Skin A&E Season 7 Episode 1

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Transcript

00:00Skin A&E is back in business and our team of top dermatologists are back in Birmingham

00:12here we go here we go ready to tackle the nation's lumps and lesions no jobs too big

00:22probably a slightly bigger pot yeah no treatment too messy I do have a habit of poking it and squeezing

00:29it very uncomfortable they'll bring relief Wow and results so happy restoring confidence thank

00:44you and changing lives doesn't want to come it's like a strawberry I've got eat my lunch this is

00:55skin A&E this week in the clinic there are surprises from head oh my goodness to

01:13tell you to sell them for five pounds on infant okay and a few in between okay I've never seen

01:22anything as big as that in 22 years of dermatology Wow the dermatologists are in Brighton early morning

01:41that's right okay let's get set up set up getting ready to help a new batch of patients are you doing

01:49this morning good thank you how are you yeah I'm good I'm good I'm ready ready there you can get

01:54and just as well because the first patient Dave has arrived and he's heading straight to Dr Emma McMullen

02:10hello hello hello hello I wonder what you've come with that's what I'm here for

02:18is it David yes there's a couple of come and have a seat David we're best talking about that

02:24goodness me right I'm Dr Emma this is Donna hi lovely to meet you and uh and your friend

02:33yeah yeah oh my goodness how has he lived with that I've never seen anything as big as that in my

02:43clinical practice in 22 years of dermatology so tell me a bit about this thing on your head

02:49this is the third reincarnation okay first one was removed quite a few years ago by my doctor

02:58uh-huh when it was just the size of a baked bean okay he did say it can come back if he doesn't

03:03extract it all yeah a couple years later it came back went to the hospital right this is the third

03:09is the largest it's been wow okay the two previous ones I still had hair then so now it's clearly

03:21exposed maybe that's why it's the largest it's ever been there's nothing to to stop it no hair so

03:31it's a oh freedom is it sore or painful or my amazingly no no only if I've got my car chicks

03:39or work in retail if I misjudge or over the cadre or it is on a rail nothing's ever come out when I've

03:46knocked is just a yes yeah that'll be the lump there then yeah and and if you work in retail

03:52you're a customer facing yes many comments from your mainly that me the children can we have a

04:00closer look of course is that all right feel free to have a little prod a little prod poke it with a

04:07stick oh there's never been any negative comment about just uh the inquisitiveness of children if it

04:15was coming up to Halloween I would say to them well you don't need to worry until the one grows in on

04:21the other side it's very soft have you had a scan of this uh yes back back to about a week ago and

04:32they said it well it was a benign lipoma hmm it's a funny place for lipoma but it's a very common place

04:38for assist and it's nice and mobile I'm not hurting you there no no so when I started to examine Dave's

04:46lump it felt quite fluid filled and it felt almost too soft to be a lipoma that confused me because

04:52the ultrasound scan said it was a lipoma okay I might just get dev to have a look at it as well

04:58and see what he thinks I might just go and see if he's free it's a good thing or a bad thing second

05:05appearance if there's somebody free definitely yeah oh yes yeah hello come on in hi how are you

05:12hi Emma are you free hi yes can I get you to come and have a look at something yes I'm not going to

05:16say anything I just want you to come in and have a look yes the main worry I had was about repairing

05:21it afterwards uh would the quality of the skin be good enough to to hold stitches you know dev has

05:28got much more experience with those sorts of things so I wanted him to come and see and have a feel and

05:32and see what the potential repair options would be if we removed this cyst and and I couldn't bring

05:38the skin back together Dave how you doing I'm Dave can I have a little look of course how long have

05:46you had it for Dave the last photo I can definitely date that it isn't there is 2016 so I think it's

05:51a cyst do you know have a feel and see what you think feel free have a oh I think have a poke around

05:57and it's all it does feel liquidy doesn't it rather than fatty it was quite shocking given the shape

06:06but I think that's what took me by surprise it was like a cone it was just very odd and very big

06:13what I was thinking Dev I don't know what I was just to do that take the skin aside lift out and

