The adult dermatology department provides a variety of services, covering a variety of skin conditions including eczema, psoriasis and skin cancers including malignant melanomas, basal cell carcinomas and squamous cell carcinomas.
There are consultant and nurse specialist clinics that are focused on skin cancer or chronic conditions, and nurse led clinics for light therapy, dermatology day treatment unit, photodynamic therapy, omalizumab, triamcinolone, patch testing, dressings and biopsy theatre. We also offer treatment to hair, nail and vulval conditions.
The service also provides Teledermatology to provide rapid access to potential cancer diagnosis.
The adult dermatology department is located at the Treatment Centre on the QMC campus and consists of 12 clinic rooms on Gateway A and 3 skin surgery theatres on Gateway G. There are approximately 80 members of staff (60 clinical and 20 non-clinical) in the department including doctors, nurses, HCA’s, CNS’s, and admin staff.
There has been a Mohs service provided in Nottingham for almost 20 years. Currently we have three experienced Mohs Surgeons, Dr Sandeep Varma, Dr Anand Patel and Dr Ashish Sharma.
We run a yearly fellowship programme to train the next generation of Mohs surgeons. Our 12th fellow is Dr Richard Jerrom
What is Mohs surgery?
This is the Gold Standard treatment for facial skin cancers and is mostly performed for basal cell carcinoma in cosmetically sensitive areas such as the eyelids, nose, lips and ears. It has the highest cure rate for skin cancers. It can also be used for Squamous Cell Carcinomas and some rarer cancers.
We receive referrals from Nottingham Dermatology and Ophthalmology as well as patients from Derby, Kings Mill, Newark and other hospitals.
Because we are the only hospital in Nottinghamshire to undertake Mohs surgery, the volume of cases and the COVID pandemic has meant that waiting times for Mohs surgery have to be considered when deciding which method to treat a skin cancer. It is perfectly acceptable to consider having simple [wide] local excision, radiotherapy, photodynamic therapy, cryotherapy, curettage or cream treatment if this is appropriate. Feel free to discuss these with your Doctor.
Please see link: https://jamanetwork.com/journals/jamadermatology/fullarticle/2764796
Our Mohs service is currently involved in research aimed at detecting BCC automatically during Mohs surgery with a machine which we have invented.
Meet the team
Dr Sandeep Varma
I trained as Dermatology registrar in Cardiff and undertook a Mohs Fellowship in Portland, Orgeon, USA with Dr Neil Swanson and Dr Ken Lee.
I have been involved with Mohs surgery for about 20 years. I have trained 11 Mohs fellows. I am currently Honorary (Consultant) Assistant Professor, Lead for Skin Cancer services, Lead for Skin Surgery and Chairman of the Nottinghamshire Multidisciplinary Team for Skin Cancer. My theme of Research is the automated detection of basal cell carcinoma during Mohs surgery
Dr Anand Patel
I completed my specialist training in Nottingham and was awarded my Certificate of Completed Training (CCT). I then went on to complete a board certified and nationally approved Mohs Micrographic Surgery fellowship here in the UK under the guile and supervision of 2 experienced UK Mohs surgeons.
I perform over 200 Mohs procedures a year and have been involved in the training of 6 Mohs fellows to date. I am currently Clinical Lead for the whole Dermatology service, Vice Chair of the Nottinghamshire Multidisciplinary Team for Skin Cancer, as well as adviser to the Divisional Board. I am heavily involved in Research and publications which in the main encompass Skin Cancer, Skin Surgery and Wound healing.
Dr Ashish Sharma
I graduated from Cambridge University, with further study at University College London. Following specialist training in the West Midlands, I completed a formal post-CCT fellowship and now perform around 140 Mohs cases per year. I am member of both the skin cancer and lymphoma MDTs.
I have authored scientific articles, learning modules, a textbook chapter and UK guidelines for cancer management. I participate in research at the level of Principal Investigator.
Dr Richard Jerrom
I completed my medical degree and foundation training in Nottingham, before moving back to the West Midlands to undertake my core medical and dermatology registrar training. In 2019 I was awarded ‘West Midlands Trainee of Year’ out of recognition for the number of leadership roles that I have held, both within the West Midlands and nationally, including a position on a national guideline committee. It also recognised my achievements and contribution to teaching, publications and clinical improvement to date.
It has always been my ambition to become a Consultant Mohs surgeon and in August 2020, having qualified as a dermatology consultant, I returned to Nottingham to join the team for a 12-month fellowship, becoming their 12th Mohs surgical fellow. Having considered a number of Mohs fellowships, I choose to apply to Nottingham because of their excellent team and facilities, but also to have the opportunity to learn, once again, from the Mohs surgeons who first inspired me into dermatology when I was at medical school.
