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00:00This programme examines dermatological conditions and the procedures involved
00:04with treating them. Due to their graphic nature, viewer discretion is advised.
00:12Quite nervous.
00:14Hello, I'm Dr Emma. Come and have a wee seat.
00:18Is this the baddie? Oh it is, isn't it?
00:21Look at your wee toe here. You wouldn't even know it was a wee toe, sure you wouldn't.
00:25If I had my way, I'd have it off.
00:27Oh!
00:28Salting a wound is probably the best description.
00:32Every day I see people in despair and it's all because of their skin.
00:36It's been 20 years since they are just getting bigger and bigger.
00:40Some of the patients have been suffering in silence for many years.
00:44It's ugly. They don't want it.
00:46And others have tried multiple treatments and nothing has worked.
00:50And that's why they come to see me.
00:53Can't wait to have it gone. It's just going to change everything.
00:58I treat everything from the most extraordinary and extreme.
01:02Well there's certainly a lot here, isn't there?
01:04I try not to look at it to be honest.
01:06To the common skin conditions that we see every day.
01:10Woo! That was a good one.
01:12Do you want to see this?
01:13Yeah.
01:14Oh!
01:15It is hard at the moment because resources are stretched and people aren't able to get the treatment that they need.
01:23That's it out.
01:24Oh, good riddance.
01:25And all I want to do is to help make a difference.
01:28Thank you so much.
01:29Oh, it's my pleasure.
01:30It's gone.
01:31It's gone.
01:32It's gone.
01:33That is amazing!
01:34What are you saying?
01:35I am so grateful.
01:36You just don't know what you've done.
01:38How was wedding dress dropping?
01:39Yeah.
01:40It was good.
01:41It was good.
01:42We didn't pick a dress but it's like Chris's sister was the one who was trying on.
02:00But didn't you try it on as well?
02:01No.
02:02No.
02:03Why?
02:04Because there's no champagne.
02:09Morning Emma.
02:10How are you?
02:11Good.
02:12How are you?
02:13Good.
02:14Ready for the day?
02:15Yeah, it's busy.
02:25It's very soul destroying when you get people look at you and pull faces.
02:30Ugh, what's that?
02:32I was born and called a red baby because I was covered from head to foot with blisters.
02:41She was born on a Saturday.
02:43I didn't see her until the Wednesday because they thought I didn't want to because of the
02:48blisters that she had.
02:49I have a congenital condition.
02:51It's called bullious ichthyostiform eryphroderma.
02:55The condition makes my skin thicken and crack.
02:59It's a nightmare because, you know, you leave trails and you can see that by rubbing them
03:06together it just flakes off.
03:10So I'm forever hoovering up, you know, because otherwise you're going to have skin all over
03:17the house.
03:22My mum was the only person that I could relate to with the skin condition because she's got
03:27it as well.
03:28Well, it's heartbreaking, isn't it?
03:31You know, you want your best for your child that you can have.
03:34And, you know, to see her like that, I was in tears lots of times over it.
03:41Right, let's do this one first then.
03:45You ready?
03:46Yeah.
03:51Because Yvonne's skin is very thick, especially on her feet, we have tried all different sorts
03:56of sanding mechanisms.
03:58I can feel that it's a lot, you know, a lot, lot smoother.
04:04Yeah.
04:05It feels nice.
04:13I just honestly think to myself, how have I got a husband?
04:18He does it all, bless his cotton socks.
04:21You know, she can't help what she was born with.
04:25Because the skin is so bad on my feet, at times I just can't walk because it is so sore
04:31and so painful.
04:32I just can't do the normal stuff that normal people do.
04:44Hello, my name's Yvonne, I'm here to see Dr. Emma.
04:47Lovely, would you like to take a seat?
04:52Are you looking forward to seeing Dr. Emma?
04:55I am, I can't wait.
04:56Hopefully she'll be able to do something for you.
05:02Hello.
05:03Hello.
05:04Is it Yvonne?
05:05It is.
05:06Hi, nice to see you both.
05:07Oh, nice to see you.
05:08Dr. Emma, come with me.
05:12What have you done?
05:13No, I've had a total knee replacement.
05:15I've had the other knee done as well.
05:16Okay.
05:17And I've got screws in my ankle.
05:19You actually are the bionic woman.
05:24Now, you have a very interesting skin condition.
