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Last Updated: Monday, 27 February 2006, 06:29 GMT
Inside Medicine - the Dermatologist
Dr Tim Clayton
'We need to stay hospital based'
In a series focusing on medical specialisms, the BBC News website meets Dr Tim Clayton, who talks about dermatology.

Dermatology is the branch of medicine that deals with the care of the skin and conditions and disorders associated with it.

WHAT IS YOUR JOB?

I am a specialist registrar in dermatology (a skin specialist), at Leeds General Infirmary. I see and treat skin disorders.

Essentially dermatologists get referred any patient with a problem with their skin, from acne or psoriasis, to weird and wonderful skin rashes, skin cancers and disorders of the hair.

WHAT IS THE MOST COMMON CONDITION?

The most common conditions we treat are acne, eczema and psoriasis.

People with these conditions might be treated by their GP, but if they have failed to respond to treatment or it gets much worse than normal they will be referred to us by their GP.

It is a bit like plastic surgery, but not as exotic
Dr Tim Clayton

We also get referred cases of acute skin problems like urticaria (a severe outbreak of itchy hives) or angioedema (which causes swelling).

We can also get referred allergic rashes to prescribed drugs, people who have used hair dyes that they are allergic to.

They might have a serious allergic reaction and we have to see them urgently through Accident and Emergency.

If they have a reaction to a new drug it can be a few spots or their skin can start to peel off.

We also get referred a lot of skin cancers, which are the bulk of our work. We get not only the melanomas, but the age related skin cancers as well.

WHAT IS THE MOST COMMON PROCEDURE?

We do biopsies and we also remove skin cancers. And when we do that we sometimes have to do grafts to cover the holes where the tumour was. It is a bit like plastic surgery, but not as exotic.

WHAT IS THE HARDEST THING ABOUT YOUR JOB?

I think sometimes the skin cancer clinics can be quite a hard part. If you have to tell somebody that they have a skin cancer, particularly if they are quite young. That can be upsetting.

But apart from that there is very little that I do not enjoy about the job.

And even skin cancer clinics can be rewarding when you tell somebody they might have a cancer and then you find they don't.

WHAT IS YOUR MOST SATISFYING CASE?

I particularly enjoy managing successfully children with severe eczema who have previously had numerous treatments and been quite poorly and then we get their eczema under control.

Also we had one man who was in his 40s who has psoriasis and awful problems with his skin. He had been to his doctor and had topical creams and phototherapy treatment, but none of these had worked and then he tried the new treatments and within a few months they started to work.

WHY DID YOU CHOOSE THIS SPECIALT?

I think there are lots of reasons. We see patients in the wards and around the hospital so we see them in all situations. We have lots of treatment options and we are even able to do surgery,.

We can remove something from someone's face and then when we see them a few months later and there is no trace of it and that is rewarding.

There is quite a lot of satisfaction in seeing the patients improve. You can see the organ you are treating unlike most of the other specialties.

I think it is one of the busiest specialties during the day, but there is not much night work.

IF YOU HAD YOUR TIME AGAIN WOULD YOU CHANGE YOUR SPECIALTY?

I would not change it at all. I am very happy.

HOW DO YOU SEE THE ROLE DEVELOPING IN THE FUTURE?

I think it is important that this specialty remains a hospital specialism, because the patients with skin cancer and life threatening skin diseases should be managed in the hospital.

I am worried that we might be moved out into the community and lose our hospital beds, GPs with special interests in subjects like dermatology have an important role, but seeing one of these is not to be confused with seeing a dermatologist.

CV - Dr Tim Clayton
1995: Qualified Liverpool University Medical School with a Bachelor of medicine and surgery
2000:Member of Royal College of Paediatrics and Child Health (MRCPCH)
2000-2001: One year working in New Zealand ( as paediatric registrar)
2001:Commenced dermatology training in Manchester
2003: National training scheme in Leeds
June 2006:Due to complete training





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