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Skin A&E - Season 7 Episode 8
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02:02I'm about to be a Glaswegian, but I don't miss the city.
02:05Okay, Jim, the doctor's ready for you.
02:07Down the hall, on your right.
02:09My wife says, you tell everybody your life story.
02:12And so I do.
02:13Happy to hear Jim's Celtic tales is Dr. Dev Shah.
02:22Hello, Jim.
02:22Hello.
02:23Yeah, that's me.
02:23Come on in.
02:24Jim, come on in.
02:25How are you doing?
02:26Thank you very much.
02:26I'm fine.
02:27Thanks.
02:27I'm Dev.
02:27Nice to meet you.
02:28This is Cherry.
02:29Hi.
02:30Hello, Cherry.
02:30Good to see you.
02:31Tell us, how can we help?
02:33I would love you to get rid of a huge lipoma I've got in the back of my head.
02:37Okay.
02:38I've had it for 14 years.
02:40It's a long time.
02:41It's called George.
02:43George?
02:43Yeah, because I had an uncle that had a lump in the same place, honestly, and he was called
02:49George, so I decided to call him a lump George.
02:53I mean, I didn't like my uncle George, but he's gave me that, I think.
02:58Yeah, fair enough.
02:59He's given me that.
02:59Okay.
03:00How is it bothering you?
03:03I've played bands all my life.
03:05It's all right when I was on stage, but see, as soon as I left the stage, you think people's
03:09looking at you, do you know what I mean?
03:10Standing in queues, queuing at the bar.
03:12So it's really affecting you.
03:13Yeah.
03:14Can I come and have a look and we'll see whether we can sort this out for you?
03:18Yes, I hope you can.
03:18Yeah, certainly.
03:19And then I'll take some pictures if that's all right.
03:22Fine, yes.
03:22And then we'll decide what we can do.
03:24Oh, yeah.
03:26Hi.
03:26He's a beauty, isn't he?
03:28Yeah.
03:28Are we able to shave a bit of your hair?
03:30Certainly.
03:31It's just a horrible thing that shouldn't be there.
03:35And it's growing.
03:36I don't know why, maybe it's my brain's leaking out into it.
03:40Would you like to hear my poem?
03:42We'd love to hear your poem.
03:44You'll like this.
03:44Go on.
03:45Ly Puma George on my head you'll find, for 14 years he's been behind.
03:51I would like him remove skin A&D, then I would be Ly Puma free.
03:56Natalia, Dev or Emma, any one of you can solve my damn dilemma.
04:01Love it.
04:03I absolutely love it.
04:05I don't think that's ever happened before.
04:08And it was a lovely, lovely gesture.
04:11Probably about that big.
04:12Can you see that blue line going around?
04:15So I think we can treat this for you.
04:17That would be brilliant.
04:19I was delighted.
04:21I think we can do it today.
04:23Is that all right?
04:23Yeah, yeah, of course.
04:24It will give me my freedom back again.
04:27Be the way I used to be before the lump appeared.
04:31What I was proposed to do is take it off like this.
04:34Yeah.
04:34Because if we just make a cut, you'll have all this floppy skin.
04:38Yeah, that's right.
04:39No one wants any floppy skin, right?
04:41No, no, no.
04:43It is wonderful to build up a bit of a rapport with a patient.
04:47Having a laugh, settling them down.
04:51Sorry, that's not me.
04:52It's not you.
04:53Jim.
04:53It's there.
04:54Not again.
04:55I wasn't with you.
04:56And having some misfunctions of beds and things like that just settles the patient in.
05:01When you're bringing together skin, if they have long hair, it sometimes flops over.
05:11Well, there he is.
05:13And gets sutured into the scar.
05:16And that will give you an infection.
05:20Sharp scratch coming up, okay?
05:21So, did you sing?
05:29Yeah.
05:30I've never been a great singer, but it's just something that you had to do.
05:34And do you miss it?
05:35I miss the money, doctor, sure.
05:37Did your wife always come to the gigs or not?
05:39Are you joking?
05:40She says I'm rubbish.
05:44Nothing like a bit of support.
05:46Yeah.
05:47I love it.
05:50Okay.
05:50Right.
05:51Lots of fingers on you, I'm afraid.
05:52Is it okay for sleep?
06:12You can.
06:13Snooze away.
06:15If you start snoring, we'll roll you over.
06:17There's actually wipe my tears there.
06:23You're okay.
06:24You will feel fiddling, okay?
06:25I'm a bit sad.
06:27What, to lose him?
06:29No, no, really.
06:30I bet you're not.
06:32Yeah.
06:34How's it feeling, by the way?
06:35No pain?
06:36Not a thing, doctor.
06:38Okay, good.
06:38Right, a lot of squishing.
06:54It was a strange feeling.
06:57You could probably hear some horrible snip, snip, snipping.
07:01Is it coming all right?
07:02Oh, yeah.
07:04He's not a squeezy one, see.
07:07Jim, he's a...
07:08Just to take it slowly, pick away at this one.
