- 6 days ago
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00:01The Skin A&E Clinic is back.
00:04Morning.
00:06But this time, they've relocated north.
00:09Hi, you're here for my appointment.
00:11And everything's bigger.
00:12My God, that's huge.
00:14Wow.
00:15You want to get rid of that.
00:17Whoa.
00:18Our team of top dermatologists
00:20have moved into a new purpose-built clinic.
00:23Doors opening.
00:25The doctor's ready for you now.
00:28They're tackling more conditions.
00:30Gosh, you've got so many.
00:32Helping scores of patients.
00:34That's like toothpaste.
00:36Is it?
00:37It's coming.
00:38Put years of bad skin behind them.
00:41Wow, you are a magic man.
00:44Wow.
00:45It's amazing.
00:46Can't believe that was inside my head.
00:48Restoring confidence.
00:50He's gone.
00:51And transforming lives.
00:53Oh, thank you so much.
00:54Oh, it's all right.
00:56This is Skin A&E.
01:09This week...
01:10Wow.
01:11I didn't expect it about me.
01:13We're breaking clinic records.
01:15That's maybe the biggest one I've ever seen.
01:18Dr. Adil receives an unexpected gift.
01:22So that's a cyst that sort of erupted.
01:24Yeah.
01:25I could not stop smiling.
01:26And Dr. Deb faces his biggest challenge yet.
01:30I'm feeling apprehensive.
01:32This is about the limits of what dermatological surgeons should be doing.
01:44Oh.
01:45It's a big day for our dermatology team.
01:48Oh, it's massive.
01:49Oh, it's nice, isn't it?
01:50As they start operating from a new, ultra-modern clinic in Yorkshire.
01:55Oh, good morning.
01:56Good morning.
01:57Bright and early.
01:58Ready to go.
01:59Very ready.
02:00Full of beans.
02:01Indeed.
02:02Coffee beans.
02:03Yes.
02:04Absolutely.
02:05100%.
02:06But they've not got long to settle in before it's business as usual, and they're welcoming
02:10their first patient.
02:11The doors are open, and first to arrive at the clinic today is 57-year-old Sean from Nottingham.
02:21Hi.
02:22I'm a university porter.
02:23I've been doing the role for 15 years now.
02:25Hi.
02:26I'm here for my appointment.
02:27Lovely.
02:28Can I take your name?
02:29Sean.
02:30Sean.
02:31Let's check you in.
02:32Lovely.
02:33My previous occupations, I've spent 10 years as a swimming teacher.
02:36I've got her qualifications in hockey, tennis, badminton, football, and cricket.
02:43But today will be a whole different ballgame, as Sean has an appointment with Dr Dev Shah.
02:49Hello.
02:50Sean.
02:51Hello.
02:52Come on in.
02:54Come and take a seat, Sean.
02:55This is Dr Shah.
02:56Hello, Sean.
02:57How are you doing?
02:58I'm good, thank you.
02:59Come and have a seat.
03:00This is Cherry.
03:01Hi.
03:02So, Sean, tell us, how can we help?
03:03I've got a large lipoma mass under my right armpit.
03:06Okay.
03:07And it's about the size of a cricket ball.
03:10And basically, it's just an obstruction that gets in the way.
03:13Does it stop you from doing anything?
03:15I mean, I used to be a very good swimmer.
03:18I still am.
03:19But obviously, I can't do the stroke movement I used to do.
03:22Right.
03:23And obviously, sporting-wise, it just gets in the way.
03:27What sports do you like playing?
03:29Badminton.
03:30Swimming.
03:31Cricket.
03:32But I gave that up nearly ten years ago now.
03:34Are you right-handed?
03:35Yes.
03:36Bowling?
03:37Yes.
03:38So it's sort of...
03:39Right-handed bowling.
03:40Is it on your right...
03:41Yeah, it's on your right hand.
03:42A lipoma is a group of cells in your body that are made up of fat.
03:49So we all have fat in our bodies, and it grows at a normal rate with your body, but a lipoma will grow at an abnormal rate.
03:57How is it making you feel?
04:00It's getting me down.
04:01If I go on holiday, I can't take my shirt off because, you know, people are looking at you and staring at it.
04:06When I'm turning, I'm knocking things off shelves.
04:09When I'm going through doorways, doorways are narrow, then I have to obviously turn sideways.
04:14So it's obviously at the back of your mind all the time.
04:17And has anyone ever said anything to you?
04:19They have.
04:20They've basically pointed out what is it.
04:22It's ugly.
04:23You know, you need to get rid of it.
04:24So over the years, obviously, I've seen the local NHS doctor.
04:28But obviously, because it's cosmetic, they wouldn't refer me on the NHS, so...