06:23then just pull it and trim it yeah and then have a linear scar the sort of same diameter as the

06:28shall we draw

06:29this is really thin this looks a bit yeah that's gonna it looks like vessel so that was the only

06:40other that wasn't not sure what's going on there either but I was expecting it to be quite squishy

06:47and spongy but it's actually quite firm and didn't feel like a lipoma at all gosh it's just a lovely

06:59shape I think that's a nice nice nice dome but yours is very much you know like that the gherkin

07:11building in oh yes it's very good with me it's a nice sort of point to it if you try and stitch the

07:21very very thin skin together it often just breaks apart and doesn't work it was difficult to assess

07:29but what bits of skin that were overlying the cysts were usable or not because it was quite red and

07:34inflamed let me know let me know all right at this point the cyst is so large there's the conflicting

07:46ultrasound scan report and the skin integrity over it looks really poor I just really don't know what

07:54to do for the best in this scenario

07:56coming up it's lovely isn't it you could sell them for five pound on only fans

08:05there you go oh it's all on the floor as well

08:09the skin A&E team are settling back nicely into the Birmingham clinic well almost I'm not all about

08:31these recycled bedrolls it's kind of like using recycled loo paper it's also brown it's just not

08:39right it might be brown but it's also green which is just as well when the clinics this busy have a seat

08:46for me I'll let you know when the doctor's ready for you okay my name is Michelle I'm 45 I'm from Essex and

08:53I'm a nurse but today Michelle's the patient and she's hoping dr. Dev can get to the bottom of her skin

09:00condition hello hi how are you no I'm good thank you hello hi how you doing Michelle yeah Michelle

09:09nice to meet you hi I'm Dev nice to meet you and this is Cherry hi good to meet you tell us how can

09:16we help I've got a lump on my back sort of lower back coccyx area it's been there for about 10 years

09:24but it's quite big and it's kind of bothering me it started off as a small pea-sized lump I suppose and

09:33maybe it's now grown into a bit of a marble size in what way does it bother you it just makes me feel

09:39really self-conscious with like clothes I'm wearing and things because if I'm leaning forward

09:43I'm worried that people are going to see it and when I go on holiday you know bikinis and things like that

09:48it's just feel really uncomfortable and what do you do for a living I'm a nurse oh are you what sort

09:54of this some practice nurse okay yeah good good still got them good you can really ask them to do

10:01anything about it one of my colleagues looked at it and that and she said maybe skin tear but nothing

10:07to worry about which okay it's reassuring but I don't know you'll just we're not the specialist so

10:12we don't know we shall have a look yeah all right so facing cherry oh you've got a nice tattoo there

10:19yes I have and it's pointing directly at it that's the thing yeah it's lovely isn't it

10:27so this sort of lump was like a dome on the skin and it looks skin colored very much like a neurofibroma

10:34and it felt like a neurofibroma it does look like either a skin tag or something called a neurofibroma

10:42which is an outpouching of the lining of the nerve okay good news we can treat it for you if you like

10:48yeah there's two ways that we do these we can either shave it flat with the skin okay which is

10:55probably the best way for you or we can cut it out but that will give you a sizable scar I would

11:00probably have it shaved in it there's a chance that it can grow back with a shave and at which point you

11:06may want to have it cut out but there's a high chance it won't okay okay that's fine yeah I

11:12didn't mind either way I just trusted his judgment and thought I was happy with him to go with the

11:17shave so what we'll do is we'll clean the area we'll just mark the area yeah and then he'll put the local

11:23anaesthetic in but we're going to take it really slowly so you shouldn't feel anything

11:27uncomfortable you keep us posted though it's always lovely to treat members of the profession

11:33it's lovely to be able to give her the opportunity to get rid of something she really hated

11:39what is the tattoo the n yeah is my name but like medieval star sign I had that done when I was 19

11:46oh right and then when I was 40 five years ago I decided to have it added to

11:51a sharp scratch coming up okay

12:04on the count of three one two three

12:11I'll tell you a story about another reason why this is really bothering me

12:15so I went to Sicily with my husband for our 10th wedding anniversary last October

