Skin A&E Season 7 Episode 2

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Transcript

00:00skin A&E is back in business and our team of top dermatologists are back in Birmingham here we go

00:13here we go ready to tackle the nation's lumps and lesions no jobs too big maybe a slightly bigger

00:23part yeah no treatment too messy I do have a habit of poking it and squeezing it very uncomfortable

00:30they'll bring relief Wow and results so happy restoring confidence thank you and changing lives

00:48doesn't want to come it's like a strawberry I've got eat my lunch this is skin A&E this week in the

01:06clinic okay I can see why you can't lie on it yeah it's huge isn't it there's gray matter oh oh oh my

01:15it's all over me head scratches yeah this is a very interesting looking rash and some tough nuts to

01:23crack I can hear the slipping or something going on you're gonna hear it it might be early but the

01:34doors are open all right let's get ready you've got a busy day today and the team wastes no time

01:42getting down to business this like home another like home and then the head must be after lunch

01:46the first patient of the day has come to see dr. Dev Shah my name is Hazel I'm 57 years old I'm from

01:54East London and I work in a university training primary school teachers have a seat I'll let you

01:59know when I'm ready for you okay I like the standing up in front of them sometimes I say if I wasn't a

02:06teacher I'd be a stand-up comedian or something like that hello Hazel come on in thank you hello

02:17Hazel hi how you doing I'm Dev nice to meet you hello this is Cherry hi yeah hi how are you feeling um okay

02:24I'm a little bit nervous but um I'm okay so I've got um a large lump on my back I've had it for a long

02:31time about 20 years it was a small about the size of a golf ball when I first noticed it so I left it

02:38and I left it and I left it and then it's so large now you can see it through my clothes okay and when

02:44I lay down I can't lay flat because it's like laying on a you know on a football or something it

02:52looks like I've got hunchback it's you know it's it's that prominent I'll be glad to see the back of it

02:57excuse the pun I'm beginning to think just how big can it get if I don't have it done now is it

03:03is it going to be the size of that packet okay okay fair enough all right what do you do as a job

03:09I train primary school teachers at a university and were you a primary school teacher to begin with

03:15I was an okay teacher you know I was probably a good teacher but I just I was an outstanding teacher

03:21that's what you should know but um I enjoy teacher training much more okay we will come

03:27and have a look at what you have and then we'll go from there is that all right yeah we'll get you

03:31to swivel around yeah that's good lovely okay just lift your top okay let's have a look okay I can

03:39see why you can't lie on it yeah it's huge isn't it when she took her top up it was very big

03:47really quite protruding from her skin so she's done a good job of hiding that really

03:53and she took off her shirt and it was just wow that's um large and I can still imagine why she

04:01wants to get rid of it I think it's very doable today lovely if we take it out with a very small

04:09hole you'll have a lot of floppy skin here yeah I think the only way to get rid of that excess skin

04:15is to just do that sort of thing which will give you a scar that will look like that yeah no I

04:23don't mind the scar at all you excited yeah now let's talk about your nerves I think it's like

04:29anything it's the it's the unknown isn't it I'm a bit scared of any medical procedure so I was very

04:37nervous at the beginning you shouldn't feel anything apart from a bit of pressure a bit of pulling and

04:44pushing that sort of thing I've had a baby so nothing can be no no it's not as bad as that

04:50this is a walk in the park not that I can talk actually but there you go so when someone says

04:55they're nervous it's really important to keep talking to them and cherry does an excellent job

05:00of uh talking a lot of rubbish really which is to distract patients hang over the pillows if

05:07you're about to have a massage but you're not Hazel was really anxious she knew that there were going

05:14to be injections and all I can do is try to calm her down so he's just having a little fiddle he's

05:23still working out how he's going to lie the scar sharp scratch coming up okay on the count of three

05:32one two three that's it how's that that's fine you ideally don't want her to feel any pain at any

05:42point but when you've got a lump overlying a rib cage you can't just jab a needle in you don't know

05:48how deep the lipoma is so you really want to numb the surrounding skin and then you'll have to put some

05:55more in as the operation goes on because you don't know how deep you should be going okay so that's

06:02the local now I already feel better than I did before good okay so let me know if you feel any pain

06:12at any point all right okay

06:14just have a look so

06:35any pain

06:40is that and that's hurting I don't know it's weird yeah if it's uncomfortable we could put some

07:07more in yeah sorry okay don't be sorry

07:10that your normal hair color I am naturally red yeah so redheads take a bit more anesthetic and

07:23you might bleed a bit more not every redhead will have that problem but it is quite common you have

07:29to ensure that it doesn't lose its efficacy or lose its potency sooner also her lipoma was really large

07:36so it's touch and go really whether we are able to do this with under a local anesthetic