04:32OK.
04:33All right.
04:34Fine.
04:35Because they're not cancerous and they're not going to kill someone in any way or ulcerate or bleed, they are not deemed to be treatable on the NHS.
04:45Would you like to take your shirt off and then we'll have a little look and then we'll see what we can do for you?
04:50Oh, wow.
04:51Right.
04:52It's big, isn't it?
04:53It is.
04:54Yeah, it is big.
04:55And you've had that for...
04:56It started when I was young at 14 and grown over the years.
04:59We're looking at maybe...
05:02So I'm 57 now.
05:04Wow.
05:07It must impede you so much.
05:09Yes.
05:10That really does get in your way.
05:12If you put your arms up.
05:14Right.
05:15OK.
05:16So I've got full movement.
05:17There's no restriction if they are, but it's just...
05:18Yeah, yeah, yeah.
05:19Yeah, yeah.
05:20They can't...
05:21We're going to have a little fiddle if that's OK.
05:23Let's have a little look.
05:24Just feeling.
05:25Yeah, fine.
05:26Yeah, it doesn't hurt.
05:27I've squeezed it.
05:28It's like a stress ball.
05:29You're going to miss it.
05:30Have you got a name for it?
05:31It's the third boob.
05:32The boy called it the third boob due to the fact that it's got a little...
05:35Nipple on it.
05:36It's his eyes.
05:37Anatomically correct.
05:38OK.
05:39There we go.
05:40That's good, isn't it?
05:41There we go.
05:42Let's have a little look then what we're doing.
05:43I think Sean's description of a third boob was probably summing it up.
05:48It was quite dramatic.
05:50I'm just impressed how he's lived with it for so long.
05:53Is that not hurting you?
05:54No.
05:55What you're looking for when you're seeing these soft things on the body is whether they
06:02are actually soft.
06:04Whether you can feel the base.
06:06Because if it was connected to his lungs, for example, could it be something very odd
06:12and a bit dodgy?
06:14Having the lipoma removed today would be a big impact, especially on family life.
06:20The wife is obviously worried about it.
06:24It is actually still growing.
06:26If you don't mind, we'll get our colleague in as well just to have a look, just to see,
06:30you know.
06:31Sorry.
06:33Most of us in dermatology work in groups and teams and we would always call each other
06:38in for interesting patients and it was an interesting presentation of something quite common.
06:45Are you more comfortable like that?
06:47Yeah.
06:48I'm not going to peel you any grapes, okay?
06:51Hi, how are you doing?
06:56I'm good, thank you.
06:57What can I do for you?
06:58Can I ask your opinion, please?
06:59Come and have a little look at this.
07:01Yeah, sure, absolutely.
07:02Yep.
07:03Yeah, let's have a look.
07:04More the merrier.
07:06Come on through.
07:10Hello.
07:11Hi there.
07:12We've got my colleagues.
07:13Hello.
07:14Hi.
07:15Nice to meet you.
07:16Good.
07:17All right, let's have a look.
07:18Come and have a look.
07:20Oh, wow.
07:21I mean, it's sizeable.
07:23You've got some gloves.
07:25Yeah.
07:28It was huge.
07:30In a very difficult and tricky position on the body as well.
07:36Coming up.
07:37That's the big one.
07:38That is a weird looking beast, isn't it?
07:40Yeah.
07:41It's just like a little creature.
07:43That looks amazing.
07:44I'm actually salivating.
07:46Oh, my God.
07:47Oh, my God.
08:01See you soon.
08:02Bye-bye.
08:03It's mid-morning at the new clinic and Skin A&E is as busy as ever.
08:09But proceedings have been paused in treatment room one, as Dr Dev considers one of the largest lipomas he's ever come across.
08:18I would say that I'm feeling apprehensive.
08:21So it's coming out of the body rather than going in.
08:26And that's unusual for lipomas to be so obvious.
08:31With 57-year-old Sean waiting on the treatment bed, Dev has asked Dr Adil to help him weigh up the decision.
08:38I'm just going to have a feel.
08:40You can squeeze as hard as you want.
08:41We've had a squash and a squeeze.
08:43It's a stress ball.
08:46It felt very heavy when I initially tried to lift it up and it was going to be a challenge for Dev.
08:54The lipoma was very big.
08:58It was the biggest we've treated.
09:01And the one thing I knew I could do for Sean if I couldn't remove the whole thing was at least to make it smaller.
09:11We'll let you know.
09:12We'll probably be a couple of hours, so, you know.
09:15Keep our lunch warm.
09:16While Dr Dev and Nurse Cherry prepare for an epic procedure...
09:26Hi, how can I help?
09:28I'm here for my appointment.