12:21and I had a massage on the beach and the lady who did the massage pulled my bikini down yeah and saw

12:30my little lump and just started laughing at me on the beach oh embarrassing everybody turned around

12:37and looked no very nice it's not is it it was so embarrassing

12:48when I took the top of the skin off there was just this yellow fat that came out

12:55and it almost just popped out it was very odd

13:01sorry you're feeling a bit of squishing yeah

13:03sorry about the pressure I think this was a lycoma oh really yeah

13:13sorry so pressure just because we tend to squish these out it's fine

13:34so it's come out yeah we may have to just change it and just put a little suture in

13:40okay we'll see how deep we are that's fine

13:46sorry we're laughing we really didn't expect this to be a lyphoma that's all right

13:52sorry about the pressure that's fine don't worry it's not hurting

13:55this are blockages of hair follicles and they have a lining lipomas in general are spongy bits of fat

14:03it just goes to show sometimes what you feel something is going to be you won't know until

14:08you've got in there there we go well that's all out oh good he has got a name oh god my children named him

14:17cyril cyril cyril because we thought it was cyst i think cyril still applies it's been cyril for a long

14:26time do you have anyone who can take stitches out yeah she's got all her mates yeah yeah he'll be itching to

14:33do it yeah they will be cyril is no more oh and he will be sent off to the lab and they will check on

14:43him okay okay thank you no problem it was quite odd having this done and having it squeezed above

14:52my bum and the sort of embarrassing factor of it but it's gone now so i don't need to be embarrassed

14:58anymore shall i show you yes please okay oh wow okay so this was the shave this is the initial thing that

15:12came off yeah and then i gave we gave it a little squeeze that popped out and then we gave it another

15:20big squeeze yeah and that popped out wow it was interesting i liked seeing it i was surprised at

15:27how much was in there actually and how big it was it was really good yeah that's amazing and can you see

15:33how cute that is i mean they're normally like big you know and that was like wow and it's just a funny

15:41little lipoma lovely all right okay thank you so much bye cyril just like to say thank you so much to

15:50dr dev and cherry for looking after me making me feel at ease and removing my little cyril look after

15:57yourself i hope you have a massage without any laughter yes so do i yes all right thank you thank

16:03you thank you you take nice to see you lovely to meet you both i would rate cherry a 10 out of 10

16:10she was so kind and caring and just put me at ease the whole time a little lipoma a little lipoma

16:18how sweet in treatment room two dr emma is facing a massive decision that could change 51 year old

16:29dave's life even if there are risks it's got going to be a nice neat open and closed removal we still

16:37have to attempt it i want to see what's in there look it doesn't erupt everywhere well it might

16:43i think it might be wise to take your shirts off and they'll give you a gown mm-hmm got one here oh

16:52you got one one i prepared earlier i can't let somebody walk home out of here with that still

17:01on their head i feel like i have to try and do whatever i can to to help dave and get rid of this

17:06right wonderful i'm just going to pop your local anesthetic in yeah does it have a name no no never

17:20named it no all right that skin's coming away quite easily it's coming away with the local is it yeah

17:27it was quite reassuring when i saw that the fluid going in and around the cyst the skin was actually

17:32peeling away from it really quite easily which is quite a good sign right where do you want me

17:40i'll just be moving around okay i'll just dance with you yeah

18:02you're not feeling any of this no it sounds very interesting

18:19as i cut into that cyst it was probably the most nervous i've ever been uh starting a procedure on a

18:26patient i was really relieved and i could see that sort of pale gray slightly shiny cyst wall

18:32i was just expecting the worst and it you know it started to go quite well

18:40so

18:51Oh, holy sugar.

19:11Oh, she blows.

19:13Yeah.

19:14Didn't miss me.

19:16Holy moly.

19:18That was a proper shoot.

19:22Yeah.

19:24I always have that little underlying hope.

19:26I know Emma likes things to come out in one go,

19:28but I love a good splat on the wall.

19:33Oh, holy sugar.

19:36It just sprayed everywhere,

19:38and I just totally was not expecting that.

