Call to do more to get skin doctors
When Lisa Rudman sought help from her doctor, she was staggered to learn Canterbury has one public health dermatologist, who has not started work yet. reports.
Lisa Rudman’s body is covered in hot, itchy, painful skin. Sometimes, her psoriasis makes it a struggle to straighten her legs and sitting down without pain is impossible.
But Rudman thinks she is one of the lucky ones, because she can afford private care.
Canterbury is suffering from a chronic shortage of dermatologists – doctors who specialise in the diagnosis and treatment of skin diseases.
Te Whatu Ora Waitaha Canterbury, formerly the Canterbury District Health Board, is advertising for a medical dermatologist to join the ‘‘team’’ of dermatologists, registrars and specialist nurses. But the ‘‘team’’ consists of one dermatologist, who has not started yet.
Rudman is calling on health officials to do more to get publicly-funded dermatologists to Christchurch.
She has suffered psoriasis for 25 years. For 18 of those years she suffered further with psoriatic arthritis. She has tried various treatments, multiple steroid creams and diets to no avail. The skin disease covers 90% of her body. ‘‘It is like having really bad sunburn. It is very hot, very itchy. You only want to wear baggy clothes.’’
The condition has affected her ability to work. Day-to-day chores can be painful and she has had to change the way she dresses.
It requires continuous self-care, moisturising up to three times a day, taking Epsom salt baths, and watching what she eats and drinks to avoid inflammation.
When she got pregnant last year, Rudman, 39, found her symptoms worsened. ‘‘I had switched to a plant-based diet which helped but when I got pregnant I stopped and with all the hormones, it went a bit crazy again.’’ That was when she sought help from her doctor and found out there were no publicly-funded dermatologists in Canterbury. ‘‘I was shocked,’’ she said. ‘‘It is [New Zealand’s] the second-largest city.’’
Over Christmas, Rudman had a bad flare-up and ended up in Christchurch Hospital where she was treated by the general medical team. ‘‘They were amazing but they don’t have that specialist knowledge. It just kind of hit home that there is no-one there to support people in the community with this condition.’’
General practice doctors manage many skin problems but some – including psoriasis – require specialist diagnosis and treatment.
Canterbury’s chief medical officer, Dr Richard French, said a new consultant dermatologist was due to arrive in Christchurch this month. The dermatology department also had a clinical nurse specialist and a trained dermatology nurse and a registrar had recently started a 12-month placement.
According to the NZ Dermatological Society, there are more than 70 practising dermatologists in the country. Grant Bellamy, a society member, said last year that Christchurch needed at least six full-time dermatologists to meet the needs of Canterbury and the West Coast. Dermatologists often left because they were overworked and unsupported, he said.
Dermatologist Louise Reiche said psoriasis affected about 2% of the population with varying impacts from little to significant.
‘‘. . . some sufferers can get quite itchy. More extensive and severe disease may be associated with other auto-immune diseases and . . . with higher risks for arthritis, diabetes [and] cardiovascular disease.’’
Because she has health insurance, Rudman has been able to get phototherapy, a type of electromagnetic radiation that is safer than some other treatments, while she is breastfeeding her 11-week-old daughter. ‘‘Mine will heal over time with the phototherapy but what about the wider community that don’t have access to it?’’ She is determined not to let the pain and difficulty of living with psoriasis upend her life.
‘‘I just try and live with it and get out and about. It is [a physical condition] but emotionally and mentally, you feel down at times.
‘‘You just have to get on with it but people need better access to support.’’
‘‘It is like having really bad sunburn.’’ Lisa Rudman