09:29Lovely. Can I have your name, please?
09:30Julian.
09:31The next patient has arrived to see Dr Emma McMullen.
09:35Hello.
09:36Hello.
09:37Come on in.
09:38Come and have a seat with Dr Emma there.
09:39Hi, is it Julian?
09:40Hello.
09:41Yeah.
09:42Come on in, have a seat.
09:43How are you doing, Julian?
09:44All right.
09:45Good?
09:46What can we do for you today?
09:47I've got a skin tag on my leg.
09:49All right, okay.
09:50It's quite a big one.
09:51Oh, let's have a look.
09:53Oh, my...
09:54Oh, right.
09:55That is a big one.
09:56Oh, it is a big one.
09:57Yeah.
09:58I think that's maybe the biggest one I've ever seen.
10:02It's the size of a large grape, I'd say.
10:07It's rather soft and squishy.
10:12Lift it up.
10:13Does it have...
10:14It's got very narrow stalk, hasn't it?
10:15Yeah.
10:16Wow.
10:17That is a beast.
10:18Yeah.
10:19Yeah.
10:20Do you know how long you've had that one for?
10:21I don't know.
10:22It's been a few years.
10:23We tend to get skin tags in areas of friction, maybe where our clothes rub or where we have
10:29folds in our skin where they rub together and the more friction that encourages them to grow.
10:34Has it ever been infected or inflamed or anything?
10:37No.
10:38It just pulls.
10:39It's uncomfortable.
10:40It's uncomfortable.
10:41It gets caught.
10:42It hurts.
10:43Hopefully you've not had anybody pass comment on it or...
10:45Just my wife.
10:46Calls it my leg willy.
10:47No.
10:48No, that's horrible.
10:49Yeah.
10:50Okay.
10:51Yeah.
10:52I was thinking, it doesn't really look like a willy.
10:59It's reminding me more of another part of the male anatomy.
11:02I'm presuming your wife will be quite happy if we get rid of it for you.
11:05Yeah, she will, yeah.
11:06Okay.
11:07Not happy that I told you that.
11:08No.
11:09That's horrible.
11:13Have you got any other skin tags or is this just the only thing that's ever bothered your
11:16skin?
11:17I've got one under my armpit here.
11:19A little peep.
11:22Okay.
11:23That's very small.
11:24You could whip that one off as well if you want it at the same time and make sure it
11:28doesn't turn into something like that because it's another area where you've got friction,
11:31isn't it?
11:32Yeah.
11:33Brilliant.
11:34Right.
11:35So, on to how we're going to remove it.
11:37So, we just numb it so you won't feel anything.
11:40We'll literally just snip it off with a pair of scissors and then cauterize the base with
11:44a little electric current which just creates like a little burn in the area and stops any
11:48bleeding.
11:49Okay.
11:50When Dr. Emma said she could remove that today, it was, you know, it was brilliant.
11:54Like, you know, just what I wanted to hear.
11:56So, do you twiddle it?
11:58When my granddaughter comes around, I go, look.
12:01Oh.
12:02Oh.
12:03Oh.
12:04My granddaughter thinks it's disgusting.
12:06But then so does my wife and daughters.
12:09Okay.
12:10So, it does sting a little bit as it goes in, but it goes in on really quickly, okay?
12:19Yeah.
12:20Yeah.
12:21All right.
12:22It did smart a bit.
12:27But, you know, it would have been worse if she'd have cut the skin tag off without it.
12:34Okay.
12:35That's it.
12:36Well, that's the worst bit.
12:38Done.
12:39I'm going to test it with the needle now to see if it's numb.
12:44Okay.
12:45Can you feel anything sharp?
12:46No.
12:47Perfect.
12:48Yeah.
12:49So, I'm just going to sniff it off.
12:50So, is that okay?
12:51Yeah.
12:52Okay.
12:53Oh, it's tough.
12:54There we go.
12:55Go on.
12:56Sounded like a clunk.
12:57Yeah, you could hear it.
12:58It's because it's really, it's like gristly.
12:59Oh, thanks, Donna.
13:00There was a big clunk, and then it was off.
13:04And I actually felt the clunk.
13:06Not painfully, but it was weird.
13:09Oh, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no.
13:12It's like a little brain.
13:13It does.
13:40Yeah, it doesn't look like the other thing that you wilded.
13:45Let's just quickly whip that one off as well for you.
13:57Right, Donna, here we go. This is going to be a good combination.
13:59Right, give us a little blast.
14:02Lovely.
14:04Look at that for teamwork.
14:06Makes the dream work. It does.
14:08It was over so quick, I think if I'd have blinked, I'd have missed it.
14:13Gillian, do you want to have a look at it?