19:41Or the volume of liquid that came out as well.

19:45It was horrendous.

19:46Coming up, people can see it.

19:52People are going to stare.

19:53People are going to be just looking in disgust.

19:55You know those sponges, the squirty sponges?

19:57Yeah.

20:00Certainly had a lot worse.

20:02With all the mucky jobs our dermatologists tackle,

20:17there's always something that needs cleaning.

20:19Okay, this is much better now.

20:21Now I can actually see through it.

20:22Treatment room two is definitely going to need a wipe down

20:33after Dr Emma finishes removing Dave's enormous cyst.

20:37You've redecorated the wall, Dave.

20:41Oh, sorry about that.

20:43Do you leave yourself up there?

20:44Yeah, there's a lot of fluid in it.

20:46That'll take some of the tension.

20:48It's still flowing out of it.

20:50I don't really want to squirt it again.

20:52I think some of it's just really, really liquid.

21:06We're just really slow and meticulous

21:08about dissecting this away from underneath.

21:11The skin, we should have plenty of skin to close it over.

21:18It's like, you know those sponges,

21:21the squirty sponges?

21:22Yeah.

21:22When was the last procedure you had done?

21:32It was before lockdown, certainly.

21:34Oh, so it's more than five years.

21:35Like 20 teens.

21:44Because of this sort of diameter of the base of that cyst,

21:47I needed to make sure that I had plenty of skin

21:50that I hadn't traumatised

21:51and that it was completely intact.

21:53So I had plenty to play with to do the repair.

21:57You okay under there?

21:59Yes, yes, thank you.

22:00I'm doing it ever so well.

22:01Yeah.

22:07Right, now we're underneath it now.

22:08Deep breaths.

22:09It's actually physically difficult to keep making that movement over and over again.

22:27And my hand was cramping and my hand was cramping and the scissors kept getting stuck over my knuckles.

22:32Nearly there.

22:34Oh, hooray.

22:39Oh, hooray.

22:40It's gone.

22:41It's gone.

22:43Little Dave is free.

22:44Oh, I was so relieved when the cyst came away and eventually, you know, relatively easily.

22:52Is this where I say that's a great weight off my mind?

22:54Yeah.

22:55Oh, you've been waiting to say that, haven't you?

22:56I've been working on that for about ten minutes, yeah.

22:58Yeah.

22:59All right, let's just get any of these little vessels.

23:02So I wasn't aware of any procedures goes for a few sort of sounds and smells, which was rather strange.

23:09Hmm.

23:10Somebody switch the barbecue on.

23:11I was like, oh, I'm going to pull it off my mind.

23:14And then I was like, oh, I'm going to pull it off my mind.

23:17And then the cyst came away and eventually, you know, relatively easily.

23:20Is this where I say that's a great weight off my mind?

23:22Yeah.

23:23Oh, you've been waiting to say that, haven't you?

23:25I've been working on that for about ten minutes, yeah.

23:26Yeah.

23:27All right, let's just get any of these little vessels.

23:29So I wasn't aware of any procedures, it goes for a few sort of sounds and smells, which was rather, rather strange.

23:31I think let's just get some of the skin out of the way.

23:36Yeah.

23:37And we can see what we're dealing with.

23:43Maybe even just start bringing the edges together and then trim a bit more.

24:01We'll be ready for a dinner after this.

24:06I just don't have barbecue.

24:08The repair turned out to be really, really easy.

24:12He'd sort of grown me extra skin.

24:14I don't know how to celebrate.

24:18The procedure was so gentle, I nearly fell asleep a couple of times.

24:31Well done, you.

24:33Dr. Emmett was definitely fully committed to the job.

24:38Third time lucky.

24:40It will not come back this time.

24:42Would you like to have a look at it?

24:46Oh, yes.

24:47Oh, yeah.

24:48Well, there's the first bit.

24:51Does anybody...

24:52See them all there?

24:53Oops.

24:54Right into the electrical socket.

24:57Health and safety nightmare.

24:59We'll clean that up in a minute.

25:02Evacuate.

