Occurrence of various dermatological symptoms – this is such a common situation that patients who encounter it often leave these symptoms without proper attention. However, a dermatological pathology may be suspected by another specialist, to whom the patient addresses for a completely different reason.
Obstetrician-gynecologist Natalya Lelyukh spoke about the correct tactics for managing a patient with dermatological symptoms if he turned to a gynecologist for help in an exclusive interview for estet-portal.com.
Does this clinical situation often occur when the patient has an underlying gynecological problem as well as dermatological symptoms?
Actually, it's always like that. Organism – this is a single whole, the right ear cannot hurt, and at the same time only the otolaryngologist will treat the patient. What if this ear hurts from trigeminal neuritis? Organism – it is integrity, and any symptoms can point us to pathology.
Leather – it is a universal indicator of everything, because it is our outer shell, reflecting all the processes occurring in the body.
And, in fact, most hormonal, metabolic or nutritional disorders have dermatological manifestations. And if a dermatologist sees signs of gynecological pathology – he will reasonably refer the patient to a gynecologist, and if the gynecologist sees, for example, that there is a formation similar to melanoblastoma on the skin of the perineum, he will photograph it with a colposcope and refer the patient to a dermatologist.
How often do you see patients with dermatological symptoms in your practice?
Such patients come into my practice every day. When I see hyperpigmentation, vitiligo, problems with hair growth or nails during a consultation, I already have a lot of questions for this patient, and, of course, I will definitely advise him to go to a dermatologist. If I see an exclusively cosmetic defect, and I understand that there is nothing complicated there – I can tell the patient that it is well corrected with cosmetics or procedures. But if the patient has dermatological symptoms – I will definitely refer him to a dermatologist.
What other tests can a gynecologist do before referring a patient to a dermatologist?
The gynecologist can accurately identify hormonal disorders, as well as identify eating disorders in the patient. The latter is a joint diagnosis with psychotherapists, but this must be reported to the dermatologist.
If a patient comes to you with acne associated with a hormonal imbalance, can you alone take this patient, or should she be referred to a dermatologist?
I can fully manage such a patient, because for more than 10 years I have been traveling to various dermatological congresses, listening to the reports of my colleagues, and I understand what and how to do, in terms of advanced technologies. If I see that a patient has acne of 3-4 degrees, which requires laser therapy and other hardware techniques that I do not own, of course, I prescribe my own treatment and refer her to my colleagues. But if this is acne of 1-2 degrees, and the patient has a classic history of hyperandrogenism and polycystic ovary syndrome, then, of course, I can manage it myself, and even prescribe topical drugs, because I understand this.
Are there often situations when only hormonal stabilization is enough to remove dermatological symptoms?
Yes, this happens quite often. If this is an uncomplicated situation, there is no bacterial infection attached, the problem has existed for no more than a year, and the patient does not have scarring and other long-term consequences, then, of course, only lifestyle changes and internal changes can already improve the patient's condition.
Do you feel that multi-specialist management is important?
Of course, and moreover, it is very important that each specialist is interested in what a colleague has appointed.
The patient needs to go to a good doctor who understands that the body – this is a single entity, and he will already refer to other specialists, if necessary.
In my practice, there are situations when a patient comes to me, says that she has already been to other specialists, shows their appointments, and asks to cross out some of the many drugs prescribed to her. Therefore, every doctor should be interested in what the patient is taking today, and for what reason he was prescribed it. A maximum of 3 drugs can be administered simultaneously in a treatment regimen, but no more.
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