14:15Yeah. Yeah.
14:16Yeah, it's kind of weird, isn't it?
14:17It is a bit weird. Kind of weird.
14:21That's it, that's it there. It's odd, isn't it?
14:24It's got, like, hands.
14:28It did look like a little man with little arms.
14:33And it felt all soft and weird and cold and squishy.
14:37I think we're glad to be rid of that.
14:39See you later.
14:40See you.
14:41Bye.
14:42Don't drown.
14:43Like a bit of chicken skin.
14:46So are you feeling okay?
14:47I am. Not feeling dizzy?
14:48Yeah, yeah.
14:49Feeling a little bit lighter?
14:50Yeah.
14:51At least half an ounce.
14:52Half an ounce, I do.
14:55My wife will definitely not miss my leg, willie.
14:59It was lovely meeting you.
15:00It's been a pleasure.
15:01And lovely treating you.
15:02Erm, we'll let you get on your way.
15:04Thank you ever so much.
15:05All right, yeah?
15:06Yeah.
15:07All right.
15:09Bye-bye.
15:11Will I miss it?
15:12I don't think I will.
15:16I think I'm good.
15:20That's the little one, which is left axilla.
15:23Barely anything.
15:24Yeah.
15:25And that's...
15:26That is a long, weird-looking beast, isn't it?
15:28Yeah.
15:29From one sizeable skin tag...
15:31Yeah.
15:32It's just like a little creature.
15:33..to an even larger lump.
15:36In treatment room one, after a thorough examination,
15:39Dr Dev is ready to start work removing Sean's enormous lipoma.
15:45We're going to localize everywhere,
15:47but I'm hoping to give you a scar that sort of looks like that.
15:50Okay.
15:51All right?
15:52Yep.
15:53All right.
15:56The reason that we proceeded with doing this is that I could feel the base
16:02and it very much felt that it was encapsulated outside of the body.
16:07And I knew the main problem would be to get the cosmetic scar looking right
16:12so it's not too lumpy.
16:14Sharp scratch coming up, okay?
16:15Yeah.
16:18This is one of the biggest procedures I think I've ever been faced with.
16:23I would say that I'm feeling apprehensive.
16:26This is about the limits of what dermatological surgeons should be doing
16:31and could be doing.
16:33I'm very reassured with how outside of the body it is, so we're not near really dangerous structures.
16:42But it's really how Sean will cope with a lot of digging and a lot of pulling.
16:47Still more going in.
16:48Okay.
16:49Are you feeling this still?
16:50You will feel pulling and pushing.
16:53You'll feel pressure.
16:54Oh, yeah.
16:55Yeah, that's all.
16:56Yeah.
16:57Very nervous.
16:58First operation I've ever had.
17:00So is it one of the biggest you've seen?
17:03Absolutely.
17:09Okay.
17:10You're in charge.
17:11If you feel anything, Sean, you let us know, okay?
17:14Okay.
17:15We'll stop and put more local anaesthetic in, okay?
17:17Okay.
17:18Anything sharp?
17:19No.
17:49Nothing.
17:50Anything sharp?
17:51No.
17:52Nothing.
18:16Bit sharp there it was.
18:17Okay.
18:18I'm just going to put some more local in.
18:26Anything sharp now?
18:27No.
18:28And now?
18:29No.
18:30And now?
18:31No.
18:32Good.
18:33I feel it's just going to come away in my hand.
18:37The majority of my job was to ensure that the gravity pulling the weight of the lipoma
18:45didn't impede what Dr. Shah was doing in removing it.
18:50It was incredibly weighty and was pulling on the skin, which made Dr. Shah's life a little difficult.
18:59As long as you know where my fingers are.
19:01Yes.
19:02Once I had started the incision, I was really scared because I couldn't find the depth of the lipoma.
19:12I was scared that we couldn't get an easy plane and we would go deeper and deeper towards the lung.
19:18I needed to find where that plane was.
19:21And getting to that point was really nerve-wracking.
19:27Is it just one then or was it nodules on it?
19:29Oh, no, just one.
19:30OK, let's get this up.
19:36Are you OK not feeling anything, sweetie?
19:41No.
19:42Well done, Sean.
19:43You're doing really well.
19:47I'm feeling that a bit tugging.
19:49OK, wait a minute.
19:53Sharp?
19:54Yeah.
19:55OK, it's just more local he's putting in.
19:57OK.
19:58Well done.
19:59Thanks for letting us know.
20:01In skin surgery, size doesn't really matter.
20:05What matters is how much local anaesthetic you can give someone.
20:09Generally, the anaesthetic lasts for about two hours.
20:11The more you dilute it, the quicker it goes.
20:14So you're sort of working against time.
