Skin Cancer College of Australia and New Zealand Annual Conference 24 -- 26 April 2010
The conference opened after lunch on the Saturday afternoon. Whilst waiting for the formalities we were treated to some background music obviously chosen by someone with a sense of humour. The songs played included "Here comes the sun" (Beatles), "Blister in the sun" (Violent Femmes), "Walking on sunshine" (Katrina and the waves) and "Burn for you" (John Farnham). Later during the conference we also got songs like "Ain't no sunshine" and "You are the sunshine of my life" plus a humorous item titled "Skin" by Allan Sherman.
The conference was opened by the Honourable Peter Lawlor, the local member in the Queensland Parliament and Minister for Tourism. Then Prof David Wheedon, one of the most highly regarded dermatopathologists, officially launched the College. The conference was then addressed by the fairly recently appointed CEO Marisa Vecchio. Marissa has an impressive CV which includes 10 years as the CEO of Australian General Practice Accreditation Ltd. She is also a former Telstra Clear businesswoman of the year. Her appointment is an indication of how far the College has progressed and provides a very good chance of obtaining full recognition by the College of GPs and the various medical boards in Australia.
The college has finalised a robust pathway to Fellowship which will not be easily obtained. Suffice to say that it includes a part one and part two exam, six years part-time or three years full-time skin cancer practice, formal dermoscopy and dermatologic surgery training, a photographic surgical log of 45 cases (three each from 15 body sites) and a traditional surgical log of 200 cases. The University of Queensland Master of Medicine degree counts as the part one exam, and the dermoscopy and surgical training. A number of GPs have already been awarded the Fellowship; most of them in full-time skin cancer practice. Full details of this can be viewed at http://www.sccanz.com/fellowship/
In the next few weeks I will be posting some of the interesting information to come out of the conference and the dermoscopy masterclass that followed it. One of the highlights was a series of presentations by primary care skin cancer doctors. These included an original paper on the dermoscopy of pigmented Bowen's disease presented by Allan Cameron, a paper by Brisbane GP Cliff Rosendahl to be published in the International Journal of Dermatology using data from the skin cancer audit and research database (SCCARD) which he developed in conjunction with a computer programmer showing that dermoscopy reduced the number of lesions excised to find one melanoma. Dr Jeff Keir from northern New South Wales presented a series of cases from his own practice showing the dermoscopic features of melanoma on sun damaged skin. These can be difficult to distinguish from solar lentigo. One of the impressive features shown was large polygons or broken polygons of pigmentation. Jeff also presented data to show that screening of self referred patients (i.e. full body skin checks) was cost effective.
One of the interesting new developments in dermoscopy is the "chrysalis sign". Chrysalis structures are bright white lines seen only with polarised dermoscopy. They are due to altered collagen and can be seen in melanoma and Spitz naevi (melanocytic) and basal cell carcinoma and dermatofibroma (nonmelanocytic). They may also be seen in lichen planus like keratosis. Prof Ash Marghoob who authored the paper described them as representing progression of a melanoma as opposed to regression.
Observation of Chrysalis Structures With Polarized Dermoscopy Ashfaq A.
Marghoob, MD; Lester Cowell, MBBS, ACCAM; Alfred W. Kopf, MD; Alon Scope, MD
More later. |