07:11Mm-hmm.
07:15You okay?
07:16Is that sore?
07:17It was, aye.
07:18Sorry, okay.
07:19We're going to put a little bit more local anaesthetic in, okay?
07:21Yeah.
07:23I thought it was just by a case of a wee cut and squeeze him out.
07:28But I'm afraid it wasn't like that.
07:30He was a big boy, wasn't he?
07:32He is.
07:33And he's not giving up easily.
07:34Is he not?
07:35No.
07:35How are we doing there?
07:37Fine, thank you.
07:38Okay.
07:40Jim's lipoma was slightly odd in that I could see the membrane around it and it just wouldn't
07:45leave his scalp.
07:47So I had to snip around the membrane to free it up at the base and allow the lipoma to come
07:53out.
07:54Okay.
07:55How are we doing pain-wise?
07:56I'm fine, Doctor.
07:58Sure?
07:59All right.
08:02Okay.
08:04Come on, George.
08:06We see all the way through at the moment.
08:08There's light there.
08:09You can do it.
08:10You can do it.
08:10There we go.
08:11There we go.
08:15There we go.
08:18Okay.
08:20George was really tricky, but Dev and I were definitely going to have our way.
08:25Well, it was very deep, I have to say.
08:28Was it really?
08:29Yeah.
08:30George was just so big that we had to put more sutures than I'd anticipated.
08:35There we go.
08:35How's that?
08:37Perfect.
08:37Well done.
08:40It's looking good.
08:41You've got a little bit of a dent in your head, though, so you've got to be careful.
08:46Here we are.
08:48Lump free.
08:49It's gone.
08:49George is gone.
08:51How are we doing?
08:52Good.
08:53Okay.
08:54That's what it looks like from the back.
08:55Great.
08:56Thank you very much.
08:57Can you see there's a line there?
08:59Yeah.
09:00But your hair has covered it already.
09:02All right?
09:02I imagine.
09:03It's gone very well, actually.
09:05Thank you.
09:05Do you send that away or what?
09:07Yeah.
09:07Aye.
09:08We'll check it.
09:09So can you take it away, me, no?
09:10No.
09:11No, let's check it first.
09:12Oh, you're kidding, Owen.
09:13We'll have a look now.
09:14Oh, aye.
09:16There we go.
09:17Oh, my God.
09:19Oh, aye.
09:21Straight in.
09:24To me, it looked like a chasney.
09:26Have you been at that in an Indian restaurant?
09:29A chasney.
09:30Just add some rice to it and you've got yourself a dish.
09:35Thank you for the poem.
09:36Thanks, Fred.
09:36Nice to see you.
09:37Look after yourself, all right?
09:38Take care.
09:39Take care.
09:40Well done.
09:40Well done.
09:41Bye-bye.
09:42Bye.
09:43Dr. Dev and Cherry, thank you very much for today.
09:46I probably missed George.
09:49He'll be hiding in that dent you've left in my head.
09:54Squeeze, breathe in.
09:56What a honey.
09:57What a lovely man.
09:59Cheers you up, people like that.
10:00Coming up.
10:02Popped.
10:02Yeah, popped.
10:03What would your song be if you were doing karaoke?
10:06Jolene.
10:06What would you do?
10:07Gangster's Paradise or something like that.
10:09Oh, really?
10:10Blowsers, when you said 50, you weren't lying.
10:13I was trying not to show my surprise.
10:15I think that tap stripping, do you want to just turn it off?
10:28What would it be?
10:30That's all we need.
10:32Just be a really fancy.
10:34A Chinese soldier.
10:35Just be a really fancy to have that in the background, wouldn't it?
10:39And Dr. Magnus doesn't want any distractions, as his next patient is right on time.
10:45Hello.
10:46Hello.
10:46My name is Paula.
10:47I've come for my appointment.
10:48Wonderful.
10:48I love my singing.
10:50I love holidays, gardening, swimming.
10:53I want to live my life.
10:54I don't want to just grow old.
10:56I want to grow old disgracefully.
11:00Okay, Paula, the doctor's ready for you down the hall on your left.
11:06Come in.
11:08Hello there.
11:09Hi.
11:10Come and have a seat there.
11:11Is it Paula?
11:12It is.
11:13How can we help you today?
11:14Right.
11:14I have a lump on my back.
11:16It's been there for about six years, and it's impacting everything I do now because of the pain.
11:23It just seems to shoot through my back when I do anything.
11:28What is it stopping you from doing?
11:31I like to swim.
11:32I can't do that because I can't lift my arm up without the pain.
11:36And I also like to sing.
11:38Yeah.
11:39It affects me when I breathe deeply.
11:41I see.
11:42So I can't hold the notes that I used to hold.
11:44It would be good for me to take a look at it today, and then I can tell you what could or could not be done.
11:50Is that okay?
11:51Do you want to maybe put your cardigan up onto the hooks there?
11:54Okay.
11:55It's on my mind every single day.
11:57It never goes away.
12:01This area here?
12:03Yeah, that's where it is.