05:27Tell me a little bit about that.
05:28It's called bullious ichthyosiform eryphroderma.
05:32Well done.
05:34Plenty of practice.
05:35My mum's got it, her mother had it.
05:38Did you have it as a tiny little baby?
05:39Well, apparently when I was born, it was blisters.
05:43And then after the blisters seemed to clear and go, then that's when the skin started to appear.
05:50What do you do with your hands and feet every day?
05:52Well, we haven't been seen by doctors or what have you for 30 odd years.
05:55So for 30 years, you've been managing this by yourself at home?
05:59Yeah.
06:00Yeah.
06:01Not seeing anybody?
06:02No.
06:03No?
06:04No.
06:05They just didn't seem to know what to do with us.
06:06And even some of them hadn't come across it.
06:08So here we are now.
06:10What is your typical routine that you do to care for the skin?
06:15I just get a knife and...
06:18OK.
06:20Or an angle grinder.
06:24My husband does my feet with it.
06:27What?!
06:29How does he know where to stop?
06:31Obviously when it does start to get, like, thinner, you can feel the heat.
06:34Feel the heat and I'm going, hot, hot, hot, like that.
06:36And it'll start and go somewhere else and then I'll go, hot, hot, hot.
06:40And it'll go, OK.
06:41But yeah, do not do this at home.
06:44Don't do this at home.
06:46And Yvonne, please don't do this again because it could be really dangerous.
06:50But it does show how desperate you are for medical help.
06:53So I'd like to have a look at your skin today, if that's OK?
06:56Yes, fine.
06:57OK, perfect.
06:59OK, that's better.
07:01Let's have a wee look at these hands.
07:03OK.
07:04So you've got this redness that comes around the edge here.
07:07And that's the kind of inflammatory part.
07:09So, you know, the erythro part of it, erythro, that's what that means.
07:13It's from the redness.
07:15And then the ichthyozo part of it is because of the dryness.
07:19And then the bullis is the blisters.
07:21It's rare.
07:23It's only about one in 250,000 or one in 300,000.
07:26So it's a very rare condition.
07:27All of this whiteness here on your hands is a build-up of keratin.
07:32So it's essentially the dead skin cells.
07:35So because the skin is inflamed, that causes the skin cells to turn over more quickly.
07:40And that's why you see them as these large, thick scales.
07:44Well, these feet are wonderful.
07:47I wouldn't go that far.
07:49Because you can see how the scales are thickened up and how they're adherent and stuck down.
07:55You know, you've got, like...
07:57Oh, my gosh.
07:58..bits. You can see it lifting.
08:00Bits.
08:02Sorry if I hit you.
08:03No, it's all right.
08:04Yeah.
08:05So good.
08:07Picking it off like that, you know?
08:10Look at your wee toe here.
08:11I know.
08:12It's awful.
08:14I mean, you wouldn't even know it was a wee toe, sure you wouldn't?
08:16If I had my way, I'd have it off.
08:18No, no.
08:19We're not doing that.
08:20A few things have changed in the last 30 years of how we come to treat this.
08:29Yeah.
08:30New things like moisturising the skin and protecting the skin.
08:33The other thing is a tablet.
08:35It's generally in the grip of vitamin A.
08:37Ultimately, it's not going to cure it.
08:39But if it can slow down the rate at which things are turning over
08:43and try and help regulate that cell, essentially...
08:46Anything that can help is a good thing.
08:49Yeah.
08:50That would be my plan.
08:51Sounds brilliant.
08:52Yeah?
08:53I'll give it a go.
08:54Yay!
08:55Get something done.
08:56OK.
09:03Hello.
09:04Well, that's really, really promising.
09:06I am so pleased she's going to try me on some new tablets
09:10and a lot more creams that hopefully, you know, do the trick.
09:14Oh, that's fantastic, yeah.
09:15I know the condition can't be cured, but I know that Dr. Emma
09:20is going to do everything she can to help me, and I am totally grateful.
09:24Ow.
09:25Ow.
09:26Ow.
09:27Ow.
09:28Ow.
09:29Ow.
09:30And this is my son.
09:31Thinking this is an earring or something to play with.
09:34This is what he does.
09:35Ow.
09:36Ow.
09:37Ow.
09:38Ow.
09:39Ow.
09:40Ow.
09:41Ow.
09:42Ow.