25:03OK.

25:04Right.

25:05Are you ready?

25:06Right.

25:07Ooh.

25:08After its initial squirt, it kept oozing.

25:10Yeah.

25:11For quite a while.

25:13There we are.

25:14It started off the first time it came out as a baked bean.

25:18And now it's sort of grown into a meatball, shall we say.

25:22And hopefully it doesn't grow back this time.

25:25That's it.

25:26Yeah.

25:27Finished.

25:28Finished.

25:29Done with.

25:30Good.

25:31My old friend are hopefully now finally gone.

25:34They will let you get on.

25:36It was lovely to meet you.

25:37Thank you so much.

25:38It heals well.

25:39And you can always...

25:40Thank you all.

25:41Let's meet you in a few days.

25:42Yes.

25:43All right.

25:44Safe journey home.

25:46Hope it goes smoothly.

25:47The lump, as you can see, is no more.

25:51Cheerio now.

25:56Wowza.

26:02Oh, it's all on the floor as well.

26:11Oh, look at that.

26:12Kim and Aggie would be proud.

26:13Mm-hmm.

26:17Hiya.

26:18Come in.

26:19Hi, guys.

26:20Hi.

26:21How are you doing?

26:22How did it go?

26:23Oh, with it, with David.

26:24With your patient, with David.

26:25Brilliant.

26:26Do you know what?

26:27I think I wouldn't have had the confidence to do it if you hadn't come in.

26:30Here we go.

26:31There we go.

26:32Look.

26:33Oh, beautiful.

26:34Do you know we were really worried that the skin was really thin?

26:35Yeah.

26:36It wasn't.

26:37The skin was fine.

26:38Great.

26:39It had a little cup of fat on it and it came together no problem.

26:41Great.

26:42Teamwork worked for Dr. Emma today.

26:44But what about the rest of the crew?

26:47Are they team players or do they prefer to go it alone?

26:51I think I prefer to go solo.

26:53I am a team player.

26:55I like working with people, you know, achieving things with a team.

26:59I honestly like a bit of both.

27:01I wouldn't like to be on my own all the time.

27:03It's great to be part of a team in case there's something I need to ask a colleague

27:06or we want to exchange notes on a patient.

27:09You're always a team player and I've got the best team.

27:17Next in the clinic is 41-year-old Amanda from Devon.

27:21I work as a one-to-one with children with special educational needs in a mainstream primary school.

27:28Hello, my name's Amanda. I have an appointment.

27:31Lovely. I'll check you in, Amanda.

27:33It's children that see the world a very different way and we learn to function in their world

27:40as opposed to get them to function in ours.

27:42Have a seat for me, Amanda. I'll let you know when we're ready for you.

27:45Thank you so much.

27:47The rewarding part for me in my job is being able to see the children thrive.

27:54OK, Amanda, the doctor's ready for you down the hall on your right.

27:59Thank you so much.

28:00No problem.

28:01Amanda is being seen by Dr Magnus Lynch.

28:05Come in.

28:06Hello, how are you?

28:08Hi there.

28:09Hi.

28:10Come in.

28:11Hi. Nice to meet you.

28:12Come and have a seat.

28:13So I'm Dr Magnus.

28:14Nice to meet you.

28:15This is Angela.

28:16Lovely to meet you.

28:17So how can we help you today then?

28:20Last year I had been told I've got lipoma on the instep of my left foot.

28:25I see.

28:26OK.

28:27I had an ultrasound and they said that it was lipoma.

28:29I see.

28:30And there's nothing they could do.

28:31It'll just be watered.

28:32Right.

28:33Since then, I've got one on my right and they've said yes again, it's a lipoma.

28:39Right.

28:40And there's nothing they can do.

28:41OK.

28:42And did you have an ultrasound scan on the right side?

28:44No.

28:45They did.

28:46My GP.

28:47Just the GP was having a look.

28:48Yeah.

28:49Fair enough.

28:50Do these lumps bother you at all?

28:52Not during the day so much.

28:54I'm on my feet with little children.

28:56Yeah.

