For skin cancer and other dermatological conditions, accessing specialist care when needed is as important as before the pandemic.
Skin conditions have been identified as Covid-19 symptoms, from the chilblain like covid toe (or finger) to various rashes. They tend to be associated with serious cases but that is not always true.
Dermatologists are working together to analyse symptoms, which for some patients are the only sign of coronavirus. This plays a role in detection, supporting patients and reducing the spread of infection.
A useful factor, although we must also take note of an issue for the whole medical profession. Allowing Covid-19 to override other treatment could in the long term cause more harm than the virus itself.
The 2019 UK long term health plan looked forward to patients accessing more care through digital technology. Arrival of the coronavirus pandemic has acted as a catalyst, for far more rapid implementation of change.
On the surface, this involves greater use of phone, or particularly video technology. A helpful way for doctor and patient to communicate.
In the background, conventional consultation models and patient management systems needed a redesign, to ensure accessibility and efficiency. Staff had to be trained and become comfortable with the approach.
Considering the timescale, a notable amount of research has gone into teledermatology and patient reaction. This has included the effect on specific conditions, such as eczema, psoriasis and skin cancer.
That many patients ideally prefer a face to face meeting is no surprise, we will be pleased when direct contact is no longer an issue. Even so, the results of surveys and studies have been surprising.
Satisfaction is high for telephone consultations but for video link, far higher than foreseen. Only a small proportion of patients had issues with the technology and very few consultations failed to complete.
There are still issues to overcome, including a national shortage of dermatologists. This increased when hospital dermatology staff were diverted to other duties and training of future specialists has suffered.
Both medical teaching centres and professional bodies are now working to correct the balance. Staff reassignment is better controlled, online webinars, or lectures have increased in number and in standard.
Throughout lockdown, care levels did suffer but since then, offering treatment wherever possible has been the key, a position which continues.
Treatment for serious skin cancers such as melanoma, or squamous cell carcinoma remained available throughout. Care for less invasive conditions, such as basal cell carcinoma, or other skin conditions can now be accessed.
Early diagnosis and treatment for a range of skin conditions increases cure rates and enhances life. Ensuring visits to specialist clinic are available matters and avoids a need for harder to access treatments, such as immunotherapy, or radiotherapy.
Health Based Decisions
Living with Covid-19 is an ongoing requirement and has practical outcomes. Staff skin health can suffer from the use of PPE, patients are not always able to access care as they would choose, training and conferences can be postponed.
None of this is ideal but each obstacle can be overcome. Specialist clinics such as ours are able to operate effectively, our patients receive the support they require and see their health protected.
There will be times when acceptance of different routines and patience are needed but not to the extent of early lockdown. We remain open for treatment during coronavirus and believe medical facilities should do so.