Around a hundred skin cancers have been diagnosed over the last seven months by general practitioners at the Varennes-Vauzelles practice.

Faced with the absence of a dermatologist in the department, nine general practitioners from the Nevers metropolitan area came together within the Skin & Health 58 association. Since April 2, they have been taking turns in a practice in Varennes-Vauzelles to offer dermatological consultations to the people of Nivernais.

All have been trained in dermascopy (use of a digital dermoscope which gives a magnified image of the lesions and which makes it possible to detect skin cancers), in biopsies (taking a piece of tissue for analysis) and in simple excisions (operation which consists of removing an anomaly).

Dermatology returns to Nièvre: trained general practitioners will take turns in a practice

Thanks to a tele-expertise system, they work in conjunction with dermatologists in Paris and Clermont-Ferrand. “There are a number of suspected cases, but they are not necessarily cancers. If we have the slightest doubt, we seek the advice of a specialist dermatologist so that he can advise on what action to take,” explains Dr. Thierry Lemoine.

A hundred cancers diagnosed

Between April and October, 326 patients were examined by these doctors. 102 biopsies or simple excisions were performed. “There are 24 diagnoses of melanoma, the most annoying skin cancers. We thought we’d find a few, but 24 is huge. We have found a little less in recent weeks, probably the bulk of it is due to the delay in diagnosis we had, due to lack of a dermatologist. We may be in the process of locking it out,” he explains.

50 diagnoses concern basal cell carcinomas (the most common skin cancer, the evolution of which is favorable under treatment) and 24 concern squamous cell carcinomas. 47 actinic keratoses, precancerous lesions, were also found.

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“For the rest, we were able to reassure people. The system works well. The figures speak for themselves: we are clearly effective. We realize that we are doing a service.” A service provided, at least, two half-days per week, the health professionals all having their own practice, and few slots to free up.

“The risk is that doctors burn out”

The association hopes to continue its activity next year. “It will depend on the funding that the Regional Health Agency (ARS) is willing to provide, in particular to finance a full-time medical assistant,” adds Dr. Thierry Lemoine.

“Managing files, once we have seen the people, is time-consuming. Letters to specialists, reminders to get the results… The risk is that doctors waste too much time on administration and become exhausted. The survival of the association will depend on the financing of this position. »

The project could then be departmentalized, with the opening of another office. “We would have to find the premises, other funding to buy the equipment and doctors to run it. But one can imagine that, if that were the case, people would resort to it. »

Élisa Especially