Block 5 Centre for GI Health Block 5 Centre for GI Health

Episode 144. Dermatology with Dr Alvin Chong (Part 2)

Clinical problems related to the integument are very common and contribute up to 15% of all general practitioner presentations. Humans are predisposed to a multitude of skin diseases ranging from acne and atopic dermatitis to psoriasis, autoimmune diseases such as SLE, vasculitis, skin cancers, viral exanthems, drug eruptions and external manifestations of internal disease - which in the gastroenterology world have erythema nodosum and pyoderma gangrenosum as interesting examples of these.

Clinical problems related to the integument are very common and contribute up to 15% of all general practitioner presentations. Humans are predisposed to a multitude of skin diseases ranging from acne and atopic dermatitis to psoriasis, autoimmune diseases such as SLE, vasculitis, skin cancers, viral exanthems, drug eruptions and external manifestations of internal disease - which in the gastroenterology world have erythema nodosum and pyoderma gangrenosum as interesting examples of these. 

Given our love affair with the sun it’s not surprising to learn that skin cancer will affect 2 in 3 Australians in their lifetime. About 2000 Australians die each year from melanoma and non-melanoma skin cancer - 800 more than the number of people dying from car accidents annually in Australia bringing into perspective the impact of this disease alone.

Inflammatory skin diseases such as acne and eczema are also very common. They are a cause of serious morbidity, both physical as well as psychological – a child with severe eczema has a burden of disease that is worse than a child with diabetes. Have you ever had itchy skin? This is one of the most distressing symptoms one may experience.The mental health issues of patients with skin disease can be severe. A recent meta-analysis of patients with alopecia areata for example found that up to 17% of those patients required professional help for symptoms of anxiety and depression.

A skin problem is very visible and yet, in the hierarchy of “medical student teaching” – dermatology is treated almost as an optional extra.  In recent years advances in skin management have been significant especially following the discovery of TNF inhibitors such as Adalimumab used in dermatology for moderate to severe psoriasis as well as in both rheumatology and gastroenterology. 

In this podcast I was curious to learn more about dermatological management, the new horizons of treatment, possible role for AI in assisting diagnosis as well as to be reminded of key tips that would be useful in primary care.

It was a real honour to discover Melbourne dermatologist Dr Alvin Chong, founder of an internationally acclaimed podcast called Spot Diagnosis that has been ground-breaking in bringing the specialty of dermatology to general practice and medical students. Alvin has established himself as a key educator in this field and has received accolades from the RACGP recognising his achievements and contribution to education.

Alvin has public appointments as Visiting Dermatologist and Director of Dermatological Education at St Vincent’s Hospital Melbourne and Head of Transplant Dermatology Clinic at Skin Health Institute. He is Adjunct Associate Professor at the University of Melbourne. 

Please welcome Alvin to the Podcast.

References:

Dr Alvin Chong

⁠http://spotdiagnosis.org.au/⁠

⁠https://www.skinhealthinstitute.org.au/page/370/spotdiagnosis⁠

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Block 5 Centre for GI Health Block 5 Centre for GI Health

Episode 143. Dermatology with Dr Alvin Chong (Part 1)

Clinical problems related to the integument are very common and contribute up to 15% of all general practitioner presentations. Humans are predisposed to a multitude of skin diseases ranging from acne and atopic dermatitis to psoriasis, autoimmune diseases such as SLE, vasculitis, skin cancers, viral exanthems, drug eruptions and external manifestations of internal disease - which in the gastroenterology world have erythema nodosum and pyoderma gangrenosum as interesting examples of these.

Clinical problems related to the integument are very common and contribute up to 15% of all general practitioner presentations. Humans are predisposed to a multitude of skin diseases ranging from acne and atopic dermatitis to psoriasis, autoimmune diseases such as SLE, vasculitis, skin cancers, viral exanthems, drug eruptions and external manifestations of internal disease - which in the gastroenterology world have erythema nodosum and pyoderma gangrenosum as interesting examples of these. 

