"I felt I hadn’t been listened to"

About: Victoria Hospital / Dermatology

(as the patient),

After waiting over 6 weeks for a dermatology appointment when I was referred from Rheumatology for the assessment and consideration of a skin biopsy to aid of diagnosis of raised patches on my big toes and the thickening of the palmer creases of my right hand.

I had my dermatology appointment and I’m so disappointed with the outcome.

Coming into the department the waiting area was full. I was called into the room, sat down and asked about what had been happening with the changes in my skin.

I explained the joint pain and swelling came first then the skin changes happened. I had made files of photos to show this. The consultant had a quick look at the photos of my hand but didn’t even look at the photos I had of my toes.

The consultant then asked to see my toes, looking from afar. Not even taking a close look they told me that it was contact dermatitis/ eczema.

I have contact allergies that I was diagnosed with in 2022 but have had no issues with my skin since then. I’m very careful with products I use and don’t change them.

I don’t think the patch of erythema is contact dermatitis/ eczema as 2 other dermatology sources have said it’s psoriasis.

I tried to explain the skin changes are only happening in areas where the joint is and that are swollen and inflamed. The skin changes I believe are coming from the inside and not from external factors. I tried to explain it’s now happening on my left hand in the skin folds, but the consultant wouldn’t listen to my symptoms, their mind was already made up that it must be my contact allergies that are causing the skin changes that I have had for months.

I asked if the thickening of the palmer creases which have left scarring has been caused by the inflamed joint or inflamed skin, but I got no answer. I’m extremely worried about what has happened in my right hand and can see it starting to happen in my left hand in the exact joints and folds. Nothing is being done to prevent the same damage that has been left in my right hand.

I asked about the option of the skin biopsy that rheumatology had asked for as this would aid the diagnosis and confirm what the erythema patch is, but the consultant wouldn’t even consider the skin biopsy. I was told that doing a biopsy on the big toe was too high risk and even if it was psoriasis they wouldn’t do a biopsy for that. Only carry out a biopsy where there’s suspensions of cancer.

I asked the consultant to have a look at my nails because all my nails in my hands and feet have changed. My big toes have the biggest changes, but they didn’t even look at them. Had a quick glance at the nails on my hand but said that’s nothing.

I was trying to explain and express my concerns regarding the changes in my skin, not only the changes I had been referred for but changes in the mind Dermographism I have which I feel is getting worse and how sensitive my skin in the areas already swollen but no one listened and didn’t have the time to listen.

I was then given the option of seeing a different consultant as they could see I wasn’t happy with the outcome of the rushed 10-minute appointment and expressed my concerns that this could take months to see someone else.

I left the room and the appointment feeling rather upset and in tears. I felt I hadn’t been listened to. The appointment was rushed and there was no examination carried out.

Therefore, after over 6 weeks waiting to see dermatologist I’m no further forward in my diagnosis and seeing the changes in my skin and in my right hand happening in my left hand I’m completely worried about the damage being done.

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Responses

Response from Fiona Mitchell, Senior Charge Nurse Fiona Mitchell, Dermatology QMH anf VHK, NHS Fife 6 months ago
Fiona Mitchell
Senior Charge Nurse Fiona Mitchell, Dermatology QMH anf VHK,
NHS Fife
Submitted on 31/05/2024 at 16:20
Published on Care Opinion at 16:20


picture of Fiona Mitchell

Dear Skull570

I am sorry to read in your message, that you feel after attending a dermatology appointment, you have not been listened to. I was part of your consultation that visit and I also met with you and a relative afterwards to discuss your disappointment. I am happy again to offer any further advice or support.

My Contact Email is Fiona.Mitchell8@nhs.scot

Kind Regards

Fiona Mitchell SCN

01383 623623 EXT 22115

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Update posted by Skull570 (the patient)

Hi,

Thank you for your response and I appreciate your time.

I was hoping for a response from someone independent and not directly involved in the situation that happened at my appointment.

I still feel I wasn’t listened to at my appointment and if there was more time taken to listen to my symptoms and was allows to express where the skin changes are coming from that it’s only happening in the skin where the joint is inflamed and the changes in my skin is coming from the inside and not external factors. Listen to all my symptoms might have changed the outcome of the appointment that I had already waiting 6 weeks on.

I’m worried that the damage done in my right hand is spreading to my left hand. I was hoping with dermatology input this would have helped rheumatology with my diagnosis, to explore different reasons why the skin changes are happening and not to make the assumption it’s due to my allergies.

I appreciate I was given the option of speaking to another consultant but this will take even more time and could take weeks to see someone by that time the damage is being done in my left hand and this should have been explored in the appointment I had already waited over 6 weeks for.

Response from Angela Glancey, Clinical Nurse Manager, Medical Directorate, NHS Fife 6 months ago
Angela Glancey
Clinical Nurse Manager, Medical Directorate,
NHS Fife
Submitted on 05/06/2024 at 15:55
Published on Care Opinion on 06/06/2024 at 07:57


picture of Angela Glancey

Dear Skull570

Thank you for taking the time to give feedback as noted above. I am sorry to hear your visit to Dermatology has not alleviated the worries you had over your health but appears to have caused you more distress. Whilst I am the Clinical Nurse Manager for the area, I do not have direct involvement with any patient care and would appreciate if you feel able to give me a call so we can discuss further and try to find a solution to your concerns.

I appreciate that you have already waited sometime since your initial referral but I can try to arrange an appointment for you for review.

I have included my details below and will discuss your concerns with the department. look forward to hearing from you.

Angela Glancey

Clinical Nurse Manager

Acute Services Medical Directorate

angela.glancey2@nhs.scot

01592 643355 ext 20099

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