- 14 hours ago
Skin A&E - Season 7 Episode 7
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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
00:23pot 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
00:48lives doesn't want to come it's like a strawberry I've got eat my lunch this is skin A&E this week
01:04in the clinic I always thought that I'd watch everything a lumpy lipoma is a sight for sore
01:12eyes removing an ear mole is a sound idea for one patient it's weird because I can hear like the
01:20scraping and with the usual selection of thrills yes I just love it I'm cyst free and spills funny
01:30looking van here oh yeah it's gone this is how we want them ready for the day then Angela
01:41that's it the dermatology team have reported for duty let's set stuff up good morning morning
01:49you've no hand towels have you hand towels these oh those ones oh take one of them thank you very
01:54much time to give some skin conditions their marching orders my name is Trisha I live in
02:01Hertfordshire great have a seat for me I'll let you know when you're ready I teach primary school
02:06children I've taught a lot of dance over the years and I've taught art I'm at the moment making sort
02:14of ceramic animals the doctors ready for you done the hall on your right thank you no problem Trisha is
02:23going to be seen by dr. Dev Shah hello come on in Patricia hi hi how you doing hi nice to meet you sit
02:36yourself down what brings you to the clinic well it's this large well I feel it's quite a large lump
02:41on my thigh okay and I it's actually been there for at least 23 years okay I did have it liposuctioned okay
02:50about 20 years ago they stuck a like a fat needle into it it was under a general anesthetic in those
02:58days believe it or not and they sucked the contents out but it just came back again after two or three
03:05months it's got so large I think that it's time to take it off before it gets any bigger okay how is it
03:13affecting you at the moment I like swimming I like to swim several times a week and I personally feel
03:21embarrassed about it when I go into the pool I shouldn't do but I do and what you do for a living
03:26I'm a primary school teacher are you and I am still teaching now and again too good on you yeah because
03:32gosh we need as many teachers as we you know can get our hands on okay may I come and have a look
03:37when I've shown my friends my lump they've usually gone good grief crikey Trisha get it off
03:47so is that painful when I do that no there's a slight complication in that you've had liposuction
03:54so it may not come out as nicely as one would expect so imagine you've got a nice encapsulated
04:02band or balloon around a fatty lump liposuction puts a needle in and sucks out the lipoma and causes
04:15trauma and that band the the balloon around it sticks to the surrounding structures it just creates
04:23a much harder thing to remove because it's more sticky and it's not as spongy so the good news is I
04:30think we can do this for you today right okay yeah we could do it under local anesthetic yeah good
04:36but like I've said there may be a bit of pushing and pulling because of the liposuction that you've
04:41had so it's not just a no may not just pop out no we hope it does but it may it may do if it's
04:47behaving I felt oh okay please but I feel oh well here we go it's gonna happen this is just him
04:58scribbling on you okay okay what age do you teach up to yes I know what you're doing yes on the
05:09count of three well they're about five six seven gosh they're late so they're really sweet oh are they
05:17no no they really how many kids do you have yourself I have three children well they're grown-ups
05:23now how are you doing with these injections absolutely fine actually to be quite honest
05:28I'm gonna say well done oh thank you do you still do golden stars I give him a star yeah I think he
05:33should have a star thank you thank you it's very kind when I was at school I barely got even a star
05:40regardless of it being gold silver or bronze anything sharp here no I don't think so
05:46okay you're earning out doing a lesson preparation or something no definitely not
06:09well done breathe in how are you doing fine squish good seeing what his muscles like we're doing fine
06:30good we're doing really well are we yeah I'm loving this thank you for being easy
06:37you get a golden star this is doing just as it should do this is how we want them perfect
06:44I was really shocked because she'd had liposuction so I thought it would come out in a fragmented way
06:50but it came out as one solid mass it was just how lipomas should come out in my book
06:58if I should just have that there okay yeah you're making a face so we need to know what that face
07:12well it just feels a bit pinchy that's okay all right so let's just make sure you're nice and numb
07:19there putting a little bit more local in okay there was a lot of pushing and pulling it honestly did feel