12:05Is that hurting when I'm touching it?
12:06A little bit just then.
12:08Okay.
12:09So when I was examining Paula, it was actually a lot easier to feel it than it was to see it.
12:15So what it feels like is a fatty growth under the surface of the skin called a lipoma.
12:23So in terms of removing it, it's a local anaesthetic procedure.
12:28You can do it.
12:28I can do it for you today.
12:30Yeah.
12:30Thank you.
12:30Yeah.
12:31Thank you.
12:31So there's no problem for me to do it.
12:35I was over the moon.
12:37It would open up the rest of my life for me.
12:40So there's quite a long scar there.
12:42Yeah.
12:42I'd sooner have that than the pain every time.
12:44Yeah.
12:44Probably most cases that will improve the pain, but we don't know for sure.
12:48That's just the thing to do.
12:49Yeah.
12:49With a bit of luck.
12:50Yeah.
12:51Touch wood.
12:52Okay.
12:53So the first thing I'd like to do is to mark the area.
12:57I wasn't completely confident whether the pain that she was experiencing was caused by
13:02the lipoma, but I thought there was a very good chance that it would help.
13:06If you'd like to lie onto the bed, onto your front now.
13:10How's that?
13:11It's good for me.
13:13Now, the next thing that I need to do is I do need to numb the area.
13:18Okay.
13:18Just a bit sharp.
13:24Just, you know, like when you're doing sewing and you prick yourself with a needle, it's
13:27no different.
13:32And I want you to tell me if it's sharp or you can feel it as a sharp touch on the skin.
13:36Okay.
13:37How's that feeling?
13:38Can't feel anything.
13:48So you're going to feel lots of stretching and pushing.
13:55Okay.
13:56But you mustn't feel anything painful.
13:57If you do, you tell me, okay?
13:59Okay.
14:05How's that for you now?
14:06Yeah, I don't know what you're doing.
14:08That's good.
14:08What kind of work did you do previously then?
14:14I was a chef.
14:15Oh, are you?
14:17Yeah.
14:18Any of this uncomfortable for you?
14:19No, that's okay.
14:23It's all kind of coming out very nicely.
14:31Oh.
14:33So sorry.
14:34A little bit more of the answer in that area.
14:36Sorry.
14:36Don't apologise, just keep telling me whenever you feel anything.
14:40Okay.
14:41It did feel as if something was being cut and it was quite painful.
14:48We'll just go slowly.
14:49Yep.
14:50So we have put lots of local anesthetic in, but even still, sometimes there can be a tiny
14:54area where it's not completely numb for you.
14:56Yeah.
14:59Oh, well, well.
15:00Feeling that?
15:01Yeah, sorry.
15:02Not to worry.
15:03I'll just let us know and we'll keep on going.
15:04You just let us know.
15:05We'll just put more local anesthetic whenever you feel.
15:07Sorry about that.
15:08Please don't apologise.
15:09Just please keep telling me.
15:10Okay.
15:12He said to me, don't apologise.
15:13Well, I can't help it.
15:14It's just me that says, oh, I'm sorry.
15:16It's hurting.
15:17I can't help it.
15:18It's obviously quite deep, so it's quite common that you can feel a little bit.
15:23Snip, snip, snip.
15:24Yeah.
15:25Just kind of getting it all out for you.
15:27So what, are you working still or are you retired?
15:35No.
15:36No, I'm retired.
15:37So what, how do you keep yourself busy?
15:39Like I said, I do my singing.
15:41What would your song be if you were doing karaoke?
15:44Jolene.
15:44Jolene.
15:45Oh, I love that as well.
15:47I couldn't do a Jolene, I'll be honest.
15:49What would you do?
15:50I'd probably do like Gangster's Paradise or something like that.
15:53I can, yeah, I can rap, but I wouldn't say I'm very talented.
16:01We're nearly done, okay?
16:03This is the last little bit now.
16:04Okay.
16:17Well done.
16:17Okay, so we've got all of the lipomer out.
16:20Oh, brilliant.
16:20And what I do need to do is I do need to just seal off the blood vessels now.
16:24I'm so, so pleased.
16:26I might go to swim again now.
16:28Yeah, good swimmer.
16:29Yeah, not bad.
16:30I used to swim for the school.
16:31Oh, nice.
16:32So in Paula's case, the discomfort that she was experiencing was a little bit unusual
16:37because she was describing a pain when she was moving her shoulder.
16:40And I think that probably the reason for that is when she was constricting the muscles and
16:45moving, that was pressing on the lipomer and distorting it.
16:51Well, good news.
16:52We're all done.
16:53I can't wait to sit up.
16:54Yeah.
16:54Have you asked, yeah?
16:55You can sit up now in a moment.
16:57Considering what I was going through.
16:59Gosh, actually quite good fun.
17:06That should heal well for you.
17:07So it is just a straight scar like that.
17:10Okay.
17:10Lovely.
17:11Now, did you want to have a look at it before you go?
17:15Yeah.
17:15So bring it over.