07:41coming up it's reminding me of something I'm not quite sure what it's reminding me of

07:47icing sugar cream cheese

07:49hiding and hiding you just kept finding more and more they've gone wider and they've gone deeper

07:58it's mid-morning at skin a and a and the clinic is in full swing the doctor will see you now down the hall on your left in surgery room one devs trying to remove a huge lipoma from 57 year old hazel's upper back but her large lump is putting up a fight

08:27it's very uh we're not going to get it out through this hole are we

08:31it's hard to find where the the encapsulation is

08:37so I think what we're going to have to do is make the scar bigger

08:41okay

08:41so if you have um skin overlying a big ball you can't get things out through a small hole

08:50because you have to try and make it bigger so you can visualize where you're going and how deep you are

08:55it didn't bother me that he had to make a bigger cut to get the lipoma out

09:00just wanted it gone so I didn't care if he took it out with a spoon

09:06I think there's just lots of little ones

09:14there we go

09:16have you got any of it out yet

09:18oh yeah

09:19little bits

09:20if you have multiple lipomas all encapsulated they don't all come out as one whole thing

09:26it looks quite aggressive when you're squeezing but obviously patients can't feel that

09:31but unless you squeeze you won't dislodge the deeper lipomas that you may not be able to see

09:36or sometimes feel

09:38does he have a name

09:42my brother calls it my back boob

09:45your back boob come on boob get let's get rid of you

09:48my third boob

09:49don't worry we're getting there

09:53that's some squelching

09:58squelching it really is hang on

10:01what's that lovely book for primary school kids

10:04yeah going on a bear hunt

10:06going on a lipoma hunt

10:09multiple lipomas really aren't they

10:21little little little little clumped together

10:24hang on a minute

10:25ah oh sorry it didn't hurt I just felt it

10:30you felt it a bit as a bit fun

10:33squeezing was quite uncomfortable the pulling and tugging was the worst part of it

10:39because he had to pull quite hard

10:41it's just hiding and hiding

10:44with hazel you just kept finding more and more because they had penetrated in different areas

10:49they'd gone wider and they'd gone deeper

10:51hello back boob how nice to meet you

11:12he really is a back boob isn't he

11:14i think it would be a she if it was a boob

11:17yeah oh just saying

11:18yeah well you know some blokes have them

11:21yeah i know a bloke who's a bit of a tit

11:24i work with one all the time who's a bit of a tit

11:28there we go right we're making some headway now

11:33now it's a matter of getting underneath that so

11:36it might come from here

11:38let me just use that

11:39i think the final one was actually quite far onto her

11:44just onto her rib cage so we didn't want to go any deeper

11:46because there's structures there that obviously we could cause damage

11:50i can't believe i'm actually doing anything

11:56came away in my hand gov

12:10okay right that was tricky

12:15with lipomas like this it's a it's a balance between keeping the patient on the bed for too long

12:24but also giving them a good result and so they're not the most pleasurable ones to remove

12:29but once you've done it you actually feel like you've done a good job for the patient even though it was difficult

12:34lovely lovely lovely it's all done

12:39we're finished

12:40done hooray

12:41we're just going to put the dressing on

12:43lovely

12:44you were marvellous well done

12:45oh i need a cup of tea

12:46both of them were very good at putting me at ease and distracting me from the procedure

12:53well done

12:54well that was a job

12:57yeah

12:58thank you for doing it

12:59it's a pleasure

13:00do you actually want to see it

13:01yeah

13:01do you feel up to see it

13:02you know i do want to see it

13:03I'm imagining it to be really disgusting.

13:06It's not pretty.

13:08Okay, are you ready?

13:09Yeah.

13:10Oh, my goodness.

13:13Oh.

13:15I've never seen anything so disgusting in all my life.

13:19Orange is my favourite colour, but not in a lipoma.

13:25Nearly half a kilogram.

13:27414 grams.

13:28I think we should claim the title as the heaviest lipoma,

13:32not necessarily the biggest.

13:33It's not always about size.

13:35Woo, a record for skin A&E.

13:38That's amazing.

13:39Ooh.

13:40I feel sort of lighter on this side.

13:42It's going to make an awful lot of difference.

13:45Look after yourself.

13:46Take care.

13:46Yeah, thank you.

13:47Don't do anything physical.

13:49I might start referring to orange as lipoma orange.

13:55That was a waffle, isn't it?

13:59There's no time to dawdle in the clinic

14:02as the next patient is on his way.

14:04Hi, I'm Terry.

14:06I'm 63 years old.

14:07I'm from Nottinghamshire, and I'm a retired lorry driver.

14:10Have a seat for me.

14:12I'll let you know when I'm ready for you.

14:13A lot of people get stressed with driving.

