Dermatology

Our experienced teams treat and manage a wide variety of dermatological conditions. We have daily outpatient clinics to provide advice on the diagnosis and management of all general dermatology problems.

What we do

Our history

The skin department at Chelsea and Westminster was planned by Dr Richard Charles Staughton, LVO, and has historically been known as the Daniel Turner Department of Dermatology, named after Daniel Turner (1667–1740), a London physician who published the first dermatology textbook in English, De Morbis Cutaneis, in 1714. The department was opened by Prince Philip, Duke of Edinburgh in 1993 and houses a teaching room with a small library, twin theatres and a day care unit (George Watts Ward) for the intensive treatment of ambulatory outpatients. In 2013 we joined with the plastic surgery team in a renovated space on the 1st Floor. 

In 2015, Chelsea and Westminster Hospital and West Middlesex University Hospital merged to form one trust. The Dermatology Department is now split across two sites with our consultants working across both hospitals. 

Dr Staughton has been the mentor of our department, with an active interest in research, and established the Skin Treatment And Research Trust (START), a charity which funded research on skin and AIDS, but also melanoma and childhood skin disease, which has recently joined the British Skin Foundation, the national dermatology research organisation. 

Our team

Our experienced team treats and manages a wide variety of dermatological conditions. We have daily adult and paediatric outpatient clinics to provide advice on the diagnosis and management of all general dermatology problems in people of all ages. In addition, we provide inpatient care for patients with complex dermatology problems and have daycare facilities for ongoing treatments and care.  

We offer a variety of specialist services:

We have a dedicated day care treatment centre for the management of acute, severely ill patients. The day care units at both sites offer education, intensive topical therapy, phototherapy, photodynamic therapy and iontophoresis enabling most patients to be treated as outpatients. 

Referrals

We accept GP referrals via the Electronic Referral Service (ERS) portal and offer GP advice and guidance for both paediatric and adult dermatology patients. We also offer an acute dermatology service from 9am–5pm, Mon–Fri, accessed via A&E or GPs. Out-of-hours cover is available from 5pm–9pm, Mon–Fri, and 9am–9pm, Sat/Sun, which are accessed via A&E or direct GP referral at the Chelsea site. 

Specialty clinics

Acne

A dedicated service for the management of acne and rosacea was established in 2016. The service is led by Dr Eirini Merika at Chelsea and Westminster Hospital. The clinic treats patients with moderate to severe acne that has failed treatment with oral antibiotics and topical treatment or where these are contraindicated, as well as patients with rosacea. This is our first fully digitalised clinic, enabling patients to have virtual appointments, when appropriate, reducing hospital visits, using health tech startup ISLA to enable patients to share images and questionnaires about their skin, both securely and remotely.

Camouflage

The camouflage clinic run on the third and fourth Friday each month under the care of Lady Mimi Lloyd Adamson. It is a valuable asset for the hospital, particularly for patients who have disfiguring conditions after surgery or accidents—the creams are well-matched and can transform their appearance and can contribute to good mental health.

Genital dermatology

Vulval Clinic

Our Vulval Clinic is one of the longest-running in the UK, having been established in 1990s. It is a multidisciplinary service for patients with conditions of the vulva, vagina or perineum. Our core team consists of dermatologists, gynaecologists and sexual health clinicians. We work closely with pelvic health physiotherapists, psychosexual professionals and other specialists to deliver patient-centred care. We also offer to link our patients to the Lady Garden Club, our peer support group for patients with vulval conditions.   

Our team works across our two sites and we receive referrals direct from GPs, consultant dermatologists, gynaecologists and sexual health clinicians. Our clinics run on Tuesday mornings at Chelsea and Westminster, and on Thursdays at West Middlesex.

Penile Dermatoses Clinic

The Penile Dermatoses Clinic is a weekly multidisciplinary clinic, originally established by Prof Christopher Bunker and currently run by Dr Ien Chan (Consultant Dermatologist) and Dr Christopher Scott (Consultant Genitourinary Physician). Once a month, they are joined by Mr Michael Dinneen (Consultant Urologist). The clinic runs on Wednesday afternoons at our Chelsea site.

We treat skin conditions including those that occur primarily on the genital skin such as lichen sclerosus and skin conditions that can occur on any part of the body but are particularly troublesome on genital skin, such as eczema, psoriasis and lichen planus. 

HIV dermatology/Kobler Clinic

The Kobler Clinic is a multidisciplinary super-specialist clinic that has run for more than two decades at our Chelsea site. It is run by experienced dermatologists, and HIV and genitourinary medicine physicians who have a specialist interest in HIV-associated skin diseases, with access to dermatopathologists, plastic surgeons, urologists and oncologists, if needed. The clinic treats routine and complex skin diseases in this cohort and is an important teaching forum for dermatology and genitourinary trainees and for research. The lead for this service is Dr Nilesh Morar and the clinics run on Wednesdays.