20:18How are we doing there?
20:19Are you OK?
20:20That's fine, yeah.
20:21OK, good.
20:24OK.
20:34He's tickling it out.
20:37Salmon tickling.
20:38Yeah.
20:39I'm just taking it slowly.
20:42And it's...
20:45Oh, oh, oh, oh, oh.
20:46It's all?
20:47Yeah, yeah.
20:48OK, OK.
20:49It's all that.
20:50Oh, oh, oh, oh, oh.
20:51Oh, it's stinging, stinging, stinging.
20:52OK.
20:53I'm really stinging.
20:54Oh, oh, oh, oh, oh, oh.
20:55OK.
21:01Coming up...
21:02If I can't see any follicles, that means the hair is gone.
21:06I saw this sort of elastic band grey tube that was clearly a nerve.
21:13Oh, oh, oh, oh, oh.
21:21Today's surgery is in full swing.
21:23Well, I know.
21:24Well, I know.
21:25It's going to seem small now.
21:26But, yeah, it's really fine.
21:32We're deflated for the day.
21:33Yeah.
21:35Next on the patient list is 40-year-old Candy from Stafford.
21:39Hi, I'm here for my appointment.
21:41I've come to the clinic today to see whether somebody could help me both sides of my head.
21:48I don't have any hair anymore and there isn't any growth there either.
21:52I've turned 40 and I want to sort out little bits of my life that need crossing off my list.
22:01With dermatology covering skin, nails and hair, Candy's come to the right place
22:06and today she'll be seeing Dr Natalia Spearings.
22:11Hello.
22:12Hello.
22:13Hi.
22:14Come in, have a seat.
22:16You must have Candy.
22:17I am.
22:18Hi, I'm Natalia.
22:19Welcome.
22:20Hi, Natalia.
22:21This is Dutta, she's assisting me today.
22:22Hi.
22:23Hi, Candy.
22:24Right, so how can I help you today?
22:25So I have hair loss.
22:26OK.
22:27Both sides of my head.
22:28Right.
22:29Starting in small patches.
22:30I think it started on one side more than the other.
22:32OK.
22:33And then it's going into two larger patches.
22:36Larger patches.
22:37So did you just suddenly wake up one day and it was missing or was it a slow progression?
22:40Slow progression.
22:41Over how long do you think?
22:43I would say I was around 15.
22:46It really makes me feel a bit vulnerable, a bit embarrassed as well because I'm a girl
22:54and you're meant to like your hair.
22:56I used to wear my hair really high up here.
22:58Right.
22:59Scraped back with a lot of hair spray.
23:02OK.
23:03I remember that look.
23:04Mm-hmm.
23:05Yep.
23:06OK.
23:07That's how I used to wear it all the time every day.
23:08Right.
23:09For school.
23:10I used to use a very thin comb to comb my hair back so it looked really tight.
23:17And I think that's where it's coming from.
23:20Let me have a look at your hair then.
23:22OK.
23:23Take it away.
23:24I was a bit concerned that it may be too late to help Candy because she'd had the problem
23:29for so many years.
23:32So it's here.
23:33Both sides, yep.
23:34If I can't see any follicles that means the hair is gone.
23:38But so this, this never grows longer than this?
23:41No.
23:42Nothing like, I've never seen any hair grow there for years.
23:47So I'm looking with this light thing.
23:49OK.
23:50Obviously at the hair.
23:51And then I'm looking at the, I'm looking closer up at the actual scalp to see if you,
23:57I can see hair follicles there.
23:58Mm-hmm.
23:59If I can see little hairs.
24:06So you have little follicles everywhere and there's little hairs as well.
24:10But I think they're so small that you can't see them.
24:12Mm-hmm.
24:15Like tiny, tiny, tiny ones here.
24:17OK.
24:18Right.
24:19OK.
24:20It was good news when I could see follicles and small hairs because that meant that it's
24:25a non-scarring hair loss, which means that there's a potential for the hair to grow
24:30back.
24:31I think you probably had alopecia areata.
24:33Mm-hmm.
24:34This is nothing that you have done.
24:39I think all the time it's my fault that I've done it.
24:42Oh, no.
24:43Yeah.
24:44No, that's terrible.
24:45So I think that's really important actually that we touch on that.
24:46Because it's definitely not what you've done.
24:47I'm glad to hear that.
24:48Yeah.
24:49Alopecia areata is an immune problem of the hair follicles.
24:54Your body has decided it doesn't like those hair follicles and attacks them and kind
24:58of stops them from working.
25:00There's something that didn't like the hair at the time.
25:03Yeah.
25:04And put those follicles to sleep.
25:05OK.
25:06And hasn't been woken up again.