14:18Driving, to me, was my relaxation.

14:21Spent 30 years driving up and down this wonderful country of ours,

14:24and I miss it, but I don't think I could go back to it now.

14:28OK, Terry, the doctor's ready for you.

14:31It's down the hall on your left.

14:34Terry's appointment is with Dr. Adil Shiraz.

14:37Come in.

14:40Hello.

14:41Hello, Doctor.

14:41Hi there.

14:42Come through, take a seat.

14:46Right, it's Terence, is it?

14:47It is.

14:48I'm Dr. Shiraz.

14:48Nice to meet you.

14:49This is Vilma.

14:50Hi.

14:51Right.

14:52Why are you here today?

14:53I've got a few lumps and bumps on the back of my neck.

14:56How long have they been there?

14:57The ones that are left now have been there 40-odd years.

15:0140?

15:01When I first noticed them, I was in my late teens, early 20s,

15:08and they just got larger.

15:12And do they bother you in any way?

15:14More vanity than anything.

15:16For 40-odd years, I haven't worn anything without high collar,

15:20or I've had long hair to cover them.

15:22People notice them, point them out.

15:24Yeah.

15:24What do they say?

15:25Oh, all sorts.

15:27You've got an extra head growing, and I mean,

15:29I've got what I call my pet nipple.

15:31It would be nice to actually wear something

15:33without a large collar on to hide them.

15:35Even though I class one as a pet, they've got to go.

15:39All right.

15:40So, if you could take a seat here.

15:43Maybe if you take your jacket off and just pop it there on the hook.

15:48Okay, just take a seat here.

15:51Okay, I'm just going to pull your collar down.

15:53Yeah.

15:54Oh, yeah.

15:54So, one there, and then one here, but these are quite prominent.

16:05Terence had his cysts for 40 years.

16:08I was surprised that they still were present and hadn't burst or erupted by now,

16:12because they were almost ready to go.

16:15We should be able to do both of those for you today.

16:18Yeah.

16:18So, what I would like you to do now is lie yourself down.

16:21Go on your side.

16:23Yeah.

16:23Just make yourself comfortable.

16:25Right, the stingy bit coming up now.

16:29Mm-hmm.

16:36Number two.

16:39So, cysts are sacs or balloons under the skin that contain dead skin and debris and oil,

16:46and they usually have an opening on the surface.

16:48It's definitely a cyst.

16:50You can see a lot of the contents trying to ooze out the opening.

16:56Already?

16:57Yeah.

16:58It's because of the pressure.

16:59Yeah.

16:59With the anesthetic.

17:01So, when you inject anything into them, and in this case, when I injected the anesthetic,

17:05the increased pressure caused some of the contents to start oozing out, even before I'd start cutting.

17:12Does this feel sharp?

17:13No.

17:14It's already leaking itself.

17:17See, they've been there that many years, they just want to escape.

17:21Yeah.

17:21They're all ready.

17:23They're rearing to go.

17:36Quite liquid.

17:37Yeah, very liquid.

17:38It's almost ready to be infected.

17:40Yeah.

17:41It's almost like pus.

17:42Yeah.

17:43What should it look like?

17:44Normally, it's a bit firmer than this, the contents.

17:49A bit like condensed milk.

17:52They've never felt squishy or soft.

17:55They've moved about, but never felt liquid.

17:59We can see the bits of the sack coming out.

18:05Not quite as sort of formed as you see in some of them, but it is the sack, nonetheless.

18:14Good.

18:14So, that one's done.

18:16Just put some stitches in there.

18:18That one quick.

18:19Right, one down, one to go.

18:31Okay, so, where's this one going to go?

18:33It looks like it's pointing directly at me.

18:35To you, yes.

18:38You're escaping.

18:38All right, let's see.

18:43Rose, to you.

18:45I'm pretty good at dodging cyst contents now, so I was well out of the way of this one.

18:50I knew it was going to erupt, and it did, but luckily, it didn't catch me.

18:58It's reminding me of something.

18:59I'm not quite sure what this is reminding me of.

19:02Icing sugar, cream cheese.

19:06Similar, but a bit more formed.

19:09I'm saying, that one was my pet nipple.

19:11Yeah, we can see why.

19:18Oh, my God.

19:26Right, let's take a picture.

19:29Okay, just stay there while we do a dressing, and then you're done.

19:35All right, brilliant.

19:45All done?

19:46Yeah, take your time.

19:47All done.

19:47Holy grudge, you get up.

19:51That's right.

19:56Okay.

19:57How was that for you?

19:58Brilliant.

19:59Because I can feel there's no lumps there already.

20:02Right, so let me just quickly show you pictures of what the scars look like.

20:06So those are your scars.