17:16It's been sitting in there long enough.
17:17I want to see it.
17:18Thank you.
17:19Wow.
17:21I can't believe it.
17:22Oh my God, it's like that.
17:25There you go.
17:26So have a little feel of that.
17:27Can you feel that?
17:28Like, it's a little bit springy.
17:30Press on it.
17:31It looked like a bit like a fish.
17:34A little tail on it.
17:37Horrible thing.
17:40Bye-bye then.
17:41Thank you.
17:42Thank you so much.
17:42You're very well, Lance.
17:43No problem.
17:44Nice to see you.
17:45Yeah, bye-bye.
17:46Thank you.
17:46Bye-bye.
17:46It impacted every minute of my life.
17:50Bye-bye.
17:51Bye-bye.
17:51Bye-bye.
17:52So with luck, hopefully, I'll be able to go back to being the normal person I was.
17:58She is doing, honestly, more than I'm doing.
18:01Yeah.
18:01She's so busy.
18:06Like Paula, the clinic is non-stop.
18:11We have BlinkPak anaesthetic and Ivergator.
18:14Sounds like Dr Natalia's ready for her next patient, 49-year-old Russell from Burnley.
18:21Okay, Russell, the doctor's ready for you down the hall on your right.
18:24Thank you.
18:24I've got lots of skin tags under my arms, both arms, and when it gets summer, it's just
18:41I set on fire, if you will.
18:42Oh, okay.
18:43I had somebody moved about 10, 15 years ago.
18:46Okay.
18:46But they've grown back with a vengeance.
18:49How quickly did they grow back?
18:50Within five years.
18:52All right.
18:53It's probably about 50 on each side.
18:54Okay, that's a lot of skin tags.
18:56Okay, so let's have a look at these.
18:59Let's see what's going on.
19:05One arm, both.
19:06Oh my goodness.
19:08Blowsers, when you said 50, you weren't lying.
19:10I was trying not to show my surprise, like my 50 under each arm.
19:15Like, it's definitely the most skin tags I've ever seen under someone's arms.
19:19With him, it was like a carpet of skin tags.
19:22Great news.
19:23I can definitely remove these today.
19:25That's brilliant.
19:26When Natalia said she could remove them, it was just like a weight off my shoulders.
19:29Let's have you hop onto that couch.
19:32We're going away to Turkey with the heat and you sweat underneath it.
19:36It's like sticking a red hot poker under your armpits all the time when you're walking around.
19:40How's that?
19:41That's fine.
19:42You look very relaxed.
19:43All right, so I'm going to just start with your anesthetic injections.
19:48Wow.
19:50You don't feel it?
19:51No.
19:52Because the underarm is really sensitive to needles.
19:55Rick, seriously?
19:56Does that hurt?
19:57You have to feel something here.
19:59Just a little.
20:00That's it.
20:01It stops.
20:02I've been thinking of flinch because I've got a heart pain threshold.
20:05I think it's rubbing tattoos.
20:08So it helps.
20:10All right.
20:10That's been fully anesthetized, I think.
20:15So you have this interesting looking tattoo on your leg.
20:18It's very pretty.
20:19It's Burley Football Club.
20:21The middle part is a dress.
20:23Oh.
20:24And then the rose at the bottom is for Lancashire.
20:26Okay, Lancashire.
20:27Lancashire rose.
20:28Lancashire.
20:29I learned to speak English in America.
20:31So this shirt thing at the end is a bit confusing.
20:33Yeah, all these like Lincoln, Lincoln shirt.
20:37Okay, so you love your football.
20:39Yeah.
20:40You love it so much and you had them tattooed on your leg.
20:42A fun thing for me is hearing a patient with a different accent and watching Natalia trying
20:49to figure out where in the UK this person is from.
20:53And the other, where's Burley?
20:55I've got me in Manchester.
20:56Oh, okay, fine.
20:58Well, you sound like a Manchester person.
20:59Or is that an insult?
21:01She is just not very good at recognizing accents.
21:04All right, tell me if you feel anything.
21:20Snippity snip.
21:23I'm getting to the point where I'm thinking I'm just going to use a scalpel and just take
21:27him off.
21:27How are you thinking of doing that?
21:29Were you having your wife do it?
21:30I'm not just doing it myself in a mirror.
21:32Well, I've tried different methods in the past.
21:36You can put a string around them and tie it to tie it.
21:38It's meant to stop them and they're meant to die and fall off, but it never worked.
21:42Yeah, I wouldn't recommend that.
21:44Generally, I wouldn't say operate on yourself in any way or capacity at home.
21:48Just see a professional.
21:54All right, I'm done with all of them this side.
21:55There's a couple of little bleeding speckles because I might hypercape.
21:59Skin tag can be really quick to remove if there's just one or two.
22:01But if you have a lot of them, like Russell did, then it can take a really long time to
22:07remove them all.
22:08Does this seem familiar from last time?
22:10Yeah.
22:11The smell.
22:12Oh, the smell, yeah.
