- Associated Press - Sunday, June 5, 2016

OMAHA, Neb. (AP) - The mole atop Alexandra Jones’ toe was smaller than a pencil eraser.

But with a family history of cancer - her dad lost an eye to melanoma - the Omaha woman brought up the irritated spot to her doctor, who referred her to a dermatologist, the Omaha World-Herald (https://bit.ly/1TY8zHe ) reported.

She had to wait more than a month for the specialty appointment. Once there, a biopsy revealed the mole was malignant melanoma, a potentially deadly skin cancer. Within weeks, doctors amputated her toe.

“Half the battle is finding the (right) doctor,” said Jones, 30.

Her situation isn’t uncommon.

That’s why the University of Nebraska Medical Center is creating a dermatology department in its College of Medicine. Officials say the department, expected to be fully operational in late 2017 or early 2018, will help address the state’s shortage of dermatologists.

The demand for dermatology services is being driven by the rising occurrence of skin cancer, the aging population and the increasing demand for cosmetic procedures, said Dr. H. Dele Davies, UNMC’s vice chancellor for academic affairs.

Currently, medical students can’t complete a dermatology residency at the Nebraska Medical Center or the Creighton University Medical Center. The locations closest to Nebraska with such residencies are in Iowa, Missouri and Colorado.

“People end up practicing within 100 miles within where they train,” said Dr. Brad Britigan, dean of UNMC’s College of Medicine. “Since no one trains in Omaha, they aren’t here. It becomes more of a challenge to recruit them back to Nebraska, even if they graduate from an Omaha medical school.”

Since 2009, 17 UNMC students have matched into out-of-state dermatology residencies, officials said.

Doctors at the Nebraska Medical Center already see patients for more severe cases when they’re referred by local dermatologists. Now, a dedicated department will expand its research and clinical expertise in the prevention and treatment of skin diseases.

Nebraska has one dermatologist for every 52,000 people, though the American Professors of Dermatology recommends one per 20,000 to 30,000 people.

The creation of a department will reduce wait times for patients, Britigan said. Currently, it can take months before a patient is seen by a dermatologist in the metro area, depending on his or her needs.

The catalyst for the new department focused on skin, hair and nails was the addition of the Fred & Pamela Buffett Cancer Center, Britigan said.

“The reality is you can’t have a world-class cancer center without dermatology to really provide the necessary expertise in skin cancers and provide better support for patients,” he said.

The department’s main office will most likely be at the 42nd Street campus, with clinics elsewhere in the city, he said.

The first step will be to hire a department chair, which will take about nine months, followed by recruiting about five faculty. Britigan hopes community dermatologists may sign on as volunteer or part-time faculty members, he said.

Eventually, the department will offer a tele-dermatology program in which patients can be seen remotely via video camera, plus establish the training program that would allow medical students to do their dermatology residency in Omaha.

The department will expand the procedures currently offered to include Mohs surgery, which removes skin cancer, said Dr. Nicole de Rosa, a surgical oncologist at the Nebraska Medical Center and an assistant professor at UNMC who will work closely with the department.

Now, six months after her surgery, Jones is living normally with just nine toes. She joked she’s still trying to figure out a way to get a discount on pedicures.

An active person, she’s training for the Market to Market Relay race between Omaha and Lincoln, and has no regrets about the amputation.

“When news like that comes, you want to make sure the services are available so you can be proactive,” she said.


Information from: Omaha World-Herald, https://www.omaha.com

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