20:08Yeah, brilliant.

20:09Looks slightly different.

20:12I'm feeling absolutely on top of the world.

20:15Thank you once again, doctor.

20:16Bye.

20:17For 40-odd years, my pet nipple and his little brother have dictated where I've slept and how I've slept.

20:25It's going to seem very strange tonight, because it's just going to be me.

20:28So, it's going to be good.

20:30Coming up...

20:38Oh, my God.

20:42It's very interesting looking.

20:43Lunch break over, and the team are sprucing up.

20:57My hair's a mess today.

20:59Ready for the next set of patients.

21:01Got it?

21:02I think so.

21:03Beautiful.

21:03Thank you very much.

21:06My name's Jake.

21:07I'm 30 years old.

21:09I'm from Northampton, and I'm a coach in a gym.

21:13Jake's come to see Dr. Natalia Spearings.

21:16Hi.

21:19Come on through.

21:20Welcome.

21:20Hi.

21:21Hello.

21:21I'm Natalia.

21:22You must meet Jake.

21:23Yes.

21:23Nice to meet you.

21:24Hi.

21:24Nice to meet you.

21:24This is Duta.

21:25She'll be assisting me today.

21:26Nice to meet you.

21:27Come and have a seat right here.

21:28Thank you very much.

21:29All right.

21:31So, how can I help you today?

21:33I've got a rash on my back, which started between my shoulder blades, and now it's spread

21:37all over my back, and it's come in across my chest as well.

21:39Okay.

21:40You're how old?

21:41I'm 30 now.

21:41You're 30 now.

21:42Yeah.

21:42Okay.

21:43And when did this start?

21:44When I was, like, 14.

21:45Oh, right.

21:46So, I've had it a long time.

21:4715 years.

21:48Yeah.

21:48If I'm proud of my body, like, I am for the hard work I've put in, but I don't like to

21:53shy off because I've got a skin condition which, like, puts a damper on the efforts that

21:58I've put in.

21:58And does it bother you?

21:59Like, does it itch?

22:00It can be itchy at times, yeah.

22:02Like, yeah.

22:02I've had it looked at many times, and they can't pinpoint what it is.

22:06I couldn't believe that Jake had seen numerous other doctors over the past 16 years to try

22:11to diagnose and manage this condition, but he had never gotten an actual diagnosis.

22:14Quite astounding, actually, to walk around with a rash.

22:17Basically, you don't know what it is for that long of a period of time.

22:20So, how does this rash kind of impact your life or affect your work?

22:23It affects my confidence a lot in my personal life.

22:25So, I wouldn't really take my top off, like, in public at all.

22:28Okay.

22:28And obviously, when it's itchy, it's annoying as well, because, like, if I'm just stood

22:31there, like, yeah, scratching it and itching it, like, it can get really annoying.

22:35Is it okay if I have a look?

22:37Yeah, yeah, yeah, it's fine.

22:47It's a really unusual-looking rash, even for me.

22:50So, if I think it's unusual, I can't imagine what just regular people around the street

22:54would think if they saw his back.

22:56You have little red dots in there.

22:57I think they're little scabs.

22:58Yeah, that's where, like, if I've scratched it and then it goes scabby like that.

23:02And where's the newest part of this?

23:05On the front.

23:06Oh, on the front.

23:07Yeah, that's the newest.

23:07These are the newest parts.

23:11And you scratched all of these.

23:12They're all my itchy.

23:13Yeah, I'm trying to scratch the front too much, but, yeah.

23:17It's mainly the back that's itchiest.

23:18Oh, it's under your arms as well?

23:19Yeah, it's a little bit under my arms as well.

23:21I'm sorry, I just need to look at the lower back, because you have a lot of redness down

23:24here.

23:25Yeah, I think that's where it was most itchy recently is, in my lower back.

23:29Oh, yeah.

23:30Yeah, you've really gone for it, because there's a lot of redness here.

23:34So, yeah, they're follicular dots.

23:38What I mean by follicular dots is that I saw pigment around each hair follicle, making

23:44the rash not smooth, but a little bit bumpy.

23:47And that's really helpful in moving me towards the right diagnosis.

23:51Okay, you can pop your shirt on.

23:52Have a seat.

23:53We can have a chat about this.

23:54I was going through kind of the list of different areas in dermatology that you could have a

24:00rash like that.

24:01So, chronic, familial, well, genetic, viral, acute.

24:05So, we call this a reticulated, hyperpigmented rash.

24:09So, that just describes what we see.

24:12So, reticulated means it looks like a net-like pattern.

24:15Okay.

24:15And pigmented means it's brown.

24:17I've never seen anything quite like this, but I do know someone will have an answer to

24:21this.

24:21Yeah.

