Question 1

Which conditions that might be considered dermatology are best seen by specialist surgeons?

Accepted Answer

Lipomas (soft lumps under the skin).
Epidermoid cysts over 1cm in diameter on trunk and limbs
Scalp cysts
Large skin cancers, where excision requires plastic surgical expertise
Skin cancers at special sites such as the ear, nose, eyelid, scalp and over the temporal artery

Question 2

Which conditions particularly need a GP referral as well as special planning before a consultation, or extra time during the consultation?

Accepted Answer

Leg ulcers (best seen as a home visit while the nurse treating them is present).
Very severe rashes, making a person red or scaly in a very widespread distribution, or causing severe blistering. 
Severe distress.
Complex medical problems with prior involvement of numerous other doctors.

Question 3

Which important treatments are not available through Manx Dermatology?

Accepted Answer

Ultraviolet light (UVB or PUVA)
Very expensive medicines, unless you are in a position to pay for them yourself
Radiotherapy
Photodynamic therapy
Regular dressing of wounds
Specialist dermatology nursing care

Question 4

Do you treat psoriasis?

Accepted Answer

Yes.  More than one consultation may be required.  The treatment available for psoriasis in private practice is limited.  Ultraviolet light is unavailable. Tablet treatments such as methotrexate and acitretin are usually helpful.  They require regular blood tests and ongoing review, which is moderately expensive. Biologic treatments can be very helpful, but are not usually practical, due to the ongoing cost of £1000-£1500 or more per month, which is not covered by insurers.

Question 5

Can you prescribe biologic treatments?

Accepted Answer

Yes, but this is usually not practical due to the cost involved. There are expensive pretreatment tests, followed by ongoing expenses of the order of magnitude of £1000-£1500 per month for many biologics.  Hence, we are not prescribing these treatments regularly. Some biologics such as ustekinumab and adalimumab now have newer more affordable brands available, called 'biosimilars'.  We would need to make special arrangements for patients wishing to pay for a biologic treatment.

Question 6

Do you see children and young people?

Accepted Answer

We only see patients of 18 years and older.

Question 7

Can you test for food allergy, such as nut allergy?

Accepted Answer

Yes. Dr Buckley is an allergy specialist and can carry out prick testing. It is advisable to bring for testing very small amounts of a range of fresh foods, 1 teaspoon approximately of each food, separately labelled and wrapped. For nut allergy, a range of separate types of nut should be brought (one of each type is enough). For fish and shellfish allergy, a tiny amount of each type of fish or shellfish, both cooked and raw, should be brought. For fruit allergy, a slice of each type of fresh raw fruit with the skin on is adequate, again separately wrapped.

Antihistamines should be stopped 5 days prior to the appointment, if possible.

Question 8

Can you test for allergy to dust, mould, pets and pollens?

Accepted Answer

Yes, Dr Buckley has commercial allergens for prick testing to dust, mould, pets and pollens. Please also bring saliva and scale from your animal, if possible.

Question 9

Is patch testing available?

Accepted Answer

Yes, Dr Buckley is a specialist in patch testing. If, after your allergy consultation, it is recommended that you have patch testing, a date will be arranged and the allergens will be ordered in specially, which may take several weeks.

Frequently asked questions