Inflammatory skin disease

We run a busy and vibrant specialised inflammatory skin disease service. We treat skin diseases including psoriasis, eczema/atopic dermatits, hidradenitis suppurativa, blistering diseases and urticaria. Our multidisciplinary team delivers bespoke treatment for adults and children with access to the latest treatments. We also offer opportunities for our patients to enrol in clinical trials. 

The service is led by Dr Chrystalla Macedo at our Chelsea site and Dr Gayathri Perera at West Middlesex.

Iontophoresis

Iontophoresis is a safe and effective treatment for excessive sweating (hyperhidrosis) that can be used to treat hands, feet and underarms. It involves using a machine to pass a weak electrical current through the affected areas of skin. The treatment is initially administered by a trained nurse in hospital who can teach you how to do it yourself, should you choose to do the treatment at home. 

Paediatric dermatology

Our consultant-led service is offered at both sites to diagnose and treat skin disease in children of all ages, including severe eczema, psoriasis, alopecia, haemangiomas, acne and vitiligo.

At our Chelsea site, the service is led by Dr Bisola Laguda—our team includes:

  • Dr Nerys Roberts
  • Dr Eirini Merika
  • Dr Charlotte Edwards
  • Dr Jacqueline Simpson (cross site)
  • Amanpreet Banga (Clinical Nurse Specialist) 

At West Mid, our team includes:

  • Dr Nicola Clayton
  • Dr Jacqueline Simpson (cross site)
  • Dr Randa Akel

Our specialised paediatric clinics at the Chelsea site include:

  • Paediatric dermatology/allergy 
  • Paediatric dermatology/polycystic ovary syndrome (PCOS)
  • Paediatric hair and nail
  • Paediatric vulval dermatoses
  • Paediatric laser 
  • Paediatric vascular anomaly clinics
  • Paediatric dermatology genetic clinics
  • Paediatric minor operation lists
  • Paediatric iontophoresis 

For more information please see Dermatology (children).

Patch testing

We offer adult and paediatric diagnostic patch testing, an investigation used to detect contact allergy, an allergy to a natural or chemical substance that comes in contact with the skin. Such substances may include ingredients in medicated and cosmetic creams, fragrances, preservatives, metals, rubber chemicals, plant extracts etc. We additionally offer paediatric skin prick testing in conjunction with the paediatric allergy team. A skin prick test is a simple and safe method of testing whether your child has an immediate allergy (IgE mediated) to a specific allergen. It involves pricking the skin with a variety of allergens with with a lancet. 

Photodynamic therapy (PDT)

Please note: This service is currently unavailable. We offer a nurse-led photodynamic therapy service, including daylight PDT for some low-risk skin cancers (such as superficial basal cell skin carcinoma) and areas of sun damaged, precancerous skin. This is a technique where a cream is first applied to the area to be treated, followed by irradiation by a special light, or daylight, that activates the cream in order to kill abnormal cells in the skin.

Phototherapy service

We provide phototherapy and photochemotherapy which uses ultraviolet light to treat a wide variety of medical skin conditions including eczema, psoriasis and vitiligo. Patients can be treated with narrowband UVB or PUVA (Psoralen + UVA (photochemotherapy). Ultraviolet treatment is given 2–3 times a week in a walk-in phototherapy cabinet or unit.

Our specially trained nurses in the phototherapy team are responsible for the safe, effective and efficient care of all our patients receiving phototherapy treatment. We are a member of the South East of England Phototherapy Network which provides the latest evidence-based phototherapy protocols for treatment. The lead clinician for the phototherapy team is Dr Charlotte Edwards, Consultant Dermatologist.

Skin cancer

We receive 7,000 suspected skin cancer referrals and manage 400 skin cancer cases each year. Our specialist skin-related cancer clinics offer quick diagnosis and assessment, including biopsies, which are sent to our expert histopathology team.

All confirmed cases of skin cancer are discussed at our weekly specialist skin cancer multidisciplinary team meeting in the presence of dermatologists, plastic surgeons, oncologists, histopathologists and radiologists to develop the best possible individualised treatment plan. We work closely with the Royal Marsden Hospital for managing more advanced skin cancers. The clinical lead for the skin cancer services is Dr Rishika Sinha. 

Our jointly run clinic at West Middlesex invites patients with a confirmed diagnosis of skin cancer to be seen in combination with plastic surgeons, clinical oncologists and maxillofacial surgeons to assess and determine the best possible treatment for each individual patient.