07:27pretty brutal yours is a squeezer apparently that's a good thing because it could come out encapsulated
07:36so if you can squeeze it all out in one it's good we're brilliant
07:43sorry about this there we are
08:07so is it out yep you just relax now and let us do the stitching
08:17I'm going to buy myself a pair of white trousers because I will be able to wear a pair of white
08:24trousers without a big lump popping out and I will feel that I can go down to the pool into the swimming
08:31pool and I won't have a great big lump on my side that I feel everyone's looking at
08:36it's all done glad to say goodbye to it good yes I'm very pleased it's not there anymore
08:42do you want to have a look oh yeah yeah so can you see it's ridged yeah those ridges will go
08:50it'll all flatten out I'm feeling pleased that it's all over okay well done and let me get
08:58your trues here we go it's quite a surreal feeling really but it's all done and the lump's been taken
09:06out it's quite a relief ready to have a look okay there we go so we've taken that bit of skin off
09:15oh right yes okay it did look pretty foul I got to say a bit blobbly and um yeah with that little
09:25bit of skin on the top it's like oh goodbye there we go all right and thanks for nothing yes yeah
09:34thank you well I'm glad we could do it for you no thank you it's a pleasure really look after
09:37yourself nice to see you keep teaching keep teaching well done you're doing brilliantly thank you okay
09:43take care yeah thank you very much thank you bye bye bye bye thank you Devon Cherry for looking after me so beautifully and
09:52coming up I could just hear a crack and then just a whole load of squelching I think there's a big
10:10vein running over the top of that it's one that might be a bit tricky you won't be able to hear me so
10:15well on this side probably a good thing with their work cut out dealing with lumps and bumps the team
10:31needs all the help they can get would you like some coffee uh yes please I'd love a coffee thank you
10:37okay no time for any biscuits Dr Adel as your next patient is already here my name is Chloe I'm 24
10:45years old I live in Hampshire and I'm a customer service advisor for St John Ambulance I like to
10:52complete random online courses it's at least over a hundred I've done allergy awareness uh where was it
11:01it was like an electrical one cyber security I've done so many because you never know where you are
11:09in life you might have to know one of those skills come in hello hello come to take a seat thank you
11:21what are we doing for you today I was hoping for you to have a look at some um lumps I have on my head
11:29that I've had now for a good three four years they started off small and now they are growing and
11:35I've got four of them currently on my head they just make me feel very uncomfortable because I'm
11:41constantly thinking are people looking at my head can people notice that I have lumps on my head
11:47are they going to think that I'm disgusting because I don't are they going to think I don't wash my hair
11:52are they thinking that I don't look after myself are they causing you any symptoms um so
11:58I I have to wear headsets a lot for work and one of them sits directly where my headset sits okay and
12:05so are the headset puts pressure on one of them so they do cause me quite a bit of bit of discomfort
12:12fine and what do you do for work um I'm a customer service advisor so you have that on a lot I have
12:17it on a lot yeah I have it on pretty much all day okay so let's have a look at them and then I will be
12:22able to tell you once I've seen them whether it's something we can do for you today all right okay
12:26so I want you to just pop yourself up on the couch you don't need to lie down just sit down
12:30get a pair of gloves I want these lumps to be taken off of my head so I don't have to worry anymore
12:37I would feel like a weight has just been lifted
12:40so so it's just there and yeah moves around thank you okay right let's just see the borders of this
12:51roughly there okay one where's the other one that's one uh the second one is up here
12:57yeah okay oh yes yeah you can see a little bit of an opening at the top so they are entirely typical
13:06cysts okay yep number two there um the third one is at the back of my head here
13:14oh yeah okay okay yep and then the fourth one it's not unusual for patients who have multiple
13:22cysts on the scalp it's just the glands and the oil glands becoming blocked and then forming cysts
13:28under the skin which ones if we can do them today were you hoping to have done um it's mainly these
13:35ones in the back one because they're the main ones that will sit with my headset mainly so we could
13:41definitely remove um at least a couple of those today for you okay yeah all right local has said
13:46it can be painful so I just wanted to see how she would cope with the anesthetic and I didn't want