09:43Ow.
09:44Ow.
09:45Ow.
09:46Ow.
09:47Ow.
09:48Ow.
09:49Ow.
09:50Ow.
09:51Ow.
09:52I have keloids.
09:59I was about 15 when my conditions started.
10:01And from then, they've just grown, had it cut off, grown, cut off.
10:06Now they're at their biggest.
10:08They're very itchy, they're very sore.
10:11They've got ridges in them.
10:14And sometimes that can be quite smelly.
10:17Hey. Hi, babe.
10:20With my step-mom, Denise,
10:22I don't think she knows the extent that they've got to.
10:27They've grown. They're at their worst.
10:29OK. Do you mind showing them to me? Yeah, I'll show them.
10:32Go on then.
10:34Oh, my gosh, Lee! Yeah.
10:37That's never been that size before. Never.
10:41And then...
10:44Oh, my gosh!
10:46Yeah, yeah. Lee!
10:49Massive.
10:50We need to get this sorted out.
10:52It's just the reoccurrence as well. Yeah.
10:55From having them cut off and then me living my best life.
10:58Never forget that. You were so happy. Yeah.
11:01I would love to see that confidently only back.
11:07The carefree, the flick of the hair, you know.
11:11She's still young.
11:13She's a mother of three, but she still wants to go out.
11:16I want her to go enjoy her life.
11:19I miss feeling good about myself.
11:23I've lost hope that they could be treated.
11:26To
11:39Here we go.
11:47Hi, I'm Leonie. I'm here to see Dr Emma.
11:49Would you like to take a seat? Thank you. Thank you.
11:53Fingers crossed, you know, you get the answers and the results that you need.
11:56Yeah. Because that's what we're here for.
11:58Exactly. So, it should be a good day.
12:01Hi, Leonie. Hi. Hi, Leonie, how are you? I'm Dr Emma.
12:04Do you want to come with me? Yeah.
12:08We're just going down here.
12:11Come on in, Leonie, and have a seat. This is Nurse Rosie. Hi.
12:15Hi, sweetie. So, tell me why you've come to Glendale.
12:19What have you done, Nick, today? I've got keloids on both ears.
12:22OK, and how long have you had those for?
12:24Um, since I was about 15, if I'm piercing my ears,
12:27and literally just started growing from then.
12:30I did have them cut off. What happened next?
12:32And then I had them cut off again. And they grew back again? Yeah.
12:36And how do you feel about them? Oh, they're disgusting.
12:40Yeah. I hate looking at them, and they're really itchy, they hurt.
12:44Even last night, from about 11 till 2, it was just frobbing.
12:48It was just frobbing, frobbing. Oh, really? Yeah.
12:50Yeah.
12:51Do you mind if we get in and have a look? Is that OK? Yeah, that's fine.
13:01It's like a wee toadstool this much, isn't it?
13:04Your side's always been the smaller side.
13:06Oh, great. Let me get to the other side.
13:08What am I doing, wasting my time here?
13:11Come on.
13:12So you past your ears, and then it sparked off this abnormal healing process.
13:17Mm-hm.
13:18And what happens is, it starts to scar, and then it forgets to stop scarring,
13:22and it just keeps scarring and scarring and scarring and scarring, and it grows out.
13:26Yeah. And sometimes it grows up on a stalk, like a thin stalk, and then it balloons over,
13:32and that's what's happened really here.
13:34Right, so let's have a look at the...
13:36Is this the baddie? Mm-hm.
13:38Oh, it is, isn't it?
13:41Anteriorly, the shape of that ear and the lobe is quite well preserved.
13:47But this one is less of a stalk, and it's more spread out.
13:51Yeah.
13:55Keloid disease, and where you have them, is in response to some kind of trauma on the skin,
14:02and that's what kicks them off. Yeah.
14:03Now, if you were to just have the surgery, you can pretty much guarantee they're going to come back.
14:08Yeah. That's it. They will do.
14:10The other alternative is, is after surgery, to have something called radiotherapy.
14:14The risk of it coming back after that procedure is probably only around about something like 5%.
14:21Radiotherapy itself has a few potential side effects with it,
14:25but very little compared to the side effects you're currently experiencing.
14:29What do you think about what I've just said?
14:30Um, yeah, that sounds good, because I haven't had it before.
14:34OK, very good.
