Michelle Rupp: Good morning and welcome to this episode of AFMC TV. We’re so happy that you’re tuning in. We’re starting this week’s episode with Catch Up on Your Checkup and today we’re talking with a dermatologist. Rebecca Denniston is joining me this morning. Good morning.
Rebecca Denniston, PA-C: Good morning.
MR: Thanks for coming in.
RD: Thanks for having me.
MR: So, we are heading into Labor Day weekend, kind of the unofficial end of summer, although we know we can still feel the summer heat well into October. We’ve spent the summer at the pool and at the lakes and at the beach. And all right, our skin is … When an appropriate time to go ahead and schedule that appointment? To get in and see a dermatologist?
RD: So really what I say is any time of year is the perfect time of year to get a skin check, but a lot of people do wait until fall or winter. 80% of our sun exposure is in the spring and summer months, so, a lot of people have a natural tan throughout the summer and so they’ll wait until fall or winter um to come in for their skin checks. But really, I tell people any time of year is fine. But a lot of people do wait until you know fall.
MR: If you’ve never been to a dermatologist, you know because you guys are really scary, what do you say to someone? How do they prepare? How do you put them at ease?
RD: There’s nothing to be anxious about. You know, they’re really pretty quick visits honestly. So, anybody who’s been in for their first time, we kind of go over your family history. Does your mom or dad have a history of skin cancer? Do you have a history of skin cancer or pre-cancer? We talk about tanning bed exposure. You know, do you wear sunscreen? And then we do a full-body skin exam on you. So, we get you in a gown typically and we look at your head to toe. We’re checking, you know, all the places that you don’t normally see on yourself, so your scalp, your back, that kind of thing. But we look, you know in between the toes. We looked everywhere. But they’re quick visits and if we see anything abnormal a lot of times we’ll do that biopsy within the visit. It’s a pretty quick procedure to do that and then we’ll send that tissue to our pathologist, and they’ll check it, and hopefully, it’s all fine. But it’s always good to take that preventative step and get checked.
MR: Absolutely. You’re mentioning a skin check. Go ahead and define that.
RD: Yes. So, a skin check is just a thorough examination and that’s kind of what we typically call it. A full-body exam is another name for it. But it’s just where we’re checking anything that you may be worried about. We have a lot of people who come in and they’ve noticed maybe a mole is changed or they have a new growth of some sort, and they just want to have it looked at. And so, a lot of times we’re doing that and then some people just come in and they have no worries and they just, you know, want us to look at them and make sure they’re okay.
MR: What’s the difference between a mole and a freckle from being out in the sun?
RD: Yes. Freckles are usually caused by sun exposure. A lot of times it is cumulative sun throughout your life, you start to get freckles. Even some sunburns can cause freckles and then moles. Usually, you’re going to make moles throughout your life into your twenties and thirties. Those are often the ones we worry about potentially changing into something pre-cancerous or cancerous.
MR: What are the different types of skin cancer? Because we hear different names and they all sound scary and some may not be as terrifying as others. Right?
RD: So, melanoma is by far the most deadly and aggressive form of skin cancer, the one we really, really worry about. But there are also other skin cancers. Basal cell and squamous cell carcinomas are the other two main ones and those are usually caused by sunburns, cumulative sun exposure throughout your life. But the key with all that is, a lot of times they are going to start off as a pre-cancerous lesion. And so, the goal is to catch those early before they turn into skin cancer.
MR: What is the treatment? I guess the preventative treatment would be the removal, either way, it’s removal, but if it gets to an advanced stage, what are we looking at?
RD: With melanoma usually it’s an excision. Further tissue is taken around the actual mole. And then all of that is checked again by pathology. With basal cell and squamous cell cancers, a lot of times we’ll do a procedure called a Mohs procedure and it’s a micrographic procedure, it’s done in the office, so it’s not anything you have to be put to sleep for. It’s just a local anesthetic. The Mohs surgeons check your tissue under the microscope before they close you back up, so they know that they’ve gotten the whole skin cancer.
MR: Got you. Okay. And the best way to avoid it all the way around?
RD: Yeah, so sunscreen is by far the best thing you can do. But then also just preventing sunburns. And that’s a big thing really. If you’ve had two to five sunburns early on in life that dramatically increases your risk for skin cancer. So, you know, wide-brim hats, sunscreen. Nowadays we have protective clothing that’s really helpful. So, all that.
MR: And how often should we be scheduling a dermatology visit?
RD: In your twenties and thirties is a great time to do an initial check. And then we may say come back in two or three years. But as you get older, a yearly annual skin check is what you want to do.
MR: Okay anything else Rebecca that we need to know about it?
RD: Well, I think the big thing is skin is the largest organ in our body. And the beauty behind skin checks is that if skin cancer is caught early, it’s very treatable and a lot of times a very non-invasive procedure to treat it. So, the earlier the better. And that’s kind of the main point. You really want to, you know a lot of people go in for their annual physical exams with your primary care doctor, maybe their annual dental exams. And so, you really want to treat your skin the same way.
MR: Okay that is great advice. Thank you so much for coming in today.
RD: Yes. Thank you