22:14If you've ever burnt your skin on an iron or a flame or something, it's a horrible smell,
22:20but Natalia just takes it in a strass.
22:22Sorry.
22:24All right, half of it, this is done.
22:25One arm down, just another 50 to go.
22:39I definitely get in a pattern with kind of holding it with tweezers pinched and snip,
22:43if you will, and it's kind of like one of these meditative type processes where you're
22:47just like going through it systematically.
22:49What can we call these?
22:52What do you think they look like?
22:55There's no sweet that's that size.
22:59Natalia's the only dermatologist I work with that compares everything to food.
23:03I don't know why.
23:05Oh, no.
23:05But you know what you put in like...
23:07Oh, no.
23:09What?
23:10You have to tell us now.
23:10For like a pie.
23:12The beads you put in pie?
23:14You have to bake the base of a pie, and you put those hard beads.
23:19Yeah, I haven't really baked anything in my life ever, but definitely not with beads.
23:24All right, I think we're done with this side.
23:31Okay.
23:32Are you ready to have a look?
23:33It's a little bloody, but you can see it'll be smooth.
23:37Once it heals.
23:39I'm over the moon.
23:40I'd have been happy if she'd only managed to take 50% of them off, but to remove them all is just phenomenal.
23:47Okay, so you can relax your arms now.
23:49So if you want to have a seat at the edge, just perch there for a moment.
23:55I quite like removing skin tags.
23:57It's different from fighting with lipomas and cysts to get them out.
24:00How are you feeling?
24:01I'm fine, thank you.
24:02Yes, happy?
24:03Very happy.
24:04Would you like to see them?
24:05Yeah, I'd like to see how many of them were.
24:06Let's have a look.
24:09So there we go.
24:11Right and left.
24:13Just one or two.
24:14Yeah, just one or two.
24:15I think this is the most skin tags I've ever removed from someone in one go.
24:17You did really well.
24:18There's not too much blood, see?
24:19You're not a bleeder.
24:21I'm stinging me with blood.
24:22Stinging me with blood, very good.
24:23All right, so we did it.
24:24Got them all done.
24:25Hopefully we won't see you again for about five to ten years.
24:27Yep.
24:28Yep.
24:28Perfect.
24:29Thank you very much.
24:30You're welcome.
24:31Thank you for coming in.
24:33When the season starts, we'll be on the Burnley Matches celebrating with his arms in the air.
24:37Take care.
24:38Thank you.
24:39It's just going to be amazing.
24:44There's quite a few skin tags.
24:45Yeah, I do think that's the most I've ever removed ever.
24:47I think that's the most I've seen.
24:49Yeah.
24:50Coming up.
24:52Okay, I'm just going to squeeze it.
24:53Yep.
24:55Wow, I can hear that.
24:58Oh, gosh, that's really, really intense psoriasis.
25:00It is, isn't it?
25:01Can you prescribe, like, maybe a summer holiday with baby's feet?
25:05Yeah.
25:05At Skin A&E, the team are knuckling down for the afternoon shift.
25:20Hello.
25:21Welcome.
25:22Look, Shrozz, I'm just going to go and get some paper towels.
25:25Sure, yeah.
25:29My name's Yolanda, I'm 55, and I'm from Manchester.
25:33Okay, Yolanda, doctor's ready for you down the hall on your left.
25:37Thank you.
25:38Seeing Yolanda today is Dr. Emma McMullen.
25:42Come in.
25:43Hello.
25:43Hello.
25:44Hello.
25:44Hello.
25:45Hello.
25:45Is it Yolanda?
25:46It is, yeah.
25:47I'm Dr. Emma.
25:48You've got Donna with me.
25:49Hello.
25:50Hi, hello.
25:50Come in, have a seat.
25:52So, Yolanda, what can we do for you?
25:54Well, I've had eczema and psoriasis since I was seven years old.
25:58Okay.
25:59And then I lost all the pigment on my face when I was nine.
26:01Wow.
26:02And then it came back.
26:04But because of my age, the psoriasis is getting worse.
26:07It's been particularly bad on my head, especially.
26:10And so when you were little, whereabouts was the rash on your body?
26:14Can you remember?
26:15Yeah, it started on my hands, and my hands started peeling like this.
26:17Like this I've got there.
26:19So it was all over my hands.
26:20It's on the palms of your hands?
26:20Yeah.
26:20The worst thing, really, is very self-conscious of the appearance of your skin.
26:25It does impact the way you dress, the way you feel.
26:30And then it was the back of my knees.
26:33Okay.
26:33So that's kind of like an eczema area.
26:35And then it started on my elbows.
26:38This side of that side?
26:39That side.
26:40So that's more like psoriasis.
26:41Yeah.
26:41Because it's unusual for people to have both.
26:43Yeah.
26:44But it's sounding like maybe you have had both of them.
26:46So eczema and psoriasis are both conditions that cause red scaly bits on the skin.
26:51They sort of tend to affect sort of opposite bits of the body.
26:54So eczema attacks the flexures.
26:57And psoriasis is on the extensor surfaces.
