin lesions. Suitable for GPs, nurses, any clinician whose work involved evaluating skin lesions | £120 | £150 |
PS for those who don’t know me and might be concerned about my bona fides, please feel free to Google ‘Stephen Hayes dermoscopy’ and you can check my GMC registration and that I am a board member of the International Dermoscopy Society, and have a long association with the Primary Care Dermatology Society-lots of my images are on their web site including many articles I have written for past bulletins. You can also see that I have been blogging here for 10 years. Should I attempt to scam anybody (God forbid!!!) a complaint to the GMC could end my career in disgrace, which is kind of the point of the GMC, to wield a strong deterrent to bad behaviour by doctors and to uphold ethical, clinical and professional standards. Cheers.
Sorry about this but the international dermoscopy conference booked for 9th June has now been cancelled due to very low booking numbers. All those who had booked have been emailed and will be fully refunded. Sorry about this and I could probably have done a better job of organising publicity, but sponsorship, whether private or NHS, in these difficult times has dried up and I cannot put on an educational event at a financial loss.
The Thursday 8th June dermoscopy day for beginners and improvers (aimed at local GPs and nurses) will go ahead, finalised details will be posted here very soon.
A patient being followed up for a melanoma several years earlier was found to have this small lesion on their back. It was new as far as the skin checker was concerned, but they weren’t aware of it.
Not very impressive, but new and with asymmetrical colours. ‘Pink and brown, make you frown.’ as the Australian skin cancer expert GPs say.
Dermoscopy is essential.
Dermoscopy accentuates the asymmetry, and reveals an atypical network with some thickening of the reticular lines.. Also, there is an asymmetrically located pink area with faint but visible pink dots. These represent dotted vessels, which are a sign of melanocytic lesion.
Using the first step of the 2 step algorithm, we ask ‘Is this melanocytic?‘ Yes, because we see reticular network and dotted vessels (both pointers to a melanocytic lesion, whether benign or malignant.)
We then move to the next step of the 2 step algorithm ‘Could it be a melanoma?‘ (or, to ask the same question a different way) ‘Can I be confident it is benign?’ The answer is a definite NO! because it is a new lesion in a high risk patient (*), is asymmetrical of colour, and there is chaos and thickened lines reticular on dermoscopy.
Histology confirmed a thin melanoma, thin enough for a 99.5% guarantee of a cure.
It is quite possible that a skilled check up saved this person’s life. They did not know it was there and it could have grown for maybe a year before starting to bleed, by which time it would have been much thicker and possibly spread.
Argument continues about the cost effectiveness and otherwise appropriateness of regular skin checks, but the US dermatology body advises annual checks for all adults (probably this is very cost effective for private dermatologists!!!) and in Australia 6 monthly checks for life are advised for all people who have had a melanoma. What is not in doubt is that melanomas detected on skilled skin checks tend to be thinner than those detected by the patient, and thicker melanomas are more likely to be fatal.
(*) Patients who have had a melanoma have an increased life long risk of getting another one or more, at least 8% over the next 5 years according to one study I have read. The risk factors (skin genetics, sun exposure) that led to the first melanoma continue to exist. One Italian study found that such patients’ melanomas were much thinner when discovered by routine skin checks that if the patient was discharged and left to their own devices.
A GP referred this patient on the urgent cancer pathway as a suspected melanoma. Rightly so.
The lesion was new over the last year, growing and had scabbed a bit. On plain view it’s about 1cm diameter, mostly pink with some scattered dots of pigment, and a sinister asymmetrically located black area about 3-4 mm diameter at the top end. It stands out dramatically from the small flat brown lesions in the rest of the field of view (these are solar lentigines, you can call them sun spots or age spots if you like.). This needs dermoscopy.
The dermoscope amplifies naked eye features and reveals features that we could not otherwise see. The black area resolves to a deep blue-black, a central ulcer (sharply defined irregular orange area with blood clot) is revealed, and there are numerous brown and dark grey dots and clods scattered around. These are irregular in size, shape and distribution, some are ‘clods within clods’ (a hallmark of pBCC). We also see sharply focused vessels that taper and branch. These are often called ‘arborising’ (tree like) vessels and are a hallmark of basal cell cancers.
This is a typical example of a pigmented basal cell cancer. An experienced dermoscopist can usually, but not always, distinguish such lesions from melanoma, but don’t try to be too clever as there is overlap (*) and even experts can get it wrong, as I have proved more than once by showing pictures to experts in a quiz! However, the features here are very typical of pigmented BCC (pBCC).
It is a wise rule to treat all suspicious pigmented lesions with the same degree of urgency.
(*) clues that point to malignancy but do not reliably distinguish between melanoma and pBCC
-chaos
-brown, grey and blue dots and globules
-irregular pigmented blotches
-atypical vessels
For more details and lots of examples, see my inexpensive Kindle e-book, Skin Cancer Diagnosis Made Easy, only £9.50
Dermoscopy 