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Articles in Category: General

General information about Palm Clinic, Auckland's leading cosmetic surgery centre


What Does a Skin Biopsy Involve?

Dermoscope

Our skin cancer expert, Dr Martin Denby, performs skin checks for cancer using a special tool called a dermoscope. This detects early skin cancers much more effectively than simply looking at your skin. He will recommend a skin biopsy if he is concerned that a skin lesion might be cancerous.

A biopsy is the removal of a small piece of skin that is then sent to the laboratory for examination under the microscope by a specialist doctor called a histopathologist. To take a skin biopsy, first local anaesthetic is carefully injected under the skin. The pain level is no worse than a blood test. A small piece of skin is then removed either with a punch biopsy tool or a special shave blade, shown below:

With a punch biopsy tool a small 3-6mm circle of skin is removed, a single stitch is put in to hold the wound together and the stitch is taken out a week or so later. With a shave biopsy, the blade is used to shave the top layer of skin (epidermis) and the top of the layer beneath this (dermis). No stitches are needed. A dry dressing is applied, you are asked to keep it dry for 24 hours and you can then have a shower with the dressing on. Both biopsies usually heal very well leaving minimal, if any scarring.

Cryotherapy - Liquid Nitrogen

Cryotherapy - Liquid Nitrogen for superficial skin cancer

What is Cryotherapy (Liquid Nitrogen)?

Liquid nitrogen is an extremely cold liquid used to treat skin lesions by freezing them. Sun damage, warts and some early or superficial skin cancers can be treated safely and effectively if used according to guidelines. It is applied in a fine spray using a cryotherapy gun like the one shown below.

Liquid nitrogen is -196.8C and freezes the skin cells to -50C. This forms ice within the cells, causing cell death. The liquid nitrogen is sprayed for 3-30 seconds depending on the skin lesion.

Using liquid nitrogen to make frozen desserts and cocktails at your table has become very popular in restaurants recently. Sadly we are not able to do this at Palm Clinic.

We ARE able to treat your skin lesions with liquid nitrogen at Palm Clinic.  We recommend an appointment with Dr Denby, our skin lesion expert to determine if it is the right treatment for you.

Skin Cancer Appointment

Skin Cancer Appointment

Your Skin Cancer Appointment

Have you ever wondered what happens during a skin cancer consultation? Here’s how it goes at Palm Clinic.

Our skin cancer doctor, Dr Martin Denby, sees you for 20 minutes. He’s a highly experienced GP with extra qualifications in treating and diagnosing skin cancer. He is currently completing his Masters Degree in Skin Cancer Management at the University of Queensland.

First Dr Denby asks where you were born, if you had blistering sunburns as a child, if you or anyone in the family has had skin cancer, how you use sunscreen and whether you’ve noticed any moles changing, itching or bleeding.

He then examines your entire skin surface from head to toe. This means looking at your scalp, armpits, groins, buttocks and feet. It’s really important your skin check is this thorough: you’re being short changed otherwise. There’s no need to be embarrassed. You’ll get to stay in your underwear and he will provide you with privacy while undressing and a towel for dignity.

Dr Denby will look over your skin for any lesions then check each one thoroughly with a special skin microscope called a dermoscope. The dermoscope is the key to finding skin cancers early. Research shows that even the most highly trained experts can only diagnose melanomas with 60% accuracy with the naked eye. With a dermoscope however, accuracy increases to 90% or more. The dermoscope enables him to look beneath the top layer of the skin (epidermis) into the deep layer (dermis) to reveal telltale signs of early melanoma and other skin cancers.

If he identifies any skin lesions of concern, he will either do a biopsy or a complete excision depending on the situation. This is booked around a week later and takes place at Palm Clinic under local anaesthetic. Dr Denby is very skilled and gentle so the pain is no worse than a blood test.

Should there be a skin lesion that does not look completely normal under the dermoscope, but has a low index of suspicion for melanoma, Dr Denby will take a high-powered digital dermoscopic photograph of the lesion. He will then see you again in 3 months to re-photograph the lesion and look for any subtle changes on the dermoscopic images. If there are no changes, the lesion is over 99% likely to be benign. If there are any changes it can be excised.

Dr Denby recommends most people should have a skin check every 12 months. Detecting and treating skin cancers early makes a big difference to survival rates from NZ’s most common cancer.

Mole checks

Skin Cancer Checks

Skin Cancer photos.

Winter time means our skin is well covered with clothing and we have generally forgotten about the deleterious effects of the sun.  The UV damage that stimulates skin cancer change has been shown to be worse in our younger years and the resultant cancerous change typically takes many years to appear.