14:35So I think the plan for you is going to be surgery and radiotherapy.
14:39Let's do the big boy first. Yeah.
14:41And then surgery and radiotherapy will do the little lady after.
14:47Does that sound OK? Sounds great.
14:49Come with me. Bye.
14:51I'm not going to do both of Leone's ears at the same time,
14:57because one can be a little bit sore while it's recovering,
15:00so I like to do them separately.
15:02The one on the right is a bit bigger, and it's stuck down all around the back of the ear,
15:07so we'll get that one out of the way first.
15:09What I'm going to do first of all is just pop the anaesthetic in.
15:17It's well done.
15:21There we go. Great.
15:22Nothing else is going to hurt you now, OK?
15:25I'm feeling a little bit nervous, a bit shaky, but, um, yeah, just excited.
15:31Good to be gone.
15:33So I'm just scoring around it initially just to identify where the edges of it are.
15:48So now we're just going to go along the base of the keloid to remove it.
15:55We're just peeling this off, nice and gently.
16:02That's it.
16:04It's lovely.
16:05I'll let you see it properly after.
16:12Beautiful.
16:15OK, so let's put a wee suture in.
16:21So I'm going to let you hold this, and then you can have a little look to see.
16:24Thank you so much.
16:26How do you feel?
16:27I feel really...
16:29..missed emotional.
16:31Aw.
16:32Are you happy it's gone, or are you crying because you want me to put it back?
16:35SHE LAUGHS
16:37She's crying, Monty. Let's put it back.
16:39SHE LAUGHS
16:40I'm very happy. Thank you.
16:43Come in, Denise.
16:44Hello.
16:45Hello, Tatum. How are you?
16:46Good. Nice to see you.
16:48SHE LAUGHS
16:50It's all gone.
16:51Oh, no! Look, it's gone!
16:55Do you want to see the keloid? Can I?
16:57Yeah. I want to see it. Oh, my...
17:02It looks like a bit of poo.
17:03SHE LAUGHS
17:04Bye, Denise.
17:05Dr. Emma, thank you so much.
17:06Pleasure. So we'll get the dressing on it for you now,
17:08and then you can go home.
17:11I'm really pleased with that operation,
17:13and I know what a big difference it can make
17:15whenever somebody has had a huge keloid
17:18that really affects so many aspects of their life.
17:22Yeah, the whole thing was just a pleasure this morning.
17:25SHE LAUGHS
17:27Dr. Emma is very special.
17:30I can't wait to, obviously, see her again
17:32and get the other ear done.
17:33SHE LAUGHS
17:35SHE LAUGHS
17:38SHE LAUGHS
17:40Oh, my God.
17:47That was a good operation for Leonie, wasn't it?
17:49Yeah, it was really good.
17:50Can you send this over to Irene at Guy's,
17:52just the operation notes,
17:53so she's got them for radiotherapy planning?
17:55OK. OK, thanks.
17:57SHE LAUGHS
18:09These are the pills that Dr. Emma prescribed me,
18:11and I am on these for 60 days.
18:15Dr. Emma has prescribed me a cream for my hands.
18:19It's really making the skin thinner,
18:22and I can see the results.
18:23Already, it also lifts the skin.
18:27You can take it off, pull it off.
18:30She's also put me on some night foot cream,
18:35which has started to take the skin off,
18:38and it's stopped a lot of the thickness.
18:42So, yes, very excited.
18:43Can't wait to see how we get on.
18:53I've spent a good part of my youth in a band.
18:58I've even supported Iron Maiden.
19:02I'd love to be teaching drums and drum tutoring as a career.
19:06I'd love that.
19:07But I'm limited because of the psoriasis.
19:10I've had psoriasis all my life.
19:18Generally, the pain's quite intense.
19:20It does often feel like a burning sensation where the skin splits.
19:26Salting a wound is probably the best description I have of how it feels.
19:31I tend to scratch without realising it,
19:34and that can then make it worse because I'm aggravating it.
19:38I see the mess already.
19:39I can leave a trail of Hansel and Gretel-style breadcrumbs around the house.
19:47You ready for your creams?
19:48That time of day, is it?
19:49Yeah, it is.
19:50There's days where he can barely move his body because the skin's so tight.
19:55It's very dry.
20:00A lot of the steroid creams over the years have thinned my skin,
20:03and it's effectively like crepe paper.