Teledermatology service

Our award-winning* teledermatology service is available at both sites for patients who have been referred by their GP via the normal two-week wait pathway for suspected skin cancer. Patients are asked to complete an electronic questionnaire and are seen in hospital within two weeks of referral by one of our medical photographers who will take high-quality, close-up images of the area(s) of concern. This information is then reviewed by a dermatologist within 48 hours and appropriate investigations or management are arranged. The outcome is communicated directly to the patient and their GP. This innovative pathway has been highly successful and we have helped other trusts around the country replicate our service. In addition, 80% of patients would recommend the service to their friends and family. The teledermatology service is led by Dr Lucy Thomas.

* British Medical Journal dermatology team of the year 2020 

Skin surgery

We offer a wide range of surgical procedures carried out under local anaesthetic, including skin biopsies, shave excisions, curettage and cautery, and excisions of skin lesions with suspicion of malignancy, pre-malignant skin lesions where there is diagnostic uncertainty, or lesions with pre-malignant potential. We treat benign skin lesions if certain criteria are met, such as when the lesion is unavoidably and significantly traumatised on a regular basis, there is evidence of recurrent infection, or the lesion causes pain and limits function. We work closely with a very experienced plastic surgery team for complex site surgery. 

Mohs micrographic surgery 

Mohs micrographic surgery (MMS) is a specialised technique used to remove specific types of head and neck skin cancers with the lowest likelihood of recurrence while removing the minimum amount of skin.

The most common type of skin cancer requiring MMS is basal carcinoma—however, we may also treat some squamous cell carcinomas and other rare tumours. The most common anatomical sites that may require MMS are the ears, lips, eye and nose. The surgery is carried out under local anaesthetic and patients normally remain in the department for the whole day.

The procedure involves surgically removing the skin cancer with small margins each time (known as layers). Each layer is frozen and analysed using a microscope. When healthy, cancer-free tissue around the tumour is reached, the tumour is considered fully removed. Depending on the site of the tumour, reconstruction of the resulting defect will either be carried out by the Mohs surgeon, craniofacial surgeon or oculoplastic surgeon. We work very closely with a skilled craniofacial plastic surgery and oculoplastic team. 

The Mohs surgery clinical team includes Dr James Shelley, Dr Prativa Jayasekera and Dr Navara Anjum.

Research and development

With a history ranging more than 30 years ago when the START (Skin Treatment And Research Trust) was created to fund research on skin and AIDS, and also melanoma and childhood skin disease, we are actively involved in research in areas including studies to understand the cause of skin conditions and clinical trials to test new skin treatments. We run clinical trials for conditions such as psoriasis, eczema, skin cancer, acne, hidradenitis suppurativa and urticaria in adults and children, giving the opportunity for our patients to access the latest treatments in development.

Teaching and training

We are a recognised teaching centre for dermatology training. We are affiliated with Imperial College School of Medicine and provide dermatology training to medical students. We are also a national training centre for specialised training in dermatology with four national training numbers and opportunities for international clinical fellowships. 

We welcome and offer plenty of opportunities for elective placements, clinical observerships and work experience placements.

Dr Mariana Noy is the local training programme lead.

Our team

Dr Eirini Merika is the service director for dermatology for Chelsea and Westminster and West Middlesex Hospital, supported by Dr Gayathri Perera, who leads the service at West Middlesex Hospital. The matron for Dermatology is Joanna Fletcher.

Consultants

Chelsea site:

  • Dr Navara Anjum
  • Dr Ien Chan
  • Dr Charlotte Edwards
  • Dr Louise Fearfield
  • Dr Claire Fuller
  • Dr Chrystalla Macedo
  • Dr Eirini Merika
  • Dr Nilesh Morar
  • Dr Mariana Noy
  • Dr Prativa Jayasekera
  • Dr Nerys Roberts
  • Dr James Shelley
  • Dr Jacqueline Simpson
  • Dr Sarita Singh
  • Dr Lucy Thomas

West Middlesex site:

  • Dr Randa Akel
  • Dr Nicola Clayton
  • Dr Charlotte Edwards
  • Dr Gayathri Pereira
  • Dr Rishika Sinha
  • Dr Jacqueline Simpson 

Nursing team

Chelsea site:

  • Joanna Fletcher, Matron
  • Ifeoma Oniri, Charge Nurse
  • Yussuf Idris, Charge Nurse 
  • Adejoke Osoba, Clinical Nurse Specialist for Biologics
  • Monica Sebastian, Skin Cancer Clinical Nurse Specialist 

West Middlesex site:

  • Alice Mwale, Advanced Nurse Practitioner
  • Julie Maher, Skin Cancer Clinical Nurse Specialist

Contact information

Chelsea and Westminster Hospital 

1st Floor, Lift Bank D

T: 020 3315 6666
E:

West Middlesex University Hospital

Outpatient Department 3
Ground Floor, Main Building

T: 020 3315 6666 (Central booking/new appointments)
T: 020 8321 5473 (Outpatients/follow-up appointments)
E:  

Useful information

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