13:50to promise her that I would do four just in case I needed to give her more anesthetic in the initial
13:55ones that's it fine yeah I should be fine ready yeah it's a strange feeling it will sting it stings as
14:05it goes in as well well done you're doing really well oh dear I was trying so hard not to really
14:13really squeeze her hand I didn't want to like break her hand well done generally the needle tends not
14:21to hurt most patients it's the anesthetic itself can be quite stingy almost like a bee sting you've done
14:27very well thank you you're welcome okay well done okay so if you lie yourself down if I could rate
14:34the pain it would definitely be an eight out of ten definitely feel they've gone numb
14:41okay let's see a bit of pressure okay it's a beautiful cyst no
15:01okay so first one gone came out pretty easy oh good so let's see what the others do brilliant
15:18the first one just popped out but I couldn't feel anything
15:24good okay one down let's bring the next one okay sharp no
15:32so Chloe which company do you work for um I work for St John Ambulance I work in our events
15:43department I love my job I do
15:47except for the headphones yes except the headphones
15:55so the second one's out okay brilliant second one had the gunk first and then the cyst came out
16:07okay the second one I could feel it squirting out my head which was a very strange feeling to feel
16:16if we get you on your tummy to get the one on the back
16:21if you just hold that hair just like that that's it okay does that feel sharp there at all
16:33no it does not feel sharp
16:34a bit of pressure yeah so this I think is your biggest one isn't it yes it is
16:41when my lumps were being pressed I could just hear a crack and then just a whole load of squelching
16:53almost there ah there we go
16:57okay so that's three down the ones that you originally came for brilliant and because you
17:12were so polite I'll do the fourth as well thank you
17:15let's buy three get one free
17:18I'm just thankful that I was lucky enough to receive that offer from him
17:25any pain there no no pain
17:30amazing all the cysts came out without any real major issues
17:47it's really satisfying when a cyst comes out as it should and I'm able to stitch the skin back up
17:55knowing that hopefully it'll never come back again
17:57there's a mirror there you can just adjust your hair
18:00it feels really relieving I feel like a whole new person
18:07I went from having a lump in my head to it just being completely flat
18:12I feel really really good really good
18:15okay do you want to have a look
18:17yes
18:17okay so I'll lift this up
18:22four cysts first second that's the smallest one there
18:27and then that's the actual sack
18:28yeah the biggest one
18:31oh my god it's like hard
18:33yeah it is quite firm
18:34I was quite shocked because I thought it was going to feel quite squishy
18:39I'm so glad to have them out of my head
18:41have you ever gotten really really squeamish
18:45when doing these
18:46popping yeah
18:47no never
18:48no never
18:48the bigger the better
18:50really
18:50thank you
18:55take care bye
18:56bye
18:56I feel just so happy
19:01I'm so ready to go back to work
19:04put on my headphones
19:05and talk to my customers
19:07talk to my colleagues
19:08and say
19:09I'm cyst free
19:11so have you ever been squeamish
19:16no I just love it
19:18I'm the same
19:19as you said the bigger the better
19:20transforming people's lives
19:27is a happy business
19:29do you have a job?
19:33is there music in the air?
19:36my name's Ken
19:37I'm 69
19:38from Middlesbrough
19:39and I'm a music teacher
19:40have a seat Ken
19:42I'll let you know when we're ready
19:43thank you
19:44music is a life changing subject
19:46for young people we work with
19:48the changes in confidence
19:51self esteem
19:53and the love
19:54and the joy they get from music
19:56oh it feels brilliant
19:57and keeping the good feeling going for Ken
20:00is Dr Emma McMuller
20:02oh hello
20:05come in
20:06that was a lot of time
20:08that was a lot of time
20:09it's Ken isn't it
20:11yeah
20:11hi I'm Dr Emma
20:12this is Donna
20:13hi
20:14come and have a seat
20:14Ken
20:15so what can we do for you
20:18right I've got
20:19a lump here
20:20that I now know
20:21is a lipoma
20:22how long has that one been there for?
20:24about 10 years
20:25I teach music
20:27it's two mixed abilities
20:28and when they notice that
20:30especially the guys with autism
20:32who need everything
20:32explaining and spot on
20:35the lesson goes
20:36it's now
20:37not a music lesson
20:38it's a skin lesson
20:40yeah
20:40my main instrument is guitar
20:42so when I'm teaching
20:43that arm is on show
20:45and if I'm teaching
20:48a guitar lesson
20:49for half an hour
20:4920 minutes of it
20:51could be the young people
20:52saying to me
20:52oh what's that on your arm?
20:54I've got a scan
20:55you had an MRI scan
20:57haven't you?