20:05It just rips open.
20:07Oh! Sorry.
20:09The worst I've ever seen Matt was a couple of years ago.
20:14There was infected sores over most of my body.
20:18It was weeping.
20:20All of his skin was peeling off.
20:22I mean, the whole soul of his foot was coming off in one sheet.
20:25We could smell the infection.
20:28It was like a stage before sepsis.
20:32It had affected his liver.
20:33It was starting to affect his kidneys.
20:36He was hallucinating.
20:37It was definitely life-threatening.
20:52Good morning, one world back.
20:55Hi, Matt.
21:00Hiya.
21:00Hi, nice to meet you.
21:01And you.
21:02You want to come with me?
21:03I'm Dr Emma.
21:05There we go.
21:09Come and have a seat up on the bed.
21:11What have you come along with today?
21:14Well, I've suffered with psoriasis all my life.
21:17As far back as I can remember, from the age of three, so my mother tells me.
21:20Oh, really?
21:21OK.
21:21Yeah.
21:22I've had various treatments over the years.
21:25Light treatment, various steroid ointments, creams, different systemic treatments.
21:30More recently, I've been on methotrexate, which is an immunosuppressant.
21:35And no matter what happens, it always seems to come back more aggressively, the older I get.
21:41Do you get symptoms with it, bud, as well?
21:43So, does it feel itchy, do you, or hot, or...
21:45Yeah, definitely.
21:46As far as I'm aware, I do a lot of my scratching when I'm fast asleep.
21:50Yeah.
21:50Picking flakes off my calf, or...
21:53So, are there blood on your sheets when you're waking up?
21:55Yeah, or a silhouette of my foot on the carpet.
21:57So, for you now, is your skin good, bad, or this is the way it just is?
22:02Just worse than average.
22:03So, this is the kind of thing that you're used to just dealing with every single day?
22:07Yeah, yeah. I had a bit of a skin infection, as well.
22:09Tell me about that.
22:11The infection became uncontrollable.
22:12My whole body shed the whole epidermis, so I could...
22:17All my hands peeled away, the bottoms of my feet peeled away.
22:21It developed into a full-blown erythroderma.
22:23So, erythroderma essentially is where our entire skin, the derma, is red, erythro.
22:30So, you've got red skin.
22:32The problem is, whenever you've got red skin all over,
22:34is that your skin is not doing the job it's meant to do,
22:38which is control your temperature.
22:40And we need our temperature to be regulated
22:42to keep our internal organs regulated.
22:45And if those things aren't working,
22:47that puts us in an area where our organs can fail as a consequence.
22:51You told me it was definitely life-threatening,
22:53and I'd never viewed my condition as that.
22:57Oh, yes, that is considered a dermatology emergency.
23:01Really scary.
23:02What I do need to do is have a good look at everything.
23:05Is that all right? Certainly.
23:06Grant.
23:08OK, you're suitably dressed for the occasion now.
23:16Let's have a good look at your skin.
23:18So, we can see this plaque and then it's got this scale overlying it.
23:28So, these flakes are appearing because the skin is turning over much more quickly
23:33than it would normally do.
23:35So, instead of growing in the space of about a month,
23:38it's doing its job in about five days.
23:40So, it's making lots and lots and lots and lots and lots and lots and lots of skin.
23:43And that's why you get the kind of the dead skin layer coming away.
23:47And this is a very classic presentation of psoriasis on these extensor surfaces.
23:52So, they symmetrically appear on the elbows.
23:55OK, set yourself forward for me and I'm going to have a look at your back.
24:01OK, and then scattered all over the back is the same thing.
24:04Little raindrops of small plaque psoriasis.
24:07And then the legs, the skin itself is thickened just like the elbows.
24:12And then you've got this scale overlying it.
24:18OK, so, this is pretty extensive, isn't it?
24:22Yeah, pretty much always has been.
24:25And it's also pretty extensive given that you've been on these medications
24:29to try and reduce it or modify it.
24:32So, we need to pick a medicine that's going to modify the disease enough
24:37that it stops these flare-ups and pain.
24:40Sometimes, it's injections.
24:43They target a specific part of the pathway in psoriasis.
24:47OK? Magic.
24:56How's it going?
24:57Good, yeah. Really positive.
24:59It would mean everything if we can find a solution long-term,
25:03especially to give me the kind of the future that I'm open for.
