GPs recommending treatment for skin issues

I think you are so right some GP's are not very good at detecting these skin cancers.  I was lucky mine gave me antifungal cream for 2 weeks and saw me again and that was it he referred me to dermatologist who then referred me to plastic surgeon

Hi 

Not all GPs are well qualified in skin cancers.

My GP didn't want to refer me back to dermatology as she was certain that the lesion on my nose was nothing to worry about.

The only reason she did was because I told her it had changed.

Yes, but that was in my opinion good GP treatment - they tried something for you and then when it didn't work referred you correctly. I wouldn't complain about that - we can't expect GPS to be experts at skin cancers. In my case though I was prescribed unnecessary treatment for a simple wart, and I think GPs should be better at identifying where treatment isn't necessary at all, and have the right tools to do so.

I think GPs have a difficult task to assess what should be referred on and what shouldn't. But if she did refer you when you told her it had changed then I think that was good GP treatment. My issue really was being given treatment directly by the GP (chemo cream) which wasn't necessary or correct, probably because she didn't have the right tool to look at it and see it was just a wart.

I see where you're coming from and I agree GPs should have the right equipment.

They don't need to be experts but they really do need a working knowledge of these things. They should have, and be able to use a dermascope correctly. As gps they'll see a lot of skin issues.

I would not be happy if I'd been given chemo cream for a wart. I didn't even know that a go could prescribe it

Thanks very much for that - both for your support of my reaction to unnecessary use of chemo cream, but also for identifying the critical tool here - the dermascope. I didn't know that was what it is called and now I have that name I have been able to read more about it. It seems to me that we shouldn't be seeing GPs re skin problems unless they are either clear we need to be referred to dermatology, or they use a dermascope themselves. I read that this is a useful instrument for GPs who have had some extra derma training, so basically if your GP doesn't have one perhaps we can assume they don't have that training and we should be asking for a GP that does.

I think GPs can reasonably be expected to judge when symptoms indicate a patient needs to be referred on to a Dermatologist, but In future if I see a GP and they don't want to refer me on, I will ask to see a GP with a dermascope.

I certainly dont think this would work at my surgery as you are lucky to see a gp never mind one with a dermascope. The gp that referred me to dermtologist just casually looked at my lesion, and at first said it didnt present like a skin cancer, but after antifungal cream didnt work immediately referred me.  Both dermatologist and plastic surgeon looked at it with dermascope and said it was a basal cell cancer, but the one I asked the plastic surgeon to look at near my eye came up inconclusive with dermascope, but was diagnosed with biopsy so dermascopes dont always pick them up. This particular one was also the worse of the two and a bigger opertion. 

Thanks for your response. Yes I must be lucky then, to have a GP with a dermascope. But it's an interesting question why more GPs don't use them. I understand that the instrument won't always pick things up and they can't always tell what it is from just that - I have had two biopsies because it wasn't clear, and obviously the dermatologist used the dermascope first. On one the biopsy turned out to be bcc and the other a false alarm. But they do give a better idea of what it is than just looking at it, and in my case if they had used a dermascope in the first place for me recently the GP would have maybe seen it was a wart and I wouldn't have been given the chemo cream. I just think that as waiting times are now so long, GPs should have the right tools on which to make judgements. I suppose I could worry that as the chemo cream didn't work and I am now being told it isn't anything to worry about, maybe I should have been referred on. But maybe some lesion appearances are clearer than others. I had already thought it was a wart from my own online research, so am inclined to believe the GP this time.

It has been interesting reading the other comments below. Since then I have found PCDS (Primary Care Dermatology Society).

Their website says 'the main role of dermoscopy in Primary Care is to help identify benign lesions'. So the claim is not that GPs can do what dermatologists do, but they can reassure patients with benign lesions that they do not need to be referred, and they can choose to refer when they can see the lesion may not be benign.

Also they say, 'in an ideal world one GP per practice should be upskilled in this technique'.

Very interesting reading Greyowl.  I wouldnt have thought these dermascopes are that expensive looking at them. Woud save benign lesions being referred and save patients worrying.  I must have been lucky that my gp wasn't happy with just casually looking at mine and referred me. (he has since left and gone back to his home country) so a loss to the practice.  The dermatologist put some oil on the lesion too which apparently gives them a beter picture. Thank you for your comments x