28:57But at night, it's like a burning sensation and pins and needles.

29:00Right.

29:01And my feet feel like they're on fire.

29:03So it's the pain really.

29:04Yeah.

29:05More than anything.

29:06And it affects my sleep as well.

29:07Right.

29:08So it's quite significant in that sense.

29:09Yeah.

29:10So step onto the bed.

29:13It's become harder and harder to find appropriate footwear.

29:17I'm only able to fit into trainers.

29:20Anything like hiking boots or high heels or anything else hurt my feet after a few hours.

29:27The left side is this one here.

29:30Mm-hm.

29:31Where is it?

29:32Just point to it for me.

29:33There.

29:34There.

29:35Mm-hm.

29:36And this side, point to where you're feeling it.

29:41There.

29:42Yeah.

29:43Yeah.

29:44Is it hurting when I'm touching it?

29:46It's very tender.

29:47Sorry if it's uncomfortable.

29:48That's fine.

29:49Yeah.

29:50A lipoma is a harmless fatty growth under the surface of the skin.

29:55I've never seen lipomas on both feet on the same patient.

30:00So, I mean, I guess what I'm feeling is lumps beneath the surface.

30:04Yeah.

30:05Okay.

30:06On the left side, you have had the scan, which as far as we can tell from that scan, it was

30:09in keeping with a lipoma.

30:11On the right side, I do think you should have a scan before we do surgery.

30:14I don't think it's a good idea to be cutting without that information.

30:17Does that make sense?

30:18Absolutely.

30:19Yeah.

30:20The problem with doing both feet at once is obviously it's going to be very uncomfortable

30:23walking.

30:24These are difficult sites for healing.

30:25So, I would recommend doing one at a time, really.

30:28Can I just take a little photo of your medical records?

30:30Let's do it.

30:31We've got that on file.

30:37I was thinking you could sell them for £5 on OnlyFans.

30:40Mm-hm.

30:41There you go.

30:43Well, it's just what I hear the youngsters say nowadays.

30:46I don't have a clue personally.

30:48But that's how they make their income, apparently.

30:51I don't really know what OnlyFans is, but I can probably guess.

30:56And there certainly wasn't planning to do that, though.

31:01So, literally, I'll numb up that area and remove what I can find underneath.

31:05I might growl.

31:07You're going to growl, yeah?

31:08It's okay, don't you worry.

31:09Growl away.

31:10I'll be gentle, I promise.

31:12I just don't like needles.

31:13I don't blame you.

31:14I'll be gentle as I can.

31:16And if you want to growl, then you can make any noise you want.

31:21Growling isn't the most common reaction that people have,

31:24but I've certainly had a lot worse, so I wasn't too worried by that.

31:29So, we'll just start slowly.

31:31Growl away now, pardon.

31:32Want to growl?

31:33Mm.

31:34Mm.

31:35Mm.

31:36Mm.

31:37Mm.

31:38Always what I've done with needles.

31:39Last little bit and a half.

31:40I really don't like them.

31:42You will feel me touching, you'll feel me moving things, but you shouldn't feel anything I'm coming for.

31:52All right.

31:57Mm.

31:58Oh, that's so cool.

32:28I feel like I should feel it, but I don't feel it, yeah, no.

32:33You know something is happening, but you won't feel any pain.

32:36Yeah.

32:37Yeah.

32:37My brain was saying, he's cutting into your foot, it should be painful, but I was just mesmerized watching, I loved it.

32:58Are you feeling that?

33:06No.

33:08I'm just getting neck ache from watching.

33:12Okay, but probably, I mean, generally wouldn't be advised to watch, really, because it's not the nicest thing to see if it's on your own sort of body.

33:22I love all that.

33:23So what shoes are you going to buy?

33:28High heels.

33:30That's what I'm going to get.

33:36You feeling that?

33:37No, I'm just looking.

33:39Okay.

33:40It's coming out, it's coming out.

33:42Quite small though, but ASIC's coming out.

34:02Yeah, sometimes they just pop out, pop right out without even needing to do anything.

34:08Oh, this one's just coming slowly.