25:18I've referred Leone for radiotherapy.
25:22And this is the best chance that she has of not having this back in her life again.
25:27Can you just take a seat about there for us?
25:30Yeah.
25:31Because I haven't had this treatment before, radiotherapy.
25:35I am nervous.
25:38Just going to flatten your ear down, just to expose the treatment area
25:43and try and make it as flat as possible.
25:46Radiotherapy, in this case, is a superficial form of radiation
25:50that stops the cells from dividing.
25:53And what really that means are the fibroblasts,
25:55the cells that are responsible for making the keloid,
25:59it kind of halts them in their tracks so another keloid isn't made.
26:03We've created a personalised lead cutout.
26:05The lead will block the x-rays from getting healthy tissue,
26:12so it'll only treat that bit that's open in the middle.
26:17Superficial radiation to the skin can actually cause a very small risk
26:22of developing a type of a cancer in the area.
26:25Just try and relax down there a little bit, that's it.
26:29But it's such a small risk.
26:31And actually, I have never seen it reported after radiotherapy for a keloid.
26:35Is that OK?
26:36Yeah, that's fine.
26:37You just don't want me to move.
26:37Sorry.
26:38Yeah? No, no, that's fine.
26:39Yeah.
26:40It's really quick. I'm back for another two treatments.
27:04We'll see you tomorrow.
27:05OK, thank you.
27:05Bye.
27:06I'm feeling OK about it because there's no pain and it went really well.
27:21I think about my skin condition on a daily basis.
27:25It feels quite grotesque.
27:29It's like it's a foreign object.
27:33And I hate it.
27:36I hate it.
27:38Hi, I'm Neville. I'm here to see Dr Emma.
27:41Yeah, lovely. Would you like to take a seat?
27:45So, how are you feeling?
27:47Quite nervous, actually.
27:51Hi, Neville.
27:52Hello.
27:53Hi, nice to meet you. I'm Dr Emma.
27:54You want to come with me?
27:55Yeah.
27:58Come and have a seat on the bed, Neville.
27:59Thank you very much.
28:00So, what brings you to come and see me?
28:04I have a growth on my leg.
28:07OK.
28:07I've had it since I was a teenager.
28:10OK.
28:10I had it looked at approximately 12, 13 years ago because it started to bother me.
28:17I was informed it was a dermata fibroma.
28:20OK.
28:21It started off as quite a small raised lump and then over the years I feel as if it's become more prominent.
28:28And it embarrasses you having it there? Does it stop you doing things that you would otherwise want to do?
28:32It's hard to put into words. I don't consider myself very vain because I'm losing my hair.
28:38My beard is now mostly grey because I'm a guy of a certain age.
28:41Yeah, but it's a great beard. I mean, it almost looks like you've dyed it. It's so perfectly symmetrical.
28:46Thank you very much. But, you know, my greyness doesn't bother me, but my leg does bother me.
28:52And have you ever in the past gone to see somebody to try and have it removed or taken away?
28:56When I spoke to the two different GPs, they essentially said it's not doing any harm.
29:02Yeah, I would disagree with that, I suppose, because it might not be harm physically to your body,
29:06but it is harm in terms of how you view yourself. Right. Now the moment of truth.
29:11I need to see this little thing. Is that OK?
29:14That's totally fine. Great.
29:21It's like a little button, isn't it? Yeah.
29:25So it feels quite firm, doesn't it? Mm-hm.
29:29And it's buried deep inside the skin as well, so it's almost a little bit like an iceberg.
29:36I actually don't think that this is a dermatofibroma. OK.
29:39I think this is possibly something called a nevus sebaceous. OK.
29:44Which is a kind of birthmark, actually, that can get bigger around the time of puberty.
29:50So I think that really, in order to get rid of it for you, we can cut it out.
29:56Wow. That would be really special.
29:58Aw. That would be fantastic.
30:08Wee tiny scratch. Well done. Very good.
30:16Well, we're just going into the dermis.
30:18OK. So we thought this was going into the skin a little bit here. It's coming up quite easily.
30:28Just running along the base of it.
30:30It cuts it out.
30:38So that little lump was in what's called the dermis.
30:42So when we cut into it, we have to go right down to the fat level,
30:47and then you know that it's all gone. Mm-hm.