25:07Yeah.
25:08So though I can't guarantee that I can make the hair grow again, I think it's worth trying
25:13a treatment for this.
25:15Mm-hmm.
25:16When she told me that there was something that could be done, it was very relieving.
25:22The treatment I would suggest is to have some steroid injections into the scalp.
25:27So the idea there is for that inflammation and the immune system response to be lessened
25:33by the steroid.
25:34Mm-hmm.
25:35And then for the hair to then wake up again.
25:37We could do that today.
25:38Brilliant.
25:39Is that OK?
25:40Yep.
25:41Just a bit overwhelmed really that finally somebody's listened to me.
25:45Sorry.
25:46It just means the world to me.
26:01OK.
26:02So I'm just going to pinch your skin a little bit.
26:05You're going to feel a sharp scratch now.
26:06Ready?
26:07And sharp.
26:08Good.
26:09Well done.
26:10And again.
26:11How are you doing?
26:12Great.
26:13Very good.
26:17You can think about the steroid injections as waking the hair follicle up.
26:20But what it's doing is it's dampening down the inflammation and stopping that immune process
26:24from causing the hair to not grow.
26:26OK.
26:27I'm going to have you turn your head the other to the other side.
26:30All right.
26:31Ready?
26:32Good.
26:37I have a few patients who have this in their beard.
26:39And I have to go around and do this in the beard.
26:41And they're always like...
26:42That's the whole treatment.
26:46That's it.
26:47Excellent.
26:48From my own clinical experience, I think there's about a 50% chance that Candy's hair
26:52will grow back after the injections.
26:53And she should see that happening within two to four weeks after the injections.
26:59What we're looking for is to see patches of short regrowth.
27:02Yeah.
27:03Because it's going to be short hair.
27:04Let's just see how it goes.
27:05OK.
27:06OK?
27:07Yeah.
27:09Lovely to meet you, Candy.
27:10All the best.
27:13Bye.
27:14I feel like I've finally ticked at least one thing off my list now.
27:19I have turned the big four out.
27:22I think that's very encouraging.
27:24Yeah, I think she should have a response to that.
27:26Yeah.
27:31Here at Skin A&E, the dermatology team love their jobs.
27:35But one of the clinic's patients wants to know if there's anything that really gets, well, under their skin.
27:42What is your pet hate? Would it be skin related or not?
27:47Somebody masticating very loudly next to me and it's out of their mouth and you can hear every bite and crunch.
27:54People driving in the middle lane on the motorway.
27:57Hate it.
27:58Hate it.
27:59I just can't deal with funky feet, like gnarly nails, any kind of weird foot thing.
28:05Just...
28:06Yeah.
28:07Not having cherry around, well, that's when my days go really badly.
28:15Luckily, today isn't one of those days for Dr. Dev.
28:18Because he definitely needs cherry by his side.
28:21As he's removing Skin A&E's biggest ever lipoma.
28:26They're halfway through Sean's procedure, but have hit a complication.
28:30Stinging.
28:31And now still stinging?
28:32Yeah, really stinging.
28:33OK.
28:34Yeah, really stinging.
28:35We'll get rid of it.
28:36This is the local.
28:37This is the local going in.
28:38Oh!
28:39There was a pain fibre, which was a nerve, coming from his abdomen going up.
28:48I kept touching the nerve with a swab, and it would fire off an impulse and make Sean quite uncomfortable.
28:55And I hadn't quite realised what that was until I saw this sort of elastic band, grey tube that was clearly a nerve.
29:05I'm so sorry.
29:06We've got, like, 80% of it done.
29:09Yeah.
29:10And it's just that last bit that's causing a problem.
29:13The lipoma was connected to one nerve ending, which sent a sharp pain, like a bee sting, but even 100 times worse.
29:20Now, just let me know.
29:22This is just more local going in.
29:24Let me know if you're feeling any of these.
29:25Just local, then.
29:26Yeah.
29:27This is local going in.
29:28Can you feel any of these?
29:29No.
29:30If you lift it all the way up.
29:32OK, ready?
29:36OK, we're a bit deep there.
29:37Right, that's fine.
29:38OK.
29:39Right, now, now let's do this bit.
29:42So, we're nearly there, OK, my friend?
29:44Oh, this is pressure.
29:45I'm sorry.
29:46Oh, it's stinging, stinging.
29:47It's just pulling.
29:48It's that pulling.
29:49Yeah, it's pulling.
29:50OK.
29:51I've just got to keep it up and close to you.
29:53Wait a minute.
29:54Stay there, then.
29:55Yeah.
29:58Anything there?
29:59No.
30:00Anything down there?
30:01No.
30:02Anything in there?
30:03No.