34:12The skin overlying that part of the foot, it's very tough and tight skin, so it's kind of spread out underneath the skin surface, and that's why it was quite difficult to get it out.

34:22Okay, perfect.

34:29All right, so I think we've got it out.

34:32I'm going to seal off some blood vessels now, and then we're going to pop some stitches in.

34:36It looked and felt like Mount Everest on the side of my foot for so long.

34:46Now to see my foot so flat, it's a very bizarre feeling.

34:53So how does it feel watching yourself have surgery then?

34:57Really weird.

34:59That would be an understatement, wouldn't it?

35:01It's very unusual for patients to watch their procedure, and I don't recommend that patients do it, but she actually managed to do it without any issues, and she was pretty, I was pretty impressed by that, actually, to be honest.

35:14So we do want to have a little look at what we've removed, yes?

35:18Yes, good.

35:18Just this fatty lump there, so do you want to have a look at that?

35:24Yeah, that's what's been causing the problem, so all gone.

35:29Are you going to miss it?

35:31Absolutely not.

35:33Okay.

35:34All right, then, perfect.

35:36Dr. Magnus is lovely.

35:38You're free to go today.

35:40Bye-bye, Vignette.

35:40Nice to see you.

35:42He is as lovely as he looks.

35:45Take it easy out there.

35:47Bye-bye.

35:50So I just want to say thank you.

35:52You've made a very old girl very happy.

35:55There we go.

35:55Coming up, people can see it, people are going to stare, people are going to be just looking in disgust.

36:05It's been a busy first day back in Birmingham.

36:24All right, I think everything's put away.

36:26But it's not time to clock off just yet.

36:30There's one more patient to see.

36:3224-year-old Shazney from Birmingham.

36:35I've been engaged with my partner since last August.

36:39We tend to go on walks every Sunday.

36:40And he just proposed to me.

36:43He was like, I just want to be with you forever.

36:45So, yeah, that's how it went.

36:48Shazney has an appointment with Dr. Adil Shiraz.

36:52Come in.

36:54Hello.

36:55Hi there.

36:56Hiya.

36:56Hello.

36:57Shazney, is it?

36:58Yes, it is.

36:59Hi there, Dr. Shiraz.

37:00Nice to meet you.

37:00This is Vilma.

37:01Hi.

37:01How are you?

37:02Good, thanks.

37:03Nice to meet you, babe.

37:04Why are you here today?

37:05I'm here about a keloid, what's on my right ear.

37:07Okay.

37:08How did it all start?

37:09So, four or five years ago now, I had my lobes pierced.

37:13And nothing went wrong with them.

37:15But it then got infected.

37:17And I thought, you know what, let me just remove the piercings.

37:20But then a year later, they started growing.

37:23Have you ever had keloids in the past?

37:24No.

37:25So, I've got piercings here.

37:26I've got a few on my ear.

37:27Never had a keloid or anything of that sort.

37:31Keloids are scars that essentially overgrow beyond their margin.

37:35So, when you injure your skin, you form a straight-line scar, for example, with the injuries.

37:40A keloid will go beyond the boundaries of this original trauma.

37:45Now, what I would like to do is have a look at it first.

37:48Yeah.

37:48Have a feel.

37:49See where it's sitting on your ear.

37:51Yeah.

37:51And then I can give you a better idea of whether it's something we can do today for you.

37:54That's fine.

37:54Okay.

37:55All right.

37:55So, if I get you up on the couch, let me have a feel.

37:58Me and my partner, we've always talked about setting a date for our wedding.

38:03I feel like the keloid still on my ear is preventing me from setting a date.

38:09Let's have a look.

38:11So, there's not much on the front side.

38:13It looks like it is all on the back.

38:16Two separate bits, aren't they, almost?

38:19Keelos are more common in darker skin type.

38:22And if you have one, then there is a chance you may get others because that's just how

38:26your skin is healing.

38:27And how does it impact you generally?

38:31So, the first time I realized that people would notice it was when I started my job and

38:36one of my colleagues had a look and I had my hair up and she looked at me.