Given our love affair with the sun it’s not surprising to learn that skin cancer will affect 2 in 3 Australians in their lifetime. About 2000 Australians die each year from melanoma and non-melanoma skin cancer - 800 more than the number of people dying from car accidents annually in Australia bringing into perspective the impact of this disease alone.

Inflammatory skin diseases such as acne and eczema are also very common. They are a cause of serious morbidity, both physical as well as psychological – a child with severe eczema has a burden of disease that is worse than a child with diabetes. Have you ever had itchy skin? This is one of the most distressing symptoms one may experience.The mental health issues of patients with skin disease can be severe. A recent meta-analysis of patients with alopecia areata for example found that up to 17% of those patients required professional help for symptoms of anxiety and depression.

A skin problem is very visible and yet, in the hierarchy of “medical student teaching” – dermatology is treated almost as an optional extra.  In recent years advances in skin management have been significant especially following the discovery of TNF inhibitors such as Adalimumab used in dermatology for moderate to severe psoriasis as well as in both rheumatology and gastroenterology. 

In this podcast I was curious to learn more about dermatological management, the new horizons of treatment, possible role for AI in assisting diagnosis as well as to be reminded of key tips that would be useful in primary care.

It was a real honour to discover Melbourne dermatologist Dr Alvin Chong, founder of an internationally acclaimed podcast called Spot Diagnosis that has been ground-breaking in bringing the specialty of dermatology to general practice and medical students. Alvin has established himself as a key educator in this field and has received accolades from the RACGP recognising his achievements and contribution to education.

Alvin has public appointments as Visiting Dermatologist and Director of Dermatological Education at St Vincent’s Hospital Melbourne and Head of Transplant Dermatology Clinic at Skin Health Institute. He is Adjunct Associate Professor at the University of Melbourne. 

Please welcome Alvin to the Podcast.

References:

Dr Alvin Chong

⁠http://spotdiagnosis.org.au/⁠

⁠https://www.skinhealthinstitute.org.au/page/370/spotdiagnosis⁠

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Block 2 Centre for GI Health Block 2 Centre for GI Health

Episode 40. Mole mapping and skin cancer surveillance with Dr Archie Xu

Non-melanotic skin cancers and melanoma are the most common cancers affecting humans. At least two in three Australians will be diagnosed with skin cancer before the age of 70 years and the risk is higher for men than women. Whilst basal cell carcinomas and squamous cell carcinomas are more common they are not as lethal as melanomas which are referred to as Australia’s “national cancer”. Indeed in 2020 it is estimated that 16,200 will be diagnosed with melanoma, that is one new case every half hour and a death every five hours.

Non-melanotic skin cancers and melanoma are the most common cancers affecting humans. At least two in three Australians will be diagnosed with skin cancer before the age of 70 years and the risk is higher for men than women. Whilst basal cell carcinomas and squamous cell carcinomas are more common they are not as lethal as melanomas which are referred to as Australia’s “national cancer”. Indeed in 2020 it is estimated that 16,200 will be diagnosed with melanoma, that is one new case every half hour and a death every five hours.

Skin clinics have emerged embracing mole mapping to assist in the diagnosis and management of melanotic skin cancers as well as non-melanotic skin cancers and we are grateful to have a conversation today with Dr Archie Xu who has been running a suburban skin cancer clinic for many years. He joins us to discuss:

· Mole mapping

· Dermoscopy

· Melanoma and non-melanotic skin cancer

I am most grateful to have had this discussion with Archie on a very important subject particularly relevant to our sun-drenched outdoor lifestyle. Please join me with Archie.

Useful references include:

www.ozscc.com.au

www.melanoma.org.au

www.cancer.org.au

www.cancercouncil.com.au

To be a guest on the show or provide some feedback, I’d love to hear from you: manager@gihealth.com.au

Dr Luke Crantock MBBS, FRACP, is a gastroenterologist in practice for over 25 years. He is the founder of The Centre for GI Health, based in Melbourne Australia and is passionate about educating General Practitioners and patients on disease prevention and how to manage and improve their digestive health.

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