Dermatology

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Dermatology News
The Newsletter of the Dermatology Dept Number 21
Summer 2007 Brighton Sussex University
Hospitals NHS Trust
Introducing Dr Bav Shergill I have recently been
appointed as a dermatology consultant in Brighton
and East Grinstead. I have joined the existing
skin cancer team to help with the treatment of
this increasingly common disease. I am looking
forward to working in a teaching hospital
department that has such strong links with the
local community. I graduated from Guys and St
Thomas Hospitals and started my dermatology
training as a Senior House Officer at the St
Johns Institute of Dermatology, London. I then
held Registrar posts at University College,
Lewisham, Barts and The Royal London, The Royal
Free and St Thomas Hospitals. I have undertaken
a fellowship in skin cancer surgery and laser
surgery at the St Johns Institute of Dermatology
and subsequently held a Locum Consultant
appointment in the same unit. My main
responsibilities at Brighton are to support and
participate in the skin cancer services we offer
specialist and local skin cancer
multidisciplinary teams our rapid access skin
cancer clinics and our day case surgery. While
surgery is one of my skills that will be used
immediately, I also hope to add my experience
with chemotherapeutic creams (Imiquimod and
5-fluorouracil) and other non-surgical treatments
that are currently an area of research within
this field. In addition to my skin cancer duties
at Brighton, I also undertake general dermatology
and laser treatment clinics at Queen Victoria
(East Grinstead) Hospital. This unique centre
has many links with Kent/Surrey/Sussex hospitals
and I will also be a member of their skin cancer
multidisciplinary team. Alongside my clinical
duties, I will also be involved in training
medical students, nurses, general practitioners
and future dermatologists to be competent in skin
cancer management, surgical techniques and laser
therapy. Bav Shergill
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• LOW PRIORITY PROCEDURES
• As you may be aware, all the Sussex Primary Care
  Trusts have developed lists of Low Priority
  Procedures which will not be funded as NHS
  treatments. The full list is available from the
  PCTs and includes information with regard to
  exceptions, supporting evidence etc.
• In principle there are several procedures that we
  now cannot undertake as we will not be paid for
  them. However, we are ALWAYS happy to see
  patients where there is diagnostic doubt, and you
  should still refer them.
• For those patients who you think need a
  particular procedure, there is a process of
  application to the PCT Exceptions Panel.
  Again, the application forms for this are
  available from the PCT. Once you have gained
  permission and funding from the Panel we would be
  very happy to treat these patients. I am afraid
  that we will be returning referral letters
  requesting these procedures, unless funding has
  already been secured.
• I have listed the procedures relevant to both
  Dermatology and Plastic Surgery referrals
• Dermatology
• Acne Scarring
• Chemical Peels
• Dermabrasion of Skin
• Electrolysis
• Hirsutism Treatments
• Laser Therapy/Laser Treatment for Aesthetic
  Reasons/Tunable Dye Laser
• Removal of Benign Skin Lesions (Includes
  papillomas, seborrhoeic keratosis, lipomas and
  sebaceous cysts)
• Rhinophyma

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Guidelines for the Management of Actinic Keratosis
History of rapid growth and/or nodular appearance?
Urgent 2-week Cancer referral or Biopsy
No
Yes
Sun-Protection Lifestyle Advice and SpFgt25
Daily Is active treatment necessary?
Symptomatic Lesions lt2 cm or Few Lesions
Symptomatic Multiple Lesions
Large Lesion gt 2 cm Ulceration/Diagnosis Uncertain
Cryotherapy 7-10 second freeze
Topical 3 Diclofenac Sodium
Satisfactory response at 8 weeks?
Yes
No
Topical 5-Florouracil cream 3-6 weeks twice
daily /- non-fluorinated steroid
Response at 8 weeks?
GPwSPI or Dermatology referral for advice or skin
biopsy
Advice about sun protection Advice about
lifestyle changes Advice about future therapy
No
Yes
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Department Personnel Dr Charles Darley Consultant
Dermatologist Dr Liz Derrick Consultant
Dermatologist and Lead Clinician Dr Russell
Emerson Consultant Dermatologist Dr Meg
Price Consultant Dermatologist Dr Bav
Shergill Consultant Dermatologist Dr Emma
Topham Consultant Dermatologist Dr Maggie
Voyce Associate Specialist Dr Jessie
Felton Specialist Registrar Dr Claudia
deGiovanni Specialist Registrar Ms Liza
Benfield Dermatology Nurse Specialist Ms Alison
Lowe Dermatology Nurse Specialist Mrs Olyvia
Choi Dermatology Senior Nurse Mrs Liz
Hayward Dermatology Senior Nurse Mrs Jo
Jenkinson Secretary Ms Jenny Edge Secretary Ms
Jenny Nicholson Secretary Mrs Julie
King Secretary Mrs Gloria Akehurst Clerk Mrs Sue
McMullan Clerk Mrs Audrey Norman Clerk

• Dermatology
• News
• Published bi-
• annually by the
• Department of
• Dermatology at
• Brighton
• General
• Hospital
• Editor
• Dr Meg Price
• Articles and
• ideas welcome!
• Next edition
• Winter 2007

Dermatological Workshops The next will be on 27
September 2007. We aim to make these fun as well
as informative. For more details, please contact
Dawn OGrady on 01273 696955 Ext 3353. The
meetings are PGEA approved for two hours (disease
management). The programme will be as
follows- From To Detail 2.00 pm 2.40 pm GPs to
see clinical cases in the Outpatient Department
at Brighton General Hospital 2.40 pm 3.00
pm Tea and Registration in Elms Restaurant (2nd
Floor) 3.00 pm 4.00 pm Discussion of clinical
cases and short lecture in the Department
Telephone Numbers Brighton General
Hospital 01273 696955 Dermatology Fax 01273
665025 Cancer Fax [phone] Outpatients and
Reception 5033 / 5989 Main Clinic 5041 Consulta
nt Office 5029 / 5100 Secretaries 5019 Sisters
Liza Benfield/Alison Lowe Bleep 3899/Ext
5035 E-mail jo.jenkinson_at_bsuh.nhs.uk