24:22I try to be as positive as I can and not take anything too negatively.

24:25So, it's kind of cool that it's rare, I guess.

24:28What I'm suggesting is that it may benefit for you to have a biopsy, and we could do

24:31that today if you're amenable to that idea.

24:34Yeah.

24:34So, the tiny, tiny biopsy is four millimeters, so you won't really see that scar.

24:39Yeah.

24:40I ingest some local anesthetic to numb it, then I take the tiny sample, but with one stitch

24:44in it.

24:44How long does the stitch last?

24:46You should get it out in 10 to 14 days.

24:4810 to 14 days?

24:49Okay.

24:49You can still do activity.

24:50Can I arc as well?

24:51Yeah, yeah, you can do it.

24:51Because I've got a competition on Saturday.

24:53Oh, right.

24:53Where are you competing in?

24:54At High Rocks.

24:55Oh, you're doing High Rocks.

24:56Oh, my God.

24:56It's like CrossFit and, like, running.

24:58Yeah.

24:59Yeah, it sounds like torture.

25:00Okay, exciting.

25:01You will be able to do High Rocks.

25:02So, if you are happy to take your t-shirt off again, it will get you comfortable on the

25:06couch.

25:07So, this is my third time lucky having a biopsy.

25:10I'm just going to keep taking chunks out of my back until they find out what it is.

25:14All right, here we go.

25:15Ready?

25:15Sharp scratches.

25:16This is your anesthetic.

25:16Yeah.

25:20When I take a punch biopsy, I'm looking to take the right type of sample.

25:24So, from the right area of the rash or lesion.

25:28So, for Jake, it was just through kind of the darkest area I could see with one of the

25:33lapapules.

25:34And also, I tried to get a little bit of normal skin in there so that they can compare the

25:37normal to the rash skin.

25:39So, do you have to train every day?

25:43I train about five times a week, if I can, ideally.

25:48Lower body one day, upper body another day.

25:50Yeah, yeah, yeah.

25:50And then work on the machines like you're rowing and bikes and things like that.

25:57High Rocks is a functional fitness race.

25:59It's become really popular now.

26:01I did my first one like three years ago now, and it's literally just blown up massive.

26:07That's how you get strong and work your weaknesses.

26:10I guess so.

26:10But then you're asking your body to do so many different things at once.

26:13Yes.

26:13I only do weightlifting.

26:14So, you're trying to do cardio and weights and trying to get all the stuff fit at the

26:19same time.

26:20Yes.

26:20Take your time getting up.

26:22You pinch a little bit.

26:22Dizzy.

26:23You say you do weightlifting?

26:24Yeah.

26:25Like Olympic weightlifting or just general?

26:27No, I'm a bodybuilder.

26:28Oh, nice.

26:29So, yeah, I'm actually an IFBB pro.

26:32Oh, wow.

26:33All right.

26:34So, we have things in common.

26:35Yes.

26:36That's awesome.

26:37Yeah.

26:37Why don't you tell me that at the start?

26:39No, because I don't like to throw it.

26:40It's not about me, is it?

26:43Anyway, you're all done.

26:44Perfect.

26:45So, we'll run this through the lab, and then we'll get back to you with something, hopefully.

26:50Amazing.

26:50Okay?

26:50Thank you very much.

26:51All right.

26:51You're welcome.

26:52Lovely to meet you.

26:53Yeah, and you.

26:53Good luck on Saturday.

26:54Yeah, good luck to you as well.

26:55Thanks.

26:56Nice to meet you.

26:57Bye.

26:57Cheers.

26:58Bye.

26:59It's a rare skin condition that we might find some answers to in the future, and if

27:05I can be, like, the first person who's got this thing, then I could be the pioneer of

27:10this new skin condition.

27:12It's really difficult to train like that, because you're just, you're trying to get

27:14strong, but you're trying to get fast.

27:16The two things just don't mesh together.

27:18You guys were practically speaking Mandarin.

27:20I tuned out.

27:22Dr. Natalia is a fitness powerhouse, but how does the rest of the team exercise outside

27:36the clinic?

27:36While I'm waiting on the kettle to boil, I try to do 10 press-ups.

27:41I recently joined CrossFit.

27:44I always make time for yoga.

27:45That's the one thing that I've never stopped doing.

27:48I don't really have one, but I do like to swim.

27:52I've just done Tarzan swings in my garden for my little son, and so we do that every night.

27:59I have just recently bought one of those vibration plates, but it's a bit, watch this space to

28:05see if it works.

28:06It's time for the cool-down, as the next patient has already arrived.

28:12Hello.

28:13My name's Tessa.

28:14I've got an appointment today.

28:15Lovely, Tessa.

28:15I'll check you in.

28:17I am 39, and I come from Levington Spa.

