There is no one size fits all treatment! We plan and tailor treatment plan according to individual needs to achieve the best chance of cure while maintaining an optimal aesthetic outcome.
NON SURGICAL TREATMENTS
CRYOTHERAPY, TOPICAL FLOUROURACIL (5-FU) & TOPICAL IMQUIMOD
Not all sun damaged skin or superficial non melanoma skin cancers require surgical intervention.
1. CRYOTHERAPY: Lesions are removed by freezing them with liquid nitrogen. Cryotherapy is suitable for multiple, small, flat patches of Bowen’s disease or Solar keratosis.
2. TOPICAL FLUOROURACIL (5-FU): 5-Fluorouracil cream contains a cytotoxic agent which can be applied to multiple lesions such as Solar Keratosis and intraepidermal Carcinoma. This is applied to skin twice daily for 2-4 weeks duration. It typically will cause an inflammatory reaction and some patients will have a vigorous skin reaction.
3. TOPICAL IMIQUIMOD: This is an immune response modifier used to treat both solar keratosis and superficial BCC. It is applied 3-5 times weekly for 4-6 weeks and causes an inflammatory reaction.
PUNCH BIOPSY, SHAVE BIOPSY, CURETTAGE & DESICCATION, SIMPLE EXCISION, SKIN FLAP, SKIN GRAFT
All biopsies and excisions are sent to hispathologist for further microscopic examination.
A skin biopsy is the removal of a skin sample. It is usually undertaken using local anaesthetic injection to numb the area. The injection stings briefly. Punch biopsy is the most common and most useful type of biopsy. It is quick to perform, convenient and only produces a small wound. It creates a full thickness of skin sampling for the pathologist to assess. A suture or two may be used to control bleeding and resulting in better wound healing before a dressing is applied.
A skin biopsy is the removal of a skin sample. It is usually undertaken using local anaesthetic injection to numb the area. The injection stings briefly. A shave biopsy maybe used for a superficial skin lesion. A shave of skin is taken using scalpel or special shave biopsy instrument. No stitches are required. The biopsy site forms a scab that should heal in 1-2 weeks.
A curettage is the removal of a skin sample. It is usually undertaken using local anaesthetic injection to numb the area. The injection stings briefly. A skin curette may be used to scrape off a superficial skin lesion for sampling.
For a larger skin excision when the defect is too big for the edges of skin to be brought together directly. In this instance, the wound is closed using local skin flap. Skin flap consists of skin taken from an adjacent area and moved to fill the surgical defect. A flap has the benefit of supplying tissue of similar appearance and thickness. This means the ultimate cosmetic result is usually superior to that of a skin graft. A special dressing is applied directly over the skin flap with an extra outer pressure dressing to protect the wound. This dressing needs to be kept clean and dry for a period of 7-14 days until you see the doctor or nurse again.
Skin excision refers to the complete removal of skin lesion with surgical margins as per the Clinical Practice Guidelines in Australia and New Zealand. The lesion is typically excised as an ellipse using a scalpel blade. The wound is closed directly using sutures. A non-waterproof (breathable) dressing is applied to the surgical site. This dressing needs to be kept clean and dry for a period of 7-14 days until you see the doctor or nurse again.
A skin graft is needed when the area of skin loss is too big to be closed directly or with a skin flap. Healthy skin is harvested from another part of the body and applied to the site where skin is missing. A skin graft is a piece of free skin without blood supply and therefore it relies completely on nutrients from the wound bed. It takes a longer time to heal compared to direct closure because the free skin graft will need to establish its own blood supply. A special dressing is applied directly over the skin graft with an extra outer pressure dressing to protect the wound and graft. This dressing needs to be kept clean and dry for a period of 7-11 days until you see the doctor or nurse again.
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PSORIASIS, DERMATITIS, VITILIGO & OTHER SKIN CONDITIONS
Ultraviolet B, which is present in natural sunlight, is an effective treatment for some skin conditions
Ultraviolet B, which is present in natural sunlight, is an effective treatment for some skin conditions. UVB penetrates the skin and slows the growth of affected skin cells. Treatment involves exposing the skin to an artificial narrow band UVB light source for a set length of time on a regular schedule.
The patient typically steps into a light box at a dermatologist’s office nude (although the genital area needs to be covered and most people wear goggles plus a cover over their eyes and face). The bulb in the light box emits a short burst of narrowband UVB light, ranging from a few seconds to a few minutes depending on the person’s skin type and the number of treatments he or she has had. A patient‘s treatment is tailored individually after initial consultation with a dermatologist.
What conditions treated by UVB phototherapy?
◊ Other skin conditions: generalised itch, prurigo, cutaneous T-cell lymphoma, pityriasis lichenoides, and symptomatic dermographism