27:00So if you think of either eczema's behind the knee, psoriasis is on the top of the knee.
27:04When I was nine, I first got this and my hair fell out.
27:07Your hair fell out when you were nine?
27:08When I was nine, yeah, when I started my cycle.
27:11Yeah.
27:11First time.
27:12Yeah.
27:12And then monthly ever since, my hair always falls out at the time of the month.
27:16Mm-hmm.
27:17It's been, I don't want to say a life sentence, but it feels like that a little bit.
27:22And then I lived in Spain and it disappeared.
27:25Okay.
27:25Yeah.
27:26In the lovely sunshine and the lovely climate.
27:28Yeah.
27:30Ultraviolet light from the sun actually suppresses the immune system in the skin.
27:34And we actually use it in the form of UVB phototherapy to treat skin conditions.
27:39May I have a little look at your scalp?
27:40Yes.
27:40Your hands, is that okay?
27:41Do you want me to hang your coat up for you?
27:42Oh, that'd be great.
27:43Thank you.
27:44Look at this.
27:45I love it.
27:46Straight away.
27:47That is so cute.
27:48That's cute.
27:49I have a rescue cat.
27:50She's my everything.
27:51Oh.
27:52Are you okay for us to have a little look?
27:54Yeah.
27:54Yeah, this looks, oh gosh, that's really, really intense psoriasis.
27:57It is, isn't it?
27:58Very, very thick.
28:00Yeah.
28:00The itch is like something's eating you and biting you from inside.
28:03It's so intense.
28:05And do you have any active plaques anywhere else on your body at the moment, on your elbows?
28:09Yeah, my elbows.
28:10Can I have a little look at an elbow and just clinch the diagnosis, really?
28:14Yeah.
28:14Yeah.
28:15Okay.
28:16An active plaque of psoriasis is one that is inflamed.
28:19It's usually a little bit itchy, whereas older plaques that have maybe started to settle just leave behind an area of discoloration.
28:26They're not itchy, they're not scaly.
28:29I can see where, you know, you've got richly pigmented skin and when you get inflammation, it can either go pale, but it can also go dark.
28:35And you've got hyperpigmentation there.
28:37I've had it on this one, but this one's a lot better.
28:39Oh, look, so you've got both.
28:41You've got hyperpigmentation and hypopigmentation, whereas you've lost your pigment.
28:45If the dermatologist could give me some pieces of some nuggets that I don't know that would change this condition.
28:51I've had all of this with psoriasis, all of this here.
28:55Yeah, that's a common place.
28:56It's where I've got a tiny little back there at the moment.
28:59It could be a different half of my life without this condition.
29:03Now, I've had something before, which is coconut base, and I've found out that I'm intolerant to coconut.
29:09Oh, that's what I was going to give you.
29:10Yeah.
29:11So this is why I'm a phenomenon.
29:13Yeah.
29:15We prescribe a lot of creams and ointments and things that you rub on the skin in dermatology.
29:20They're not all very well tolerated.
29:21Some of them are really greasy.
29:23Some of them are really smelly and nasty to use.
29:25And for most patients, there's a good bit of trial and error until we get something that they like to use and that actually works for the skin.
29:32I'm going to get you some of our special in-house made SCC sal cap, it's called.
29:38So it doesn't have coconut oil in it, but it has the coal tar.
29:42Yes.
29:42And it has the salicylic acid in it in a really strong ointment.
29:46Wonderful.
29:47That's amazing.
29:47No problem.
29:48It's amazing.
29:49So tell us about your cat.
29:53Tell us about your cat.
29:54She's called Princess Riley Patience Precious Blessing.
29:57Marvellous.
29:58What?
30:00Yolanda's cat had a really long name, but I can't quite remember it.
30:03So this is my latest picture of her.
30:06Oh, she's gorgeous.
30:07Oh, look at her green eyes.
30:09Oh, she's a stunner.
30:11It definitely had a title and a first name and a surname or something like that.
30:17I've discovered this thing.
30:18It must be a menopausal thing that I can draw.
30:21I never knew I can draw, so I've been drawing her and painting her.
30:25That's my mind.
30:25I thought you were going to say that when women hit a certain age, they start collecting casual
30:32dogs.
30:33And it's called the menopause.
30:35Isn't it?
30:36That's so funny.
30:37Get it?
30:38Menopause.
30:38So I've written a little treatment plan in here.
30:45Can you prescribe, like, maybe a summer holiday for you, maybe?
30:48You know, in Germany, they used to prescribe, like, two weeks on the beach for their psoriasis
30:54patients because, actually, you're relaxed, you're not stressed.
30:57Maybe you can suggest that.
30:59Unfortunately, no.
31:00But it would be a very cost-effective thing.
31:03I think we need to start a new political party called the Let's Go On Holiday for skin
31:08conditions party, led by Dr. Emma.
31:11Thank you so much.
31:13You're very welcome.
31:14It's been great.
31:14It's been great.
31:15We'll let you get back to your cat.
31:16I'm not going to try and say the name.