28:20Have a seat for me.

28:21I'll let you know when you're ready for it.

28:22No problem.

28:24I was born in Cape Town, and it's just the most beautiful place in the world.

28:29I said, would you like me to speak Afrikaans with you?

28:36Okay, Tessa, doctor's ready for you down the hall on your left.

28:41Tessa's here to see Dr. Emma McMullen.

28:49Hi.

28:50Hi, is it Tessa?

28:50Hello, it is.

28:51Hi, I'm Dr. Emma.

28:52This is Donna.

28:53Do you want to come in and have a seat?

28:54Hi.

28:54How are you?

28:56I'm good.

28:57Yourself?

28:58So, Tessa, what can we do for you?

29:00I have a cyst on my jaw.

29:03Oh, yeah.

29:03And I, yeah.

29:04You've had it well hidden there with your hair.

29:07Yeah, I do.

29:08I do hide it with my hair.

29:09Oh, yeah.

29:10Yeah, and I've got two really big moles over there.

29:13Yeah.

29:13And one here.

29:14Mm.

29:16Yeah.

29:16I was kind of hoping that you can sort of see it here today.

29:19Okay.

29:19So, tell me a little bit about the cyst first.

29:21How long has that been there for?

29:22About 20 years.

29:24Oh, it's a long time.

29:25A long time.

29:26Has it ever oozed or got infected?

29:27It never oozed, no.

29:28It started off with like a little spot.

29:30Uh-huh.

29:30And then it just kind of grew from there.

29:32And these moles, have they been there a long time?

29:35As long as I can remember.

29:36All right.

29:37Yeah.

29:37Okay.

29:37Do you mind if I have a little look at these?

29:40Yeah, sure.

29:40And I'll feel them up close.

29:42Every time I look in the mirror, I can see the imperfections.

29:46And it's just not pleasant, so I just avoid looking in the mirror.

29:49And, you know, I try not to see it, but it's there all the time.

29:53So, let's have a look at these moles.

29:54Yeah, they're nice and wobbly.

29:56They don't look like anything worrying.

29:59And then let's have a feel of this cyst.

30:04Okay.

30:05It's quite nice and mobile.

30:08Obviously, if we remove these things, they leave scars.

30:11Yeah.

30:12So, the moles, they're really easy to remove.

30:16I think I could remove those today if you wanted.

30:19That would be amazing.

30:19Yeah.

30:21The cyst, obviously, those are a bit trickier to remove.

30:23But, again, it's nice and superficial, so I think I can do that one

30:25as well.

30:26Thank you so much.

30:27You get four for the price of one.

30:28Thank you so much.

30:29I'm so happy about that.

30:32Absolutely elated.

30:34It's something that I've been living with for so long.

30:37And, you know, it's just time for change.

30:41So, what would you normally be doing today?

30:43Today I'm working.

30:44I'm working like a little biltong shop.

30:46Biltong?

30:47South African biltong shop.

30:48Oh, yum.

30:49Oh, you like it?

30:50I love biltong.

30:51Oh, brilliant.

30:52I'm a vegetarian.

30:53So, I'm a vegetarian working in a meat shop.

30:59You all right if I pop your local in now?

31:02Tessa, this is obviously going to sting.

31:06Sorry.

31:07Think about areas that are very sensitive to touch.

31:10Obviously, when you inject local anaesthetic into those areas,

31:13it's more painful than it is if you inject it in the middle of your back.

31:16Well done.

31:17It's close to the mummy.

31:18You make your eyes water.

31:20I'll do lower.

31:22Because it's on the way.

31:23Yeah.

31:24Okay.

31:27When I'm removing moles on the face, I like to use a derma blade.

31:35A really flexible, thin, sharp blade that has a lot of movement in it.

31:42All right, let's do this one.

31:43It, you know, can bend and flex to the contours of the face.

31:53Gives a really nice, neat finish.

31:56It's just a bit close to your nose.

31:59I don't want to...

32:00Cut one in.

32:01Yeah.

32:06Okay, you can't feel anything sharp, no?

32:08No.

32:13Okay, right.

32:16If you can turn towards Donna slightly, so the...

32:19Oh, sugar.

32:34I think when I'd made the incision, the initial incision, I'd nicked the cyst wall.

32:41Donna was absolutely delighted.

32:44I'm always willing to burst the cysts.

32:49It's much better if they squeeze all out, isn't it?

32:53Oh!

32:54Well, I was just about to say it hasn't squirted.

32:57I wonder if I think I might have put some local in it.

32:59Look, Donna, can you...

33:00Let's just get a bit...

33:02Oh, sugar.

33:03Oh, my God.

33:05Well.

33:06Oh, yeah, that was good.

33:08I was quite shocked.