30:04Now, how are we doing here?
30:12Good.
30:13Is that sore?
30:14No.
30:15OK, wait a minute, Jess.
30:17Just keep...
30:23How are we doing?
30:24Good, thanks.
30:25How are we doing?
30:26Good.
30:27How are we doing?
30:28Good.
30:32You sure you're OK?
30:33Yeah, it's fine, yeah.
30:35Sure you're OK?
30:36Yeah.
30:37I wasn't in the netball team for nothing.
30:40Wow.
30:46OK, wow.
30:47OK, great.
30:48It's gone.
30:49It's out.
30:50It is out, my darling, yeah.
30:51She's got good hands, good rugby hands.
30:53Right.
30:54We've just got to close it up now.
30:56OK.
30:58All right?
30:59Yeah.
31:00OK.
31:05Anything sharp?
31:06No.
31:07I mean, the lipoma was hard enough to get out.
31:11But now, I've got this huge wound, a good sort of 20, 25 centimetres.
31:17It was, you know, a big ruler and it was gaping.
31:20Go carefully.
31:22OK.
31:25How are we doing there?
31:26OK.
31:27When you get skin together at either end, you create redundant areas of skin.
31:33Is it like a patchwork quilt?
31:34No, you're looking fantastic.
31:38And unless you remove that excess skin, you'll have big lumps,
31:43which would look probably just as bad and has a big risk of infection.
31:49We're just going to take a bit more out.
31:51At the top.
31:52Just not a lipoma, but it's just a redundant skin.
31:54Yeah, OK.
31:55Just because otherwise it's going to be a bit baggy for you.
31:59But you have to remove that to make the scar look flat.
32:04OK.
32:05Put that there.
32:06I'll just finish off some suturing.
32:19Yeah, we're almost done.
32:20OK.
32:21Oh, we like to challenge you.
32:22We do like something challenging.
32:23It's nice to be challenged.
32:24Yeah, it is nice to be challenged.
32:25I was a bit worried about your nerve, but that's settled now.
32:26Fantastic.
32:27Great.
32:29How are you doing?
32:30We've finished.
32:31I'm going to put a dressing on.
32:32OK.
32:33The dressing is going to be a bit bulky.
32:34I was quite surprised about Sean.
32:35He was really stoical.
32:36You're in a better position.
32:37Really took it in his stride.
32:38He was actually a pleasure to treat.
32:39Your scar comes up to here.
32:40OK.
32:41But it's quite flat.
32:42It's quite lumpy inside.
32:43Yeah, that's the swelling.
32:44And then, at the back, it's...
32:45It's magical.
32:46Yeah, so, he's losing his head.
32:47It's really flat.
32:48It's just a iron cap, and then it's got a different weight.
32:50You knew this.
32:51Oh, my God.
32:52Oh, my God.
32:53Look at that.
32:54Look at that!
32:55Oh, my God, I'm going to be a normal bone.
32:56Yeah.
32:57How are you doing?
32:58We've finished.
32:59I'm going to put a dressing on.
33:00The dressing is going to be a bit bulky.
33:02I was quite surprised about Sean.
33:05He was really stoical.
33:10You're in a better position.
33:10so you know just relax okay strange feeling now getting my arm against my
33:17side for the first time in donkey's years yeah I'm really happy with that
33:23can see through it yeah third boob is now gone boobless thank you there we go
33:30how are you feeling all good you're feeling well in yourself feeling well
33:34in myself yeah good okay do you want to have a look at it and shall we measure
33:39it yeah have a look I took a photo you want to pop some gloves on because
33:43you're going to want to hold it there you go pop them on Wow I didn't expect it
33:57about me it's big isn't it the size of it really shocked me you can compare it to a
34:03rugby wall whoa do you want to put it on I do the honors put it on that tray
34:09don't forget little bits and the extras 317 grams dr. shells a winner
34:21knowing that lump was in my body was unbelievable literally something out of a film don't have a
34:32picture with it yeah then you sort of like you know it's like your trophy it can't really tell
34:40yeah it let go which has been it oh yeah that's the that's the hammer see I'm a brilliant brilliant
34:49I can now obviously feel confident that the only thing people will see is a slight scar I'm not
34:59worried about knocking anything over or bumping into anything now it's gone thank you that really is big
35:11huge dr. dev and cherry they've made me feel confident without them this would not be possible
35:18so the actual weight of the lipoma was 317 grams in terms of skin A&E history it's I've got to be the
35:26biggest the heaviest lipoma so far hasn't it
35:29they're gonna get a shot mad mad coming up I would like to have done the squirting myself
35:46after a busy day the skin A&E clinic is winding down yeah nice one but not before their last
36:07patient is seen she's 39 year old Sarah from London I am an artist I make weird and
36:16rude sculptures anything unconventional stuff that kind of incites a reaction from people
36:23sculptor Sarah will be seen today by dr. Adil Shiraz
36:28hello hi I'm filming hello yeah come through take a seat thanks right we have Sarah yeah I'm dr.