31:19I just remembered, was there even a princess in there?
31:22Maybe there was.
31:23I can't remember.
31:24Do you answer to anything nice?
31:25Yeah.
31:26Yeah.
31:26If there's a treat involved.
31:29So I've been giving some good advice and a good plan going forward.
31:33Take care.
31:34Bye-bye.
31:34Bye-bye.
31:35Bye-bye.
31:35Bye-bye.
31:35Bye-bye.
31:35Bye-bye.
31:35Bye-bye.
31:36Bye-bye.
31:36Bye-bye.
31:36Bye-bye.
31:36Bye-bye.
31:36Bye-bye.
31:38To know that I've got something that's going to help soothe and heal my condition, it's
31:43really exciting and I can't wait to see the results.
31:51Yolanda adores her princess.
31:54But does the team have any pampered pets?
31:58I have a cat called Lenny and a goldfish called Bob.
32:04So we've got a cat called Crystal.
32:07I don't have any pets.
32:09I'm allergic to dogs and cats.
32:12I have my two cats, Margot and Wilma.
32:16I was younger.
32:17I begged my parents for some gerbils.
32:20I named them Chip and Dale.
32:21She's very, very interesting character, actually.
32:25I have no pets and I absolutely love animals.
32:30So I did just get a puppy, four tortoises, seven chickens.
32:34This full name is Arnold Botox Spearings.
32:40We call him Arnold.
32:42And Betty, she's like my little shadow.
32:46That's enough pause for thought for today.
32:54My name is Mikhail.
32:55I'm 32 years old.
32:57Hello.
32:57I come from Romania by believing in England for the last 10 years.
33:01Have a seat for me.
33:02Thank you so much.
33:03I'm trained in Romanian traditional dancing.
33:06I'm trained in Ukrainian dancing, Russian dancing, a bit of Polish dancing.
33:11and what else, Latino, break dancing, a bit of samba.
33:15Yeah, it's quite a lot, actually.
33:17The doctor's ready for you now.
33:19It's down the hall on your left.
33:21Seeing Mikhail is Dr. Adil Shiraz.
33:25Come in.
33:26Hi there.
33:27Hi.
33:28Hello.
33:28It's Mikhail, is it?
33:29It is.
33:30Hi.
33:30Right.
33:30What can we do for you?
33:31Why are you here today?
33:32So I have five lungs on my head.
33:34I believe there are six.
33:35Three bigger ones, two smaller ones.
33:37Yep.
33:37And how long have they been there?
33:39About 15 years, maybe more.
33:40OK.
33:41But I think they keep growing, you know?
33:43OK.
33:43They're getting bigger, you think?
33:44OK.
33:44Yes, yeah.
33:45The problem is, when I go for haircuts, sometimes I'm actually being refused by the barbers.
33:50You know, dealing with the skin issue is something that doesn't make you feel great and think
33:54great about yourself.
33:55Sure.
33:56Not nice, is it?
33:57It's not pleasant.
33:58Can I have a look?
33:59Yeah, of course.
33:59Yeah, no worries.
33:59Yeah.
34:00Let's get you to sit down over here on the bed.
34:02Thank you.
34:03Thank you.
34:03Thank you.
34:04Thank you.
34:05Thank you.
34:06Thank you.
34:08Thank you.
34:09Thank you.
34:10You can see one right away.
34:12Put your head slightly forward.
34:14There we go.
34:14That is a good size one, isn't it?
34:16Yeah.
34:17So one.
34:18Or I can feed another one here.
34:19Second big one.
34:19Yeah, there's another big one here.
34:22Two.
34:22Again, mobile.
34:23Third one, big one here.
34:25It's a different shape, that one.
34:26Yeah, a bit more oval.
34:29Yeah.
34:30Yep.
34:30Three.
34:31And then this side here.
34:34Yeah, I can see that.
34:35And one above.
34:35That's visible as well.
34:37Four.
34:37And then five.
34:39They feel soft and squidgy, as I would expect this to do.
34:43They feel fluctuant, like they're full of fluid, and they are mobile as well.
34:47I think we can probably do all of them for you today.
34:49Thank you so much.
34:50Okay.
34:51Thank you so much.
34:51Get it all done for you.
34:52Five in one.
34:52When I heard that I'll have all five removed, I was like, great.
34:57I want to wake up tomorrow and touch my head, and nothing to be there.
35:01And I'll be happy.
35:04Let's see what we can get.
35:06Yep.
35:08Okay.
35:08So step one is the injection.
35:10Yep.
35:11Okay.
35:11This bit will sting.
35:12Yep.
35:12But it will go numb.
35:13And you're going to need, obviously, five, because we're doing five.
35:16So we'll have to do five lots of injection.
35:17Okay.
35:19Okay.
35:19Right.
35:19You ready?
35:20This is going to sting.
35:21Yeah.
35:21I'm sorry.
35:22It's fine.
35:22You okay?
35:23Yeah, I'm fine.
35:25Okay.
35:26Look towards me now.
35:28Okay.