33:11Oh, my God.

33:13I think it might have hit the trolley, so...

33:16Yeah, it's really liquidy.

33:20It's all over me.

33:27Oh, there's still more.

33:29It's a lot bigger.

33:33Yeah.

33:34There's a lot more in there than what you...

33:37would have thought.

33:41See, that's why I put an extra large drape out.

33:44Yeah.

33:46Absolutely.

33:49Oh, I've just put my...

33:50Oh, no!

33:56Yeah, it always gets that, but doesn't it?

33:58You are really sharing this.

34:04I'm so sorry.

34:05Oh, don't be silly.

34:07I'm all right over here.

34:09It's all gone that way.

34:20There we go.

34:22Looks like nothing.

34:23I can't believe it's gone.

34:32Right.

34:3420 years just left me.

34:40Right.

34:41Let me bring you back down to earth.

34:43Okey-dokey.

34:44Dr. Emma was absolutely fantastic.

34:48They were both so accommodating, and they kept me calm.

34:52The moths went really quickly, and actually, the cyst didn't take that long, either.

34:56Do you want to have a look at them?

34:58They're all in the pot.

35:00There's not very much left of the cyst, because it's on me and this thing.

35:04So it's just...

35:05No way!

35:06It wasn't as impressive as I thought it would be.

35:10The stuff inside was really liquidy, so...

35:12Yeah, it's everywhere.

35:13Yeah, it's everywhere.

35:13It's everywhere.

35:14And it's everywhere.

35:15Shock that went.

35:16No!

35:17Like, yeah.

35:18Thank you so much, Dr. Emma and Donna.

35:21I'm going to let you go.

35:22Thank you so much.

35:24Thanks, you too.

35:24Really lovely to meet you, Tessa.

35:26Bye-bye.

35:27Bye-bye now.

35:29I feel like this is a new chapter for me.

35:31I feel more confident, and I'm just really looking forward to where this is going to take me.

35:38It's like a tube to test.

35:39Yeah, it was very satisfying, that.

35:43It was an upset for her, wasn't it?

35:45Yeah.

35:49Coming up...

35:50I can hear a sniffing or something going.

35:52You're going to hear it.

35:54I'm not screaming, Tessa, but we're all right.

35:57It's good.

35:57You're a good patient, then.

36:09The curtain is about to fall on another hectic day at the clinic.

36:14But there's one more patient waiting in the wings.

36:17My name is Peter, and I am 59 years old.

36:21I live in Bedfordshire, and I'm self-employed.

36:27Have a seat for me.

36:27I'll let you know when the doctor's ready for you, okay?

36:29Thank you very much.

36:30No problem.

36:31During the summer months, I work as a bat surveyor.

36:35I run a furniture restoration business.

36:38And I also work in the TV and film industry as a background artiste.

36:41Today, Peter is co-starring with Dr. Magnus Lynch.

36:48Hello, how are you?

36:49Good to come in.

36:50Hi, come in.

36:51Hi.

36:51I'm Dr. Magnus.

36:53Nice to meet you.

36:53Have a seat for me.

36:55This is Angela.

36:56Lovely to meet you.

36:57So, what's bothering you?

36:59Well, I have a cyst or a lump on my forehead, which basically I feel so self-conscious about.

37:07And I have done probably, it must be knocking on about eight years now.

37:11And so, therefore, I just wear my bandana all the time to cover it up.

37:16It gets to the point now where I won't answer the door without thinking, where's my bandana?

37:23Bandana is my safety net.

37:26It's my me.

37:27But without it, then I just feel emotionally naked to be in public.

37:34Is it stopping you from doing things that you would want to do?

37:36Yes, yeah, I mean, I do work in the film and TV industry as a background artiste.

37:42I've done that for 25 years.

37:43And if my agent said, oh, I've got a casting for you for a part and things, that was fine.

37:47But then the lump developed.

37:49And at that point, I kind of lost the confidence to do that.

37:53Because it's there.

37:54It's like you look in the mirror and it's saying, hello, I'm still here.

38:01Can I have a little look then?

38:02Yeah, go for it.

38:02If I'm just going to touch your skin.

38:04Yeah, go for it.

38:06Yeah.

38:10Okay.

38:11And you did have a scan of that as well, didn't you?

38:14Yes, I had a scan which confirmed it was a cyst.

38:17My GP told me that it was probably from a blocked hair follicle, which for me is pretty good going.

38:24I'm not certain if it's a cyst, being honest with you.

38:27Just from the feel of it, it might be something else such as a harmless fatty growth or a lipoma.

38:32It felt spongy and soft, which is more in keeping with a lipoma, whereas a cyst would feel more like a sort of inflated balloon underneath the surface of the skin.

38:42I can do that for you.