20:57just have a little look at it
20:59there was a few concerns
21:00I think there's a big vein
21:02running over the top of that
21:03right
21:03and it looked quite vascular
21:05right
21:06so it's one that might be
21:08a bit tricky
21:08and better dealt with
21:09by somebody who specialises
21:11in sort of soft tissue problems
21:13but let's have a little feel of it
21:16yeah
21:19it feels very firm
21:20it doesn't feel as squishy
21:21as a normal lipoma
21:22it feels a bit fixed
21:24there as well
21:25so a normal lipoma
21:27is pretty much just fat cells
21:29but there are variants
21:31and one of them's
21:31an angiolipoma
21:32and that's a lipoma
21:34that's got lots of blood vessels
21:35running through it
21:36I think it'd probably be a good idea
21:39to take a biopsy off it
21:40at least
21:41but when we're in there
21:42and if it feels easy to remove
21:44then we'll remove all of it
21:45if we can
21:46so shall we do that?
21:48whatever you think
21:49does that sound okay?
21:50is it going to happen now?
21:51yeah we'll do it now
21:52alright
21:52yeah we'll do it today
21:53we'll get you on the bed
21:55and get you comfy
21:55I've always wanted it removed
21:58but then I've always been worried
22:00is that going to have some effect
22:02on my left hand?
22:04could it hit a nerve or something?
22:06could it be that I would never be able
22:07to play an instrument again?
22:08I'm just going to draw
22:12round the
22:14lipoma
22:16and then put your local anesthetic in
22:18right I'm just going to start
22:22doing your local okay?
22:28take it you've played for years then
22:31do you play in a band or anything?
22:33oh my band days have gone
22:35I'm just mainly teaching
22:37I'll go to the open mic night
22:39every now and again
22:40it's nothing like live music
22:41oh yeah
22:42brilliant
22:43wonderful
22:45it made me feel at ease
22:47I wasn't nervous
22:48I felt I was in the right hands
22:50literally
22:52Ken can you feel anything sharp here?
22:59nothing
22:59so let's have a look and see
23:03because that ultrasound scan report
23:07it did mention one large vessel
23:09running over the top of it
23:10I was quite worried about
23:12going through that
23:13coming up
23:16he did some WD-40 on it I think
23:19it's weird because I can hear that
23:24that's scraping
23:25it's mid-afternoon at Skin A&E
23:39and in treatment room 2
23:41Dr. Emma is assessing Ken's lipoma
23:44so normal lipomas just look
23:48very sort of orangey yellow
23:50but sort of vascular ones often
23:52can be look a bit red purple
23:54that looks like a very pale yellow one
23:58are you alright there?
24:00yeah I'm fine yeah
24:01I always thought
24:04that I'd watched everything
24:06that was going to happen
24:07and then the last minute
24:09I bottled it
24:10so when you were
24:15with a band
24:16what kind of music did you
24:18oh my 70s rock
24:19yeah
24:20yeah
24:21but glam rock as well
24:22T-Rex
24:23Bowie
24:23Zeppelin
24:24yeah
24:25Sabbath
24:25from this area
24:26oh wonderful
24:27yeah
24:28how's it looking?
24:33well there's one
24:34sort of funny looking vein
24:35here
24:36when I cut into
24:38Ken's lipoma
24:39you could see lots of small vessels
24:41sort of running through it
24:42as I had to cauterize a few of them
24:44with the hyphricator
24:45it was generally quite vascular
24:47which may mean it's an angiolipoma
24:49just because of the scan
24:53saying it had that big vein
24:54I'm being a bit
24:55more cautious than I normally am
24:57that's okay
24:58that looked like it was going to
25:09I know
25:10be kind then
25:12and then it didn't
25:12did it
25:13a bit of patience
25:14with this one
25:15so yeah
25:16bit by bit
25:17it's a right awkward one
25:20go on
25:27go on
25:27give it some welly
25:30yeah
25:30once we'd started
25:32it was clear that
25:33even though it looked a bit odd
25:34it wasn't going to bleed loads
25:36and it didn't feel like a
25:37particularly difficult procedure to do
25:39therefore because it looked abnormal
25:40I thought let's get out as much as we can
25:42and then there's more tissue
25:44for the pathologist to review
25:45and just make sure there's nothing nasty going on with this lesion
25:49it's quite fibrous and tough
25:55it looks like not as jelly like as a normal
25:57oh yeah no it is tough
25:58so what I want to do actually
26:00in case it all comes out in tiny bits
26:02is just take a good big specimen
26:04that I haven't mashed up too much
26:06so that this pathologist has got a good chunk too