38:41She was just staring, but she wasn't staring at my face.

38:44She was staring at my hair and when she asked me, oh, what happened there?

38:49And since then, I don't put my hair up.

38:52People can see it.

38:52People are going to stare.

38:53People are going to be just looking in disgust.

38:56In terms of removal, that should be something we can do today for you.

39:00And hopefully, we'll get rid of it for you.

39:02Let's get you up here then.

39:03I feel like my face just light up.

39:08I just felt so happy.

39:10What I'm going to do first is give you an anesthetic injection.

39:13Yeah.

39:14Okay, right.

39:16Ready?

39:17Yeah.

39:17Sorry, a little sting.

39:24I generally thought I was going to be in pain.

39:27I was going to have to brave it.

39:29You okay?

39:30Yeah.

39:31But it felt like there was nothing.

39:40Okay, any sharp bits there?

39:43Oh, no.

39:44Anything sharp at all?

39:45No.

39:46Good.

40:01Almost there.

40:18That's it.

40:23Let's just come on to the smaller one now.

40:51So, you can hear a buzzing sound now.

40:53That's fine.

40:53And this is just to stop some of the bleeding.

40:58Is that okay?

40:58Any pain?

40:59That's fine.

41:04The larger keloid had a big base.

41:08I'm going to put a really fine suture.

41:10I'm just going to see how it looks.

41:11I decided to suture the larger wound because it would have taken too long for it to heal.

41:17And there's a chance the keloid may have come back in that time.

41:20See the front of the ear?

41:33So, it looks pretty okay, doesn't it?

41:35Mm-hmm.

41:36Doesn't really change the shape.

41:39Okay.

41:40Once the procedure was completed, I injected some steroid directly into the wound.

41:47This essentially reduces the risk of it recurring.

41:56Right.

41:57We're all done?

41:58I was so excited.

41:59I was just thinking, oh, my God.

42:00I can't wait for this to be over so I can see what my ear finally looks like.

42:05There you go.

42:06Just be careful not to touch the ear right now.

42:08Oh, wow.

42:10Seeing the mirror, wow.

42:12The emotions.

42:14Thank you so much, Dr. Adil.

42:16You're welcome.

42:17You're very welcome.

42:18I was trying my best not to cry, but I already had a tear in my eye because I was just, like,

42:23thinking about everything.

42:25Do you want to see what we removed?

42:26Yes, please.

42:27Yeah?

42:27Okay.

42:28So, you had two.

42:29You had the bigger one, and then you had the smaller one.

42:31Do you want to feel them?

42:32Yeah.

42:33Yeah?

42:33Okay.

42:36So, there they are.

42:39Oh, my God.

42:42Smaller one, bigger one.

42:46Oh, my God.

42:47It just amazes me, like, such a small person.

42:51They weren't thinking cause there.

42:53Yeah.

42:53I'm glad they're gone.

42:57It was so weird seeing them just there and not on my ear.

43:02And they were much bigger than I expected.

43:04Like, I was like, oh, wow.

43:06Thank you so much again, honestly.

43:09You're a lifesaver.

43:12You do.

43:15All right, Shazney.

43:16Lovely seeing you.

43:17Take care.

43:18Bye.

43:18Bye-bye.

43:19Bye-bye.

43:21Now that this procedure has gone well, I know that my fiancé, he's going to be having to

43:26step up, and we're going to be planning this, not out of my pocket, but out of his.

43:31See you soon.

44:01I'm really looking forward to having a new pair of heels that my husband's going to buy me.

44:22We've actually looked at venues, so I am so excited.

44:26You guys have quite essentially changed my life.

44:30Next time on Skin A&E.

44:33I can see why you can't lie on it.

44:35It's huge, isn't it?

44:37Oh, oh, my God.

44:39Fall over me.

44:41We're not going to get it out through this hole, are we?

44:43A record for Skin A&E.

44:44That's amazing.

44:56We're not going to get it out through this hole.

44:58We're not going to do this once.

44:59All right, we're waiting for eat.

45:00We're not going to get it out through this hole.

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