30:51Oh, can I get a skin hook, please?
30:54So what we're doing now is putting inside stitches in,
30:57and these inside stitches are the things that hold all of the strength.
31:02Mm-hm.
31:03And especially on the leg, which is obviously something that you're moving all the time.
31:08Which is why I should lay off the running for a little while, then.
31:11Exactly.
31:12OK. Doctor's orders.
31:17All done. All finished.
31:18Yeah. Can you see that tiny little line straight down the middle?
31:22Yeah. That will be the scar.
31:24Okey-dokey. Excellent.
31:25Where is it? Let's see.
31:28Oh, you want to see? Yeah.
31:32There you go. There's your little button.
31:34Oh, my goodness.
31:36That is something else.
31:38Oh, good riddance.
31:41Thank you so much. Pleasure.
31:43That is amazing.
31:45That was really fun to do that for Neville.
31:48We've got all of this out in one go,
31:50so I really don't think that this is going to come back.
31:54Dr. Emma and her team did a fantastic job.
31:57Are you OK walking on it?
31:59Yes, I'm OK, thanks.
32:00And now I just can't stop smiling.
32:17Let me see that right one.
32:18Oh, my God.
32:20Wow.
32:21Can we see the left?
32:24No.
32:25Goodbye. Goodbye.
32:26Today, I've come to remove my left keloid.
32:30I can't wait.
32:32I feel a bit love-sided, so, yeah,
32:34I've just been counting down the weeks till this one gets removed.
32:38Hi, Leonie. Hi.
32:39How are you doing?
32:40I'm fine, thank you.
32:41Good. Hi.
32:42Come on.
32:44Bye.
32:45Nice to see you.
32:48How did the radiotherapy go?
32:50That went smooth, yeah.
32:51OK, good.
32:52Let's have a wee peek then.
32:53What a difference!
32:56What a difference.
32:57Yeah.
32:58Oh, that feels lovely.
33:01Really, really lovely.
33:04I mean, this keloid is...
33:06It's the size of your ear.
33:07Mm-hmm.
33:09Oh, I can't wait to get that up for you.
33:11I can't wait.
33:15It's going to feel a wee tiny scratch, wiggle those toes.
33:17Good job.
33:18Well done.
33:23Anything sharp or sore, just you let me know, OK?
33:25Yeah, yeah.
33:31There we go.
33:34And last little bit.
33:38There we go.
33:42Lovely.
33:43So we're just...
33:43We've taken out the keloids.
33:46So we're just going to close it, just like we did the last one.
33:53I'm just looking forward to getting my life back, not having to worry,
33:57not having to feel down.
33:58And hopefully they don't come back.
34:01I'll be keloid-free forever.
34:05It's like I automatically feel like myself already.
34:10Oh, God.
34:11Thank you so much.
34:12Thank you so much.
34:13Oh, it's my pleasure.
34:14It's my pleasure.
34:25I was prescribed this self-injection.
34:28An injection every four weeks to begin with, and then one injection every 12 weeks.
34:34This is a drug that blocks interleukin-23. And why that's important, it's a specific
34:40part of the psoriasis pathway that causes the inflammation.
34:45I'm just going to administer that now.
34:47And therefore, if we can target that, then that means that the inflammation will all be settled.
34:54And would hope to start to see an improvement in around about 10 to 12 weeks.
34:58All positives so far.
35:06How are you getting on with your new boots?
35:07Oh, they're absolutely brilliant. I can walk so much better in them now.
35:14Hello, I'm Yvonne, here to see Dr. Emma.
35:17Hi. Yeah, that's perfect. Do you want to take a seat?
35:23Can't wait to see Dr. Emma and see what she thinks.
35:27Hi, Yvonne. Hello.
35:29Nice to see you. Come on down.
35:34Come and have a seat. And this is Mossy. He's our nurse.
35:38And so I'm excited to see you back and see how you've been getting on with the
35:42medicines that we've put you on to try and help out with the scales on the hands and the feet.
35:47How have things been going? Oh, absolutely amazing.
35:50The creams have helped to, like, soften the skin and the peels have obviously, you know,
35:55thinned the skin as well. I think it's brilliant. Really brilliant.
35:59When I used to rub my, like, thumb over my hand, I could feel that it was really thickened.
36:03And now I can feel a lot of difference, which is amazing.