26:09yeah
26:10normally lipomas are just like
26:14they're almost like a jelly consistency
26:15so they're like kind of soft
26:17whereas the lesion felt really fibrous
26:19so if you can imagine like tendons
26:21it's sort of tough material
26:22there's no way that would have squeezed or popped out
26:25just because there's so much
26:26sort of dense tissue running through it
26:28so I had to use the scalpel to get bits of it out
26:32that little one there
26:35yeah
26:36oh that's a good chunk
26:40yeah
26:41can't see anything
26:43from this angle
26:45no I know you've got your beady eye
26:47Emma asked me to keep an eye on the vein
26:52obviously she has to concentrate on where she's cutting
26:54so an extra pair of eyes is always very useful
26:58all right you just squeeze that
27:00I'll just what it is is we'll loosen
27:02squeeze and then I'll just cut it with the scalpel
27:04let me know if your fingers get tired
27:10yeah
27:12that's coming out nicely
27:14oh sorry
27:20I nearly flung that
27:23yes I'm sorry
27:24oh that's brilliant
27:25I think we've got the majority of it
27:43if you look now
27:46if you look now
27:46I'm not allowed
27:48look
27:49so it's nice and flat
27:50okay so we've got most of it out
27:52but there's a few little stubborn bits
27:54I've been nice to get it out that small
27:56yeah
27:57and I started watching the procedure
28:01and whoosh I'd have watched it from the start
28:04because it was fascinating
28:05once I get this bit out
28:06I think we'll just leave it right there
28:09yeah so I think you know we've left little bits in there
28:14because it's quite vascular
28:16we're going to put some deep stitches in
28:18by the end I think we managed to remove most of that lipoma
28:22I was expecting a lot of bleeding
28:24so it was a real relief when it came out so easily
28:27you're getting braver now
28:31you've got a good few there haven't you
28:33that's some really nice work
28:36stitch wise
28:37yeah so look after it
28:39no drumming
28:40no no
28:41feels great
28:44it's something I've waited for for a long time
28:47and I won't miss it now it's gone
28:50if you want to sit up and have a look
28:53very juicy isn't it
28:55it was quite bitty
28:57yeah looks more like mince
28:58aww
29:00it looked like prime beef mince
29:04I'll be getting lamb mince in future
29:06I know that's tight but it's doing the job
29:09no
29:09all right
29:10yeah yeah
29:11it's been a pleasure
29:12would you believe
29:13totally delighted
29:16I'd just like to thank them for making the procedures so easy and so gentle
29:23do you feel okay
29:24I feel brilliant
29:25right
29:26good
29:26brilliant
29:27lovely to meet you
29:28nice to meet you
29:29and you
29:30thanks a lot
29:30all right see you later
29:32bye bye
29:32bye bye
29:33you did good
29:38we did it
29:39yeah
29:39we could do with a brew
29:41couldn't we
29:42yeah
29:42before we battle another one
29:44yeah
29:44well dr emma hit the right notes with her instruments
29:52but what tunes do the team enjoy
29:54I am an absolute music lover
29:58anything from classical to rock
30:01I love live music
30:03I love traditional music
30:04I like soul music
30:06I love folk music
30:08a good 80s mix
30:10ballads
30:11right now I'm into dance music
30:13I love children's nativity plays
30:16heavy metal and punk music
30:18I love choirs
30:19my favourite music is prince
30:21rock music
30:23I'm not a music person
30:25isn't that sacrilegious
30:27a few surprises there eh
30:30next into the clinic is victoria from hampshire
30:34she's got an appointment with dr natalia spearings
30:38hi welcome
30:42come on through
30:44hello
30:45hi you must be victoria
30:46hello
30:46come in natalia nice to meet you
30:48nice to meet you natalia
30:49hi
30:49this is duta
30:50she'll be assisting me today
30:51how can i help you today
30:52um basically i've got these lesions on my face
30:56in the last six months
30:57this one's got darker
30:58it's got bigger
30:59okay
31:00and there's other lesions just popping up
31:02willy nilly over the last couple of months
31:03there's one here
31:05another one here
31:06and it's a bit worrying
31:08because i'm wondering where it's going to end
31:10how old are you
31:11i'm 63
31:12okay so with the one under your eye
31:15you must have had that one for quite a while
31:17about six years
31:18six years okay
31:18and the one the bigger patch on this side
31:21the discoloration in the skin since i had my daughter