The Consultant and CNS clinics run daily occupying all 12 clinic rooms.
Skin Cancer SSMDT meetings are held every Thursday afternoon to discuss treatment options for complex patients. Oncology, Radiology, Plastics and Ophthalmology colleagues attend and help form the SSMDT.
The Light therapy and dermatology day treatment unit runs every Monday, Wednesday and Friday and treats up to 80 patients a day.
The dressings and biopsy clinic runs daily, treating 25-30 patients per day, and finally, the Patch clinic runs on Monday and Friday, and our photodynamic therapy runs on Tuesday and Thursday.
The department runs a yearly MOHS fellowship for dermatology doctors to specialise in Mohs surgery. Mohs surgery is considered the most effective technique for treating many basal cell carcinomas and squamous cell carcinomas, the two most common types of skin cancer.
For very complex reconstruction post-Mohs surgery we work alongside the ocular surgeons and plastic surgeons.
Meet the team
Head of Service
Dr Anand Patel
Specialty General Manager
Dr Sandeep Varma
Dr Shanti Ayob
Dr Ashish Sharma
Dr Rosalind Simpson
Dr Sowjanya Ayyalaraju
Dr Kyle Tang
Dr Jane Ravenscroft
Referrals are accepted from other hospitals, consultants within the Trust and from GPs within primary care through the NHS e-Referral service
The NUH adult dermatology will provide a full elective and outpatient service Monday to Friday and a limited acute service as described below.
The Paediatric Dermatology service will continue to run independently within the Family Health Directorate and will provide a full service to local children. The remaining Paediatric consultants will not be able to see adult patients.
|Adults||In medical emergencies with primary dermatology issue (90% BSA affected, widespread desquamation, skin failure, systemically unwell, with or without established skin diagnosis), please arrange admission via ED to general medical ward.|
|Adult Dermatology Emergencies (NUH Inpatients & A&E)||
Referral to dermatology should be made by the medical team Consultant via Nervecentre. This is a Monday-Friday 9am-4pm service and the on-call dermatologist is alerted via a mobile device once certain referral criteria are met.
There is no on-call dermatology service for out of hours. Appropriate referrals will be picked up the following morning via Nervecentre.
In extreme emergencies that a dermatology opinion is going to significantly affect the patient's outcome, the attending medical consultant can contact consultant dermatologist via switch for advice remotely.
Urgent outpatient referrals
For outpatient/GP advice:
Contact dermatology via NUH switchboard (stating whether it is for adult dermatology or paediatric dermatology) between 9am-4pm, Mon-Friday. The message will be reviewed by consultant in-hours who will call to offer advice or arrange an appointment if deemed necessary by Dermatologist.
In case of dermatology emergencies which cannot wait until next working day, see above under Emergencies.
Please avoid referrals which can be dealt with post-discharge. Chronic conditions should, in general, only be referred by primary care to dermatology service.
For advice regarding skincare for patients with established dermatology diagnosis, please refer to the last clinical letter on DHR.
For patient require dermatology input during inpatient care, please referral to NUH dermatology via Nervecentre. This is a Monday-Friday 9-4 service and the on-call dermatologist is alerted via a mobile device. Please take photos via Nervecentre or arrange medical photographs of skin condition so that they can be reviewed by the Dermatologist.
Where appropriate, patients who are ambulatory, systemically stable and non-infectious may be offered an appointment at the Treatment Centre during their inpatient stay at NUH. If this is not possible, the Treatment Centre consultant will offer advice but will not be responsible for the management of the patient – this will remain with the consultant under whom they have been admitted at NUH.
|Suspected Skin Cancer||NUH inpatients: For incidental finding of suspected skin cancers during inpatient stay, please refer via Skin Cancer 2 week-wait referral to Dermatology-NTC2@nuh.nhs.uk.|
|Routine Referrals (GP or NUH)||
Please consider Advice & Guidance via ERS or Teledermatology service for diagnostic uncertainties.
Always use F12 guidance/intranet guidelines to ensure compliance with referral guidance. We can only accept your referral if it complies with the referral guidance. For routine referrals, refer to Treatment Centre on NHS E-Referral system.
For appointment queries, please contact Treatment centre on (0115) 919 4477 Ext: 78990.
For secretaries to dermatologists, Ext: 78941
|Post-operative complications from TC||A wound check nurse is available at the Treatment Centre and patients will have been given the contact details on discharge. If call received at NUH, advise patient to contact the nurse at TC direct on 07812 268 113. Out of hours, contact the NUH Plastics Registrar through switchboard on 0115 924 9924.|