Dermatology services

Click on the links below to jump to that section:

• General
• Cancer care
• Wilkinson Day Unit
• Vulval
• Drug monitoring
• Paediatric dermatology
• Nurse paediatric
• Leg ulcer and wound healing
• Acne clinic
• Phototherapy service
• Photodynamic therapy
• Medical photography

General

General dermatology clinics are run on a daily basis, delivered from our three acute sites and also from community centres located in Thame and Buckingham. These clinics are designed for the diagnosis and treatment of patients with inflammatory skin conditions (rashes) referred by their general practitioners. The clinics are run by a named consultant working with a team of specialist doctors and nurses. Some patients may require investigations such as blood tests or a skin biopsy, which would generally be taken on the same day, or scheduled at a separate appointment. Most patients can expect to be discharged back to their family doctors after their initial consultation with a management plan. Very few prescriptions will be actually dispensed at the hospital, except in cases of emergency, or lack of availability of the medication in the community. These clinics dove-tail with triage clinics designed for patients with suspected skin cancers and other skin ‘lumps and bumps’.

For more information about emollients and moisturisers, click here.

 

Cancer care

Patients with suspected malignant skin cancers are referred by a special fast-track pathway from the community and can be expected to be seen within 2 weeks and to have their initial treatment within 30 days of their diagnosis. They will be seen and examined by a specialist doctor working with a consultant in charge of the clinic. This clinic is not designed for routine skin consultations or cosmetic concerns. Patients with proven skin cancer are managed as part of a multidisciplinary team consisting of members of a number of hospital departments including dermatology, histopathology, radiology, plastics and reconstructive surgery, oral surgery, and oncology. Buckinghamshire Healthcare Trust has been given recognition as a regional skin cancer centre, able to offer a complete range of modern treatment options for cutaneous malignancies.

 

Wilkinson day unit

This is a service that offers dermatological treatments and education for patients in a daycase setting. It is available for those patients who do not require an overnight stay in hospital and cannot have their treatment carried out at home.

This is a nurse led unit and is supported by the Dermatology Consultants and doctors.

For more information about the day unit, click here.

 

Vulval

The vulval clinic provides diagnosis and management of vulval problems. These include inflammatory conditions, which may produce itching or soreness, precancerous conditions and pain affecting the vulval area. 

Please click on the links below for some useful leaflets:

• Care of vulval skin 

• Lichen sclerosus

• Vulvodynia and vestibulodynia

 

Drug monitoring

We have a dedicated drug monitoring clinic where patients with severe psoriasis, eczema and immunobullous disease who require systemic drugs are managed and followed up. The drugs commonly prescribed include vitamin A derivatives, immunosuppressant drugs and biologics. Services provided include:

• Discussing with the patients the different treatment options available for management of their condition, including their use, effects and side effects, time taken to be effective, and the dosage schedule; and deciding which would be most suited to them.
• Screening using blood tests, and scans where needed, prior to initiating treatment and throughout the duration of treatment.
• Monitoring blood test results and contacting the patients when needed with advice about dose adjustment.
• Periodic assessment of the efficacy of treatment and making decisions in liaison with the patients about stopping a drug or switching to an alternative one if indicated.

 

Paediatric dermatology

We see children of all ages up to the age of 16 with a wide range of skin conditions including:

• Eczema, psoriasis and other inflammatory skin conditions
• Skin infections
• Moles
• Vitiligo
• Hair and nails disorders
• Vulval disorders
• Vascular malformations and other birthmarks
• Photosensitivity
• Rare skin conditions like autoimmune blistering diseases

We offer a large range of treatments including cryotherapy, immunotherapy, iontophoresis and phototherapy. We have close links with other allied services like Allergy and Patch Testing.  Our paediatric dermatology specialist nurse runs her own clinic and offers advice on the practical aspects of skin treatments, as well as providing education and support to children and their families. Children with severe skin disease needing inpatient treatment are admitted to Stoke Mandeville Hospital under the care of the Paediatric Department with regular review by the Dermatology Team. We actively participate in clinical research with the aim of continually improving the treatment of children with skin disease.

 

Nurse paediatric

The Paediatric clinics run in conjunction with the doctor led paediatric clinics.

We provide support, education and practical advice on a wide range of dermatology conditions.

A nurse led food challenge clinic is run for children to see if they have out-grown a food allergy, once they save been seen by our allergy team.

Leg ulcer and wound healing

Patients are referred into this clinic by their GP for advice and management on hard to heal wounds on their legs.

The clinic is nurse-led with supervision from the doctors if required. The clinics run at both Amersham and Stoke Mandeville Hospitals.

A full assessment including ABPI assessments and duplex scans are carried out to obtain a diagnoses.  If arterial disease is suspected the patient is referred to the vascular team for further ongoing management.  If venous disease is suspected a plan of care including compression therapy is usually advised.

If the ulcers are still not healing with a plan of care a biopsy or referral to vascular is sometimes needed.

Patients are usually followed up every three months and cared for in the community or practice nurses inbetween.

For more information on leg ulcer and wound healing, click here

 

Acne clinic

Patients are referred to this clinic by Dermatology doctors, and commenced on Isotretinoin and a plan of care given. Female patients are seen every 4 weeks to check their progress and discuss side effects and repeat pregnancy test and blood test if required. If all of this is satisfactory another four week prescription is issued.

Male patients are seen every eight weeks instead of four.

  

Phototherapy service

We offer whole body and hand/foot phototherapy services (Narrowband-UVB and PUVA) at Amersham and Stoke Mandeville Hospitals. Extended evening and weekend opening hours are also available at Amersham Hospital.

We treat a variety of skin diseases including:

• psoriasis
• eczema
• vitiligo
• polymorphic light eruption
• mycosis fungoides 

Our unit belongs to the South East of England Phototherapy Network that ensures that minimum treatment and safety standards are met.  They also give our phototherapists on-going support, training and education with the aim of encouraging ever improving clinical standards of care for our patients.

 

Photodynamic therapy (PDT)

PDT is a new type of treatment for Solar Keratosis, Bowens Disease and some types of skin cancer, for example Basal Cell Carcinomas.

It involves application of a cream to the lesion to be treated, followed a few hours later by shining a special type of light on to the area.

For more information about Photodynamic Therapy please click here

 

Medical Photography

The Department of Medical Photography has a presence on each of the Trusts 3 main sites and we provide a professional medical photography service to all departments and specialties.  We provide photographs that will form part of a patient’s medical record as well as images for teaching of other healthcare professionals.

When you have been seen by your doctor they may request that you have some clinical photographs taken of your condition so that it may be better recorded and monitored. When you see the photographer they will explain exactly what will happen and what you need to do.

You may be sent directly to see the photographer following your consultation or you will be asked to contact us to arrange an appointment.