31:25so 24 years
31:2624 years
31:27um
31:27has it changed
31:28no it's kind of been constant
31:31but one of these whatever this is
31:33one of them has started growing inside that
31:36and it's it feels rough
31:38itchy like crazy
31:39they all itch
31:40okay so let's have a look
31:42i've noticed that when i'm talking to people
31:45their eyes come down off from my eyes
31:49and they are literally looking at this
31:51and uh you know it's
31:53i can't do anything with it
31:55i can't hide it
31:56i would like it gone
31:57i'm just going to use this device
31:59a dermatoscope basically magnifies
32:04uh the lesion but also
32:06it allows us to see
32:07almost like the microstructure
32:08of that lesion
32:09okay so i'm just going to point out to you
32:12which one's which
32:13okay
32:13this one is a seborrhe keratosis
32:16that's a warty growth you get as you age
32:18okay
32:20then you have the same kind of thing but flatter here
32:24here and up here
32:25and same on the other side of the face
32:28here and here
32:29so a seborrhe keratosis doesn't spread or kill you
32:32it's not a skin cancer
32:32it never will be one
32:33it will never turn into anything
32:35thank goodness so they're all fine
32:36they're all fine
32:37thank you
32:37so everything is fine
32:38so which is good
32:40lovely
32:40you do you're welcome
32:41and you do have a fair amount of like freckling
32:43so this the flat bit of this
32:45is what's called a lentigo
32:47so a sole lentigo
32:48so it's a sun related freckle
32:49okay
32:49not like a normal freckle
32:50that goes away when you're out in the sun
32:51that one stays there all the time
32:52to be told that it was all okay
32:55she gave me that confirmation
32:56absolutely fantastic
32:58with the main one that you're mainly concerned about
33:01which is this one
33:01i do think we need to cut this out
33:05it'll give you the nicest result
33:06you'll have one stitch in
33:08okay
33:08or two very fine ones
33:10um and then you'll have those out in seven days
33:12okay
33:13when she said that she could remove it
33:15perfect
33:16i wasn't keen on removing the other lesions on victoria's face
33:20because the mark left over from either shaving or excising
33:23would be cosmetically unacceptable
33:25at least to me and i think for victoria as well
33:27the lesion on her cheek is the one she was most concerned about
33:31but also most keen to remove
33:33just relax your face a little bit
33:36and you're gonna feel a short scratch now
33:38ready
33:38and shrub, shrub, shrub, shrub, well done
33:40and just deep breath you're gonna feel a sting
33:43it's gonna go down really quickly
33:44and that's it
33:47there are really only two ways to remove a lesion from the face
33:52you can either shave it off from the surface of the skin
33:54or you can remove it with an excision
33:57and just cut into the skin
33:58and put a suture there
33:59i always have to weigh
34:01which one will be better than the other
34:03for the aesthetic outcome
34:05the mid cheek is especially tricky
34:07and i do think that
34:09cutting this lesion out
34:11is gonna be the best way to go
34:13okay
34:14so now i'm gonna do the procedure
34:16you can close your eyes
34:16you don't have to watch me doing it
34:18okay
34:31just removing it now
34:33when removing victoria's lesion
34:38i decided to use a punch biopsy like this
34:40which is kind of like an apple core
34:41in order to take it as a perfect circle
34:44when you remove it as a perfect circle
34:45you can still close it
34:47without risking having little standing cones on either side
34:50so it gives a nice flat scar
34:51but only if the lesion is small enough
34:53i'll drop it
35:05it's amazing you can't feel it a thing
35:11yeah it's amazing
35:12it's a weird sensation to hear it and not feel it
35:15i know it's weird
35:16it might look like a really simple procedure
35:18but everything that goes into planning that
35:21is actually quite complex
35:22and especially making sure the patient understands
35:24what the scar will look like
35:26you're very swollen already
35:29oh
35:29you can close your eyes
35:30i'm trying to make sure it looks even
35:32okay i'm really happy with this
35:41you're going to freak out a little bit when you see it
35:43but you have to believe
35:44that you know it's going to be fine
35:47okay
35:48it's just you're really swollen out
35:49and a bit poofy
35:50so can we get bigger
35:51yes you might get more