36:40Shiraz nice to meet you nice to meet you what are we doing for you today well I've got this massive
36:44cyst that's been on my scalp for around 20 years and I just want it gone and it's embarrassing like I
36:51can't have my hair in any other styles and scalp cysts are extremely common we see them very frequently in
36:58our clinics they are caused by often oil glands that don't function properly and result in pumping all
37:05back into the skin and does it cause any pain or discomfort no no let's have a look at them if
37:10you take a seat yeah just can see it just from here yeah is it painful to touch no okay so I want
37:18you to tilt your head this way for me slightly that's it yeah you can see it just there mmm it's a
37:27reasonable sized one isn't it yeah your hair is the right color for the procedure exactly I don't
37:34think there'll be any issues there it should come out pretty straightforward I'm single so sometimes what
37:41I like to do on dates I like to take their finger and I like to place it on the cyst just freak people
37:50out of it all right yeah let's get you to lie down and let's get going then great um before that go on
37:56because I do art and weird sculptures sculptures for a living okay I actually have a little gift so
38:05that's a cyst yeah they're all cysts they're all different types of cysts people are squeezing them
38:10so that's a cyst that's sort of erupted yeah but then you've all go drawn around it like we would
38:16normally draw around this is that's great sales gifts were by far the most unusual thing I've ever
38:22had usually it's a chocolate or a cake maybe initially I thought they were little tarts until I
38:28realized that they were figures of cysts and this is the most stringy one yeah they were quite creative
38:42and very precise the unique you don't see many people doing this type of work just gonna sting a
38:50little bit right I'm sorry that's fine so as it goes in it'll pressurize yeah what do you reckon
38:59it'll be do you can't be mushy or what I think it'll be I think it'll be mushy oh okay and then
39:04we'll get the sack as well oh but both we'll get a bit of us great right anything feel sharp you let me
39:16know okay it's it going everywhere what's it look like oh it looks like one yeah yeah yeah
39:46oh my god please do take a picture oh this is amazing thank you I was a little bit surprised
40:05that Vilma suggested we take a photo mid procedure but I think in the end it's what Sarah really wanted
40:11oh that looks amazing I'm actually salivating oh my god I would like to have done the squirting
40:24myself I'm so grateful they took a picture of it I will cherish that picture forever you have a great
40:29job now what we need to do is get this hack oh okay and that's coming it's about to come yeah okay
40:40wait wait a second just to make sure it's intact we don't break it
40:47this is amazing
40:52so that's all gone for you now amazing
41:08stitches to come out in 10 days 10 days okay the entire process throughout it I could not stop
41:18smiling I was so excited it was it was great I loved it
41:22that was yours and that was yours as well actually oh my god that's kind of weird it's like I predicted it
41:33that's great let me show you what it actually what it looks like oh absolutely am I not allowed to
41:39touch it with my actual fingers you can if you want to touch it with your fingers is that weird yeah
41:45it is weird but you can do it yeah take the glove back
41:49are you sure you're going to touch it yes I want to feel it I want to feel it on my skin okay so
42:00so that's all the squirty bit that's come out some of it was in the gauze so have a feel if you want
42:06to feel that that's up to you yeah oh wow gristly it felt kind of like lumpy it's kind of warm this is the sack
42:20oh oh oh my god that's so cool that was a joke I'm not going to eat it
42:30okay I got the tub ready yeah I should wash my hands now thank you
42:38I would love to have taken it home but I know you're not allowed to public health no okay
42:45I thought it was very unusual she wanted to touch without gloves it was a bit gross
42:54thank you so much for these these are brilliant so well these are so good
42:59thank you I was going to shake your hand I think I will miss freaking people out with my assist
43:10especially men on dates but I won't miss trying to hide it with the same hairstyle I'm very very happy
43:20it's gone this is great this is amazing this is really good which one are you going to take that
43:27for the shots I don't know I'm not sure I want any of them as you can see the scar is healing really
43:43well well I'm driving get ready for the summer as you can see got the shorts on
43:56since the lump has been removed I feel so much more confident within myself and I've also been
44:16able to experiment with new hairstyles next time on skin A&E I kind of laughed for like all that I was
44:25thinking you have got an absolute task on your hands
44:28can a new medical director save a crumbling hospital from ruin catch drama new Amsterdam available
44:47to stream now on five next day car power cops
44:51you
44:51you
44:56you
44:56you
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