36:07Yeah, you really can. What you've done, even just with the peels, I am so grateful.
36:12Really am so grateful. Oh.
36:15You just don't know what you've done.
36:18Oh. Sorry.
36:19That's okay. But this has been your whole life, hasn't it?
36:23No. Yeah.
36:24No. I think you'll be quite amazed with the feet.
36:27And it's nice because I can wear nice shoes now.
36:30Yeah.
36:31I don't have to wear trainers all the time anymore.
36:34My pleasure. Don't make me cry.
36:36Right. Can I see your feet?
36:39Do you want to? Yes.
36:44Get them up here.
36:48Look at that.
36:49What do you reckon?
36:51That is amazing.
36:55Oh, my goodness.
36:58So, we started taking the tablets about three months ago.
37:01Yeah. That's pretty remarkable.
37:03It is. It's amazing.
37:05You got pink bits on your wee toes.
37:07I know.
37:08I haven't got crusty loaves anymore.
37:10I have feet.
37:11And then, on the actual sole of the foot as well,
37:15I mean, this looks like it's reduced, I'd say, by around about, what, 50%,
37:19maybe even more.
37:20I never thought that I'd get a result like this.
37:22Never thought I'd get a result like this.
37:24Ultimately, what we would like to see, really,
37:26is the rest of all of this thickened scale not being there.
37:29Yeah.
37:30And, obviously, you'll have to keep taking the medicines
37:33and keep using the creams, because if you don't,
37:36it will just build back up again.
37:38As long as it all keeps working, I'm a happy bunny.
37:41I can see.
37:43You've made one lady very, very happy.
37:46Oh, I'm so pleased.
37:47I'm so pleased.
38:04Mr. Kyrene, he hasn't got no keloids anymore.
38:08You can see he's touching my ears and there's no more keloids for him to pull.
38:13I'm just so happy with the results.
38:15I'm so grateful to Dr. Emma.
38:17What I'm looking forward to most about the future
38:19is my friends calling me on a whim and me being like,
38:22yeah, I can come.
38:23And I just don't have to worry about them massive,
38:27big keloids that were once there.
38:29Yeah.
38:29I'm just so happy.
38:31Yeah, I'm really happy.
38:44Back down to see Dr. Emma.
38:47Hiya.
38:49Really positive about what's happened so far.
38:51I'm sure she'll be really pleased.
38:54You look so well.
38:56I feel it.
38:57Like a different person.
38:58Come on.
39:01Tell me how things have been since we last saw each other.
39:04I started treatment about three months ago with the new injections.
39:07By week six, I was almost clear.
39:10That is quick.
39:12I bet you couldn't believe it.
39:1435 years versus six weeks.
39:17By the time I'd had the second injection, you almost couldn't see it.
39:21And how has that made you feel?
39:24Amazing.
39:24Things have really turned positively work-wise.
39:27Being able to handle and react to stressful situations in a better way.
39:31Because I'm not already wound up because of the skin.
39:34Quality of life is improving as well as my physical health.
39:37That's amazing.
39:38Brilliant, yeah.
39:39And what about your family?
39:41I'd like to think they've seen me in a better mood most days.
39:44You're honestly a chilled, cool cucumber now.
39:47Very much so, yeah.
39:48Because your skin is chilled.
39:49Definitely, yeah.
39:50I can't wait to have a look at your skin.
39:58OK, good.
39:59Right, let's have a look.
40:01Shall we look at these arms, first of all?
40:03Look at that.
40:04I mean, really, hardly anything at all.
40:11A slight little glimpse.
40:14But, I mean, perfect.
40:18And then let's have a look at the back, because that was a bit of an issue too.
40:22It's just completely clear, isn't it?
40:23Completely.
40:25Oh, I mean, look at this.
40:28I haven't seen my knees for years.
40:30That is amazing.
40:33And this has only been three months.
40:35Yeah, it was like that after six weeks.
40:38This is quite phenomenal.
40:40So I would say that the trial has been a success and we should continue.
40:43I would agree.
40:46Well done, Matt. Thank you.
40:47I've dealt with psoriasis as far back as I can remember.
40:53I'm finally at the point where I feel like I'm free of it and I can look forward.
40:56Really optimistic about the future.
40:58I can crack on playing the drums to get back into my sports.
41:02It's just absolutely amazing.
41:05It means the absolute world.
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