35:53yes in the next 72 hours you can get increased
35:54swelling
35:55oh my god
35:59it sounds terrible
36:00noisy bed
36:02needed some wd-40 on it i think
36:04oh yeah it's gone
36:07yeah it's gone
36:07brilliant
36:08sorry
36:08you can hold the mirror
36:09and look at yourself
36:10it'll be easier
36:11that's brilliant
36:12thank you very much
36:13oh my goodness
36:14stitches are so neat
36:15oh
36:16i'm so happy that it's not there
36:17i couldn't believe it
36:19i mean even now
36:20in its raw state
36:21it looks so much better than it did before
36:23wow
36:24so
36:25so you can pick it up if you want
36:27it kind of looks smaller doesn't it
36:29yeah it does
36:30it shrinks
36:30they contract a bit of shrink
36:31when they get taken off
36:32so that's the fat underneath
36:33that's your skin right there
36:35and then you can see the furry thing on top
36:37do you see that
36:39wow
36:40yeah
36:40um all right perfect
36:43brilliant thank you very much
36:44you're welcome
36:45any questions
36:45i don't think so
36:47i think you've answered them all
36:48see you turn me home
36:49thank you
36:50thank you so much
36:51bye bye duta
36:51thank you
36:52thank you
36:52bye
36:53thank you bye bye
36:54thanks
36:55it'd be great to be talking to people
36:57and hold their gaze with my eyes
37:00instead of their eyes wandering
37:01to lesions on my face
37:02coming up
37:08my wife mentioned to me
37:09that it looked like raspberry
37:10because he was certainly red as well
37:11it's been a very busy day at skin a&e
37:25and some of the teams
37:27are getting ready to clock off
37:29lovely
37:29are you doing anything nice this evening
37:31um
37:32just to take the dog for a while
37:33yeah
37:33now you can't all go home
37:36there's one more patient to see
37:38my name's stefan
37:39i'm 44 years old
37:41i live in south wales
37:43my wife
37:43my son
37:44and i have five dogs
37:45the oldest dog
37:47is my baby
37:48he's 16
37:48he's a springer spaniel
37:50he was his police dog
37:51from when i served with the police
37:52obviously he's long retired now
37:53and then the others
37:54are sort of rescuers
37:55that were collected
37:56like you know
37:57when we lived in spain
37:58the doctor's ready for you now
38:00down the hall
38:00on your right
38:01thank you
38:02stefan has an appointment
38:04with dr magnus lynch
38:06come in
38:08hello
38:10hi there
38:10hi there
38:11hi
38:11nice to see you
38:12it's here
38:12great have a seat
38:13thank you very much
38:14for magnus
38:15nice to meet you
38:15this is angela
38:16hello
38:16good to see
38:17tell us like how we can help you
38:19what's worrying you
38:20i've got a growth on the back of me here
38:21yeah
38:22it seems to be getting bigger
38:23over the last couple of years
38:24how long has it been there for in total
38:25would you say
38:26i think about probably about 15 years
38:28it's been one of those
38:28i'm always going to go and get something done
38:30and never get an appointment
38:31yeah fair enough
38:32well have a careful look at that for you
38:34yeah thank you
38:34do you want to take your coat off
38:35yeah
38:35when i was in spain
38:38i tried to get an appointment with a dermatologist
38:40the dermatologist on another island
38:42it was one of those where i was always going to go
38:43always going to go
38:44and never got around to it
38:45okay let's have a little look at that then
38:47so i'm just having a look with the
38:50the dermatoscope
38:50which is like a skin microscope
38:52yep
38:53i mean it certainly looks like a
38:55like a harmless mole
38:57so when i saw the lump behind stefan's ear
38:59i thought that it was a mole called a benign intradermal nevus
39:03you can develop them anywhere
39:05but it was a little bit larger than average
39:07presumably it's having a bit of an impact on you
39:10yeah
39:10in fact every time i go somewhere i think
39:12can anybody see it's there
39:13even though perhaps no deep down they can't
39:15yeah
39:15it's just the fact it's there
39:16and then people noticing it
39:17and not
39:18they don't know what it is
39:19yeah
39:19so it is that worry as well
39:21i went to get my hair cut once
39:23and he caught it
39:24and he made it bleed
39:24i don't think i've been back to a barber since
39:27can remove it for you surgically
39:31yep
39:31um
39:32what i would do is just kind of cut it off across the base there
39:35yeah
39:35i might put a couple of stitches in
39:37to help it to heal
39:38yeah
39:39yep
39:39and obviously we'd send it off