Melanoma typically arises as a result of a genetic tendency although a sub type called melanoma in situ arises as a direct result of sun exposure. Normal benign moles (naevi) can undergo malignant change to form melanomas and the usual ABCD (Assymetry, irregular Border, Colour change and Diameter >6mm) signs should be watched for.

Most other skin cancers reflect the degree of UV damage particularly when we are vulnerable as children and young adults.  The first sign of UV damage on the skin is generally small scaley patches on the face and other sun exposed areas of the body.  These are actinic keratoses (AK's) or solar keratoses and they tend to go through cycles of heaping up keratin causing the scaley patch which often comes off or is picked off leaving the skin smooth for a while until the keratin builds up again.  AK's are a precancerous lesion which may change to skin cancer if left unattended.  It is a good idea to have your skin checked if you are getting this type of problem particularly if they are multiple areas on the face or scalp.

For those who have a BCC or SCC or melanoma previously they are at significantly increased risk of a new skin cancer and should have regular skin checks.

Dermatoscopy Course

The Doctors at Palm Clinic recently attended a dermatoscopy course to hone our skills at detecting skin cancers. With New Zealand having amongst the highest rates of skin cancers in the world, it's important that we, as clinicians are excellent at detecting skin cancer early. The course, run through the University of Queensland, is internationally recognised, and covers dermatoscopy and advanced surgical management of Skin Cancer. Dermatoscopy allows early skin cancer changes to be detected long before these changes are visible to the naked eye.

We were lucky to gain Dr. Martin Denby last year, who works exclusively in detecting and treating Skin Cancer at Palm Clinic. He is working towards his Masters in Skin Cancer

We highly recommend having a full body skin check once per year if you have had high sun exposure, sun burn or a family history of skin cancer. Much like a warrant of fitness on your car, it's a way to check for potential problems that may not be visible to you before they become major ones.

Palm Clinic is an Affiliated Provider to Southern Cross Health Society for skin cancer treatment, skin biopsies, and skin cancer surgery. Medical necessity criteria apply.

Testimonials

Botox, Dermal Fillers and Laser Testimonials

Here are some of the many testimonials received from clients of Palm Clinic.

"I am very happy indeed with the treatment I had. What made all the difference was the wonderful Doctor I saw, who explained everything so well, and made such good explanations suggestions as to the treatments available."  SB Age 49

"Just to say a big thank you to you for my treatments. I am really please with the results and feel fantastic. Look forward to my next visit. I so appreciate the input for Dr Sarah Hart and Dr Sam Dunn as well. Thanks so much again."  KT

"I am thrilled with the laser treatment results." DM Age 45

 "Having the dermal filler was so easy and looks so natural, it’s like magic!" SD Age 45

 “After treatment I now don’t look tired all the time, my make-up looks better as no creases. It has made me feel better with everything, especially at stressful situations at work. It’s been really good, I love it!”  LV Age 36

ELOS to face and neck for facial redness and pigmentation. “My face looks fantastic, I had no idea your IPL could do such a wonderful treatment. Thank you so very much.”  BN Age 54

Elos TO FACIAL PIGMENT:  “I am so pleased and amazed at how well the treatment is working’.

“Oh my goodness, the Botox result is fantastic. Thank you Clare. I can’t believe how well it works”.  FT Age 40

ELOS to pigmentation & uneven colouring. “It’s fantastic, I’m absolutely thrilled. My skin looks amazing, and much smoother”.  JD Age 56

Fraxel treatment to severe melasma pigmentation and Dermal Filler:  “I just wanted to let you know I couldn’t be happier all thanks to the Fraxel, and then also the Dermal Fillers, thank you so much.”  SH Age 20+

“Fantastic results thank you. After a few days of your treatment serums the redness to the skin on my neck and chest has gone down a lot, and the skin is so much smoother”. JL

"You’ve given me exactly the Botox results I wanted, wonderful, thank you”  CM Age 45

“I just wanted to tell you how lovely it was to received a phone call from you after my treatment, even though I am a long standing client of Palm Clinic.”  JC Age 70

After just one Fraxel Laser Treatment to Melasma:  “Now I have beautiful clear skin with only the very smallest sign of melasma, I am really, really happy with the results. When I look closely I can see a very faint shadow, but otherwise all the melasma has all gone. I don’t need to wear make up all the time which is great”. Thank you so much!  HP Age 49

"Everyone should come to Palm Clinic for their Botox and Fillers. If only people knew that Botox and Fillers don’t have to make you look like those overdone women in magazines. Who is advising them?! They should go to Palm Clinic, you make everyone look so lovely and natural." KP Age 46

"What she did was absolutely brilliant, so good I can’t even see where the problem was! I’m so glad I came to Palm Clinic."   A.L. Age 60+

Are you bothered by annoying skin lumps and bumps but don't want them surgically cut out?