35:30Coming up now.
35:35You made me jump.
35:38I wasn't expecting that.
35:41I just wanted to make sure that Vilma was awake.
35:50So we'll start off with the one at the back.
35:52Yep.
35:58Does that feel sharp at all?
35:59No, I can't feel a thing.
36:05I'm worried it's going to explode.
36:09Yeah, there you go.
36:10Okay.
36:10Okay.
36:21Okay.
36:21It's all coming.
36:22Okay.
36:22Okay.
36:22It's all coming.
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38:26Thank you
38:28There we go
38:34Another one, there are two there, oh wow, two small ones
38:51Occasionally we'll find a couple of cysts together, in this case there was a much tinier cyst attached to the larger one
38:58Good thing I saw that, otherwise it would just come back
39:02Dr. Schrauss has like this magnifying vision that he was able to see this tiny baby cyst on Mikael's head
39:10Okay, does that feel sharp there?
39:13No, is it all good?
39:14Okay, let's just see
39:22I left the biggest cyst till the end, I just wanted to end with a bang
39:34I left the biggest cyst till the end, I just wanted to end with a bang
39:46Just put your head straight now, okay, now the last one
39:50Yeah
39:51All right
39:52Best for last
39:55Yes
39:56Let's see if it's an easy or hard one
39:58Okay, right, does that feel sharp there?
40:01No, I can't feel a thing
40:03Popped
40:10Yeah, it popped
40:11Okay, I'm just going to squeeze it
40:15Yep
40:15I think it's a better one, you cannot see it because it doesn't make you feel maybe sick
40:19Wow, I can hear that
40:26Is it painful?
40:33A bit, but it's okay
40:34I can take it
40:35You've still got some more
40:37Yeah, I can give you some more
40:37Let me just get this out
40:38It's all right, it's all right
40:39No, I don't want you to feel any pain
40:41The doctor could see I'm getting a bit of a pain
40:44So I said, shall we give you a bit more anesthetic?
40:46And I said, no, it's all right, you can carry on
40:47I was going to take that pain, you know, I just wanted it out
40:50It is a big one, so sometimes the anesthetic goes into the cyst
40:53Right
40:54Rather than in the skin, so
40:55Yeah
40:56But he added a bit more anesthetic
40:58And he made you feel more numb again, so he was all right
41:01Okay, right
41:03I'm going to see if I can get this sack out now
41:06Yep
41:06Wow
41:11He had to put a little pressure and kind of squeeze out
41:14Get as much out as possible
41:16Okay
41:19Almost there
41:21Yep
41:21And like someone is just pushing onto your head with the thumbs
41:26I can feel it, it's trying to come out, but not
41:29Almost there
41:45No problem
41:45No problem
41:46Okay
41:51Okay
41:51Is it hard to get out?
41:59Yeah, it's just a bit bigger
42:00Yeah
42:00There we go
42:05It took quite a bit of work getting that last sack out
42:10I was relieved we got it all in the end
42:13I was trying to get it through a relatively small hole
42:16So it took a bit of persuasion
42:17Okay
42:21Good
42:22Take a seat here
42:24Thank you
42:24How was that for you?
42:28Yeah, it's just, you know, it's life changing
42:30Good
42:31And we got all five
42:31And they're all completely out
42:33So you'll see the sacks are complete
42:34Which means that they won't come back now
42:36Very, very unlikely for them to come back
42:38Yeah
42:38Do you want to have a look?
42:39Yes, please
42:39Do you want to have a feel as well?
42:40I don't know
42:41No, okay
42:41With a glove, I might
42:43Yeah, with a glove
42:43Yeah, give you some gloves
42:44Yeah, okay
42:45Yeah, we wouldn't expect you to test it with bare hands
42:47Thank you
42:49Right, let's have a look where they are
42:51So this is what comes out of it
42:53Right
42:54Okay
42:54But the cysts themselves
42:55Look like this
42:57Ooh
42:58Wow
42:59All in your head
42:59And all out of your head now
43:01Honestly, I'm so grateful
43:03Thank you so much
43:04You're welcome
43:04You're very welcome
43:05I'm really happy
43:07And I won't look hideous
43:09With all those looms and booms in my head
43:11Thank you
43:11Take care
43:11Bye
43:12Bye
43:12Bye
43:12Yeah, I can finally touch my head
43:16And nice and flat
43:17Yeah
43:18The life home on my back
43:27That was restricting my life
43:29Now it's gone
43:30I'm really, really happy
43:32I can go to the barbers now
43:38Without feeling uncomfortable
43:40And I can have a short haircut
43:42That I couldn't have
43:43For the past 15 years
43:45All healed
43:51And looking forward to going on
43:52All in a few weeks' time
43:53I thank Miss Cherry and Dr. Shah
44:06For ridding me of George
44:08Hello
44:10Next time on Skin A&E
44:15It's a big one
44:16Redefines deep massage
44:20Just trying to get to the bottom
44:23There we go
44:24Oh yeah
44:27St. Clair
44:30Hey
44:31Hey
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