39:41but i'm not worried it's going to be something dangerous
39:43that sounds good
39:43thank you
39:44are you keen to go ahead with that
39:45yeah yes please
39:46yeah thank you
39:46for me to know it's not there
39:48it'd be massive for me
39:50and be really really pleased
39:51so we're just literally going to just stick it this way
39:55you won't be able to hear me so well on this side
39:58probably a good thing
40:00be as gentle as i can
40:04and then i'll go nice and numb for you
40:06do you have time for any kind of hobbies or are you
40:12i've got dogs so i've obviously
40:14what dogs have you got
40:14i've got a spring of spaniel
40:15he was my police dog when i was in the police
40:17yeah
40:18so he's 16 years old now
40:19so he's obviously long retired
40:20right you've done the hard part
40:22can relax
40:23honestly you can relax now
40:24so with the working dogs what's that kind of
40:28so i had a golden labrador
40:29and he was trained in explosive detection
40:31so we looked for bombs
40:32so it was based up at nuclear power station in north wales
40:35right
40:36it's actually for explosives
40:37oh it sounds great
40:40yeah
40:41really exciting
40:42oh it's not
40:43so this this dog was working in a nuclear power station
40:47yeah
40:47checking for
40:49explosives
40:49gosh
40:50really
40:50yeah
40:51i could have listened to stephan's dog stories all day and all night
40:56that's the truth
40:57angela can you just hold that ear for me
41:00yes certainly
41:01okay so i'm going to start the procedure then
41:04well okay for you
41:10yeah can't feel anything thank you
41:11shouldn't do
41:12it's weird because i can hear like the scraping
41:17but
41:17that is always what people say when we're doing stuff on the air
41:20it's like you can hear it
41:21but you can't feel it
41:22i can't feel it
41:22no
41:23that is always the way
41:25let's just pull that onto the
41:30there we go
41:32that's all done
41:34great
41:35i've removed it
41:37wow okay
41:38yes
41:38gone
41:40so i'm just going to seal off a few blood vessels
41:43and then i'll decide whether or not i'll put one little stitch in there
41:45it's a little bit of buzzing and then we're
41:47yeah
41:47and i could feel him sealing the blood vessels
41:50and it was a really weird sensation because i could hear it
41:53and i could feel it but not in a painful way
41:55it was a strange sensation
41:57so what i'm going to do is put one dissolvable stitch in there because it'll just make it heal
42:01a little bit quicker
42:01yep thank you
42:02um but it's all gone really smoothly
42:04yeah even without a stitch just this would heal fine but i just think it'll heal a little
42:11bit quicker
42:11i'm so glad that it's gone
42:14so just sit on the side of the bed
42:16yep
42:16take a minute
42:17get all that stuff off you
42:18it feels better already
42:22when i looked in the mirror after the procedure it was just a massive relief
42:25it's perfect thank you very much
42:27but it yeah it's brilliant now it's gone
42:29so the main thing is to keep it nice and dry
42:32yep
42:33for about 48 hours
42:35yep no problem
42:36i can't wait now to get to the barber's
42:38get my hair cut properly
42:39and give my wife a break from having to cut my hair
42:41and me complaining
42:42so there it is
42:45wow
42:46there is some gloves for you
42:47thank you
42:47yeah you can have it you can even touch it if you want to
42:49how do you feel
42:50okay
42:51oh
42:52that's it
42:53it's horrible
42:56yeah
42:56part of you
42:57yeah yeah
42:58that's mad
42:58my wife mentioned to me that it looked like a raspberry
43:00and it did because he was certainly red as well
43:03thank you very much
43:04thanks doctor
43:05thank you nice seeing you
43:06thank you
43:07just want to say a massive thank you to dr magnus
43:09the nurse in there
43:10look after yourself
43:11thank you bye
43:14and i'm really really happy with the results
43:19he's a nice guy
43:20really nice guy yeah
43:21it's just brilliant to go swimming wear what i like without thinking about a great big lump sticking out of my leg
43:36i'm healing amazingly my life has changed absolutely for the better since having this procedure done
43:43i'm healing amazingly my life has changed absolutely for the better since having this procedure done
43:50i'm healing amazingly my life has changed absolutely for the better since having this procedure done
43:57i'm
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