38:43Oh, that's fantastic.

38:44Yeah.

38:46This thing is right there and it's staring at you.

38:49To have that lifted off your shoulders is suddenly...

38:52So I make a cut like that under local anaesthetic.

38:56I remove everything that I can find under the surface and that will flatten things down for you.

39:02Can we get you to change into a gal and otherwise you might get a good job in there.

39:04Yeah, yeah, go on.

39:05That's fine.

39:05If you're all right with that.

39:06Are there arms there?

39:07There are, yeah.

39:08Oh, yeah.

39:09You can make yourself comfortable there on that couch.

39:12Put this under your beard.

39:13So you said you worked in sort of filming.

39:15I used to teach medieval swordsmanship.

39:18Yeah.

39:19And over the years I've just ended up getting agents and then agents have done things.

39:23I've done things from Batman movies, Star Wars movies, Guardian of the Galaxies, Paddington's, Game of Thrones, House of the Dragon.

39:31I just found Pete to be absolutely fascinating.

39:35He, you could have put him in anywhere, found, found, you could have found a role for him doing anything, really.

39:41You distract, that's it.

39:46So were you sort of telling people how to fight or?

39:49I don't tend to do that stuff that much more these days.

39:52I tend to just do, well, anything that comes along really, background work.

39:56Yeah.

39:58But what I have avoided is anything where I can't wear a hat or my bandana.

40:03Yeah, of course it is.

40:05It should all be nice and numb for you now.

40:09Obviously, if you are feeling anything, tell me immediately.

40:13I shall do.

40:13You all right there?

40:31Yeah, no, I'm fine, I'm fine.

40:33You let me know if it's anything?

40:34Yeah, yeah, no, it's great.

40:37So when I initially cut into the lump, I could see immediately that it wasn't a cyst because I could see that there was fatty tissue beneath the surface.

40:47I can just hear whatever you do.

40:49You're going to hear it.

40:50I can hear the snipping or something going on.

40:53Yeah.

40:54I was hearing this kind of like snipping, maybe crunching noises, maybe a little tugging.

41:06But everything was fine.

41:10The difference with a lipoma versus a cyst is that the lipoma does have a blood supply itself.

41:17So inevitably, in removing that lipoma, you're expecting to see some bleeding.

41:21There we go.

41:30So that's removed.

41:31Gosh, you've already removed it.

41:33Wow.

41:33Yeah, I've done it before, don't I?

41:37Probably like you're doing a sword fight or something.

41:41When he said, that's it, we're done, it was kind of, hang on a minute.

41:45I could feel you tugging around, but I thought we had just started.

41:48Well, I'm going to do, I'm just going to seal off some blood, but you're going to hear a bit of a buzzing noise.

41:57Very tiny little vessels.

42:00The main issue that you might encounter at that site is really bleeding, which can be significant, but in this case, it was nice and straightforward.

42:12Last little stitches going in now.

42:14I'm going to lay down.

42:17Then I will let you have a little look at the wound before we put the dressing on.

42:24You're getting quite comfortable.

42:25Yeah, first of all, just sit up on the side of the bed.

42:28You're going to have a little look in the mirror there.

42:30Okay.

42:33Whee!

42:35It's like a veil has been lifted off.

42:37Great.

42:39It's probably going to take me a while to calm down because I feel so happy.

42:45I just feel so good.

42:47Lovely suits.

42:48You have a good day, yeah.

42:49All right, yeah, cheers.

42:50Thanks, sir.

42:51Thank you as well.

42:52Great, you're very welcome.

42:53And don't forget your bandana.

42:54Oh, don't forget the bandana.

42:57This is the first time I'm going to walk out and keep eating my pocket.

42:59Yeah.

42:59Delighted.

43:00Cheers.

43:00Bye, friend.

43:01See you.

43:01Bye-bye.

43:02Bye.

43:05At long last, we can kind of go our separate ways and, you know, do our own things for a change.

43:11So, thank you for all your help, bandana.

43:14But for now, there you go.

43:15I had my birthday last weekend and I had a lovely weekend away with my family and I was able to wear my party dress and it just felt really great.

43:45As you can see, I am mole and cyst-free.

43:52She's got the tiniest little scar on my face that doesn't bother me at all.

43:56I've never been able to wear anything with that collar before in at least 40 years.

44:04So, as you can see, no hunts.

44:08I've been able to reapply for castings and my confidence has rocketed and I go out and about with or without my bandana because I choose to.

44:23Next time on Skin A&E.

44:25Keep slipping back in.

44:27I've looked at, like, putting a pin in it.

44:29My GP was like, do not do that.

44:30This is way bigger than you thought it was, I think.

44:32I think you're going to love it.

44:34LAUGHTER

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