Here at Palm Clinic we are able to offer the removal of such benign skin lesions by
using and alternative device called Surgitron.

Under local anaesthetic the lesion is "shaved" off instead of being cut out, so no
stitches are required!

If you have any such lumps or bumps give us a call and we can see you for a
consultation.

Day Stay Hospital Accreditation

Palm Clinic has recently completed an organisation wide survey by DAA Group Ltd for day stay hospital accreditation which has been awarded until November 2015.  Although this applies to all treatments provided at Palm Clinic it is particularly applicable to liposuction, endovenous laser ablation and ultrasound guided sclerotherapy for varicose veins and skin cancer surgery.

The following were assessed and passed:

Clinical Function

Standard 1.1: Consumers/patients are provided with high quality care throughout the care delivery process

Standard 1.2: The organisation provides care and services that achieve effective outcomes.

Standard 1.3: The organisation provides safe care and services.

Standard 1.4: The organisation is sensitive to the diverse needs of individual consumers/patients.

Support Function

Standard 2.1:  The governing body leads the organisation in its commitment to improving performance and ensures the effective management of corporate and clinical risks.

Standard 2.2:  Human resources management supports quality health care, a competent workforce and a satisfying working environment for staff.

Standard 2.3:  Information management systems enable the organisations goals to be met.

Standard 2.4:  The organisation encourages and adequately governs the conduct of health and medical research to improve the safety and quality of health care.

Corporate Function

Standard 3.1:  The governing body leads the organisation's strategic direction to ensure the provision of quality, safe services.

Standard 3.2:  The organisation maintains a safe environment for employees, consumers/patients and visitors.

Skin check by dermascope?

Malignant Melanoma

Malignant melanoma

What is the best way of detecting and monitoring for skin cancers?  The Australasian skin cancer guidelines suggest that a full skin and mole check by an experienced doctor using dermoscopy is the best way to thoroughly review your skin and detect early skin cancers.

Serial photographs such as mole map are clearly useful for detecting change in a mole but dermoscopy shows very early changes in pigmented lesions.  The earlier a melanoma is detected (before it thickens) the better the prognosis. 

Our recommendation is to have an annual skin check particularly if you have a past history or family history of skin cancer.

Palm Clinic is an Affiliated Provider to Southern Cross Health Society for skin cancer treatment, skin biopsies, and skin cancer surgery. Medical necessity criteria apply.

Skin checks & skin cancer surgery

Affiliated Provider Southern Cross Healthcare

Skin checks & skin cancer surgery

Palm Clinic is now an Affiliated Provider to Southern Cross Healthcare for consultations for skin cancer, skin biopsies, liquid nitrogen and skin cancer surgery.

Any suspicious skin lesions are biopsied and any skin cancers are removed surgically.  Actinic keratosis ( a precursor to skin cancer ) is treated with liquid nitrogen and seborrhoeic keratoses which are causing irritation can also be treated.

Dr Martin Denby has recently joined Palm Clinic and he has a special interest in skin cancer with postgraduate certificates in dermoscopy and dermal imaging plus skin cancer surgery.

Dr Martin Denby

Dr Martin Denby

Dr Martin Denby is the latest doctor to join Palm Clinic.  Martin has a special interest in skin cancer diagnosis and management.  He has post graduate certificates in dermoscopy and dermal imaging plus skin cancer surgery.

Palm Clinic is now an affiliated provider to Southern Cross for skin checks, skin biopsy and skin cancer surgery.  Under this arrangement you are entitled to an annual skin check and treatment of any suspicious skin lesions.

Skin care made easy.

I am often amazed at the marketing power out there that drives women (and men) to spend an absolute fortune on skin care. A friend of mine recently asked me what's good to use on your face, and she told me her mother had a $1500 tub of face cream! I just about fell off my chair. I don't doubt that that product is good, but in my mind there is no need to spend anywhere near this much on good, proven skin care. There is a mentality out there that the more you pay the better a product is, and this is not always the case.

UIP meeting Monaco

International Vein Meeting in Monaco

Dr John Barrett from Palm Clinic has been invited to give a presentation at the UIP (Union Internationale Phlebologie) meeting in Monaco at the end of August. He will also act as moderator for two of the UIP sessions.