Dr Sabine Sommer
Consultant Dermatologist, Te Whatu Ora Hawke’s Bay
Consultant Dermatologist, Te Whatu Ora Hawke’s Bay
Dr Sabine Sommer came to Te Whatu Ora Hawke’s Bay as a belated midlife-crisis, peri-retirement move in 2021, after a trial run 2017/18. She can barely remember qualifying from the Free University of Berlin (apart from the ‘free’ bit) or defending her MD at the Medical University Lübeck, Germany, and then boarding the plane to the UK the very next day in 1992. There she moved jobs etc until getting seriously attached to first her husband and then Leeds Teaching Hospitals Dermatology in 1995.
An initial enthusiastic spell of about 30 academic papers came to a sudden stop with the publication of 3 children. However, she continued writing patient information leaflets for the British Association of Dermatologists, dermatology e-learning modules for the BMA, NHS and Health Education England, as well as working as honorary senior lecturer for Leeds Medical School, including their admissions team. |
Her departmental roles included peer mentor, consultant appraiser, dermatology registrar educational supervisor, clinical lead and core membership of various multi-disciplinary teams. Apart from general and skin cancer clinics, as well as skin and nail-surgery lists, she had subspecialty clinics in laser dermatology, nail disease and male genital dermatoses. She is a fellow of the Royal College of Physicians London, a member of various professional organisations and reviewed for different dermatology journals. These roles have now been eclipsed by being the only public dermatologist in Hawke’s Bay.
Dermatology in Older People
‘Inflammaging’ - evolving concept / therapeutic targets
Skin care - emollients before/after shower
Eczema - intermittent potent topical steroid od, e.g. mometasone (ointment better than creams / lotions); 2.line: phototherapy, methotrexate, mycophenolate mofetil, (dupilumab)
Senile Pruritus- ? Skin ? drugs, FBC, U+C, LFT, ferritin, ESR, CXR; Non-sedating antihistamines x4 updosed, stop if ineffective. Gabapentin, amitriptyline, SSRI, mirtazepine; phototherapy
Dermatoporosis - gentle handling, low adherent dressings, protective clothing.
Dissecting haematomas - surgery
Skin cancer - treat patient, not lesion
Actinic keratoses / field cancerization - treat chronically sun-exposed sites yearly: Remove crusts scales; +/- cryotherapy; (oral Vitamin D3 10,0FBC, 00 IU od 5/7), calcipotriol + 5-fluorouracil cream bd 4/7 face, 10/7 body, chemowrap-occlusion limbs.
Basal cell carcinoma - imiquimod od 6-12/52
Stasis / Dermatoliposclerosis - postural drainage (leg/bed elevation), compression, emollients, potent topical steroids.
Cellulitis - never bilateral, ALT70 score, skin temperature difference >3oC
Incontinence/ moisture irritant dermatitis - hair dryer after shower, avoid talcum. Emollients, zinc-oxide - dimeticone barrier creams, low potency combined anti-biotic/yeast/topical steroid. Avoid wet-wipes, scented products (contact allergy)
Genital lichen sclerosus, Zoons balanitis / vulvitis - avoid urine contact. Emollients as soap, barrier ointments, intermittent (super-) potent topical steroids. In men, circumcision can cure.
Onychogryphosis/onychomycosis - Chiropody, 20-40% urea cream; control with topical terbinafine / 3% citric acid in soft paraffin. Cure difficult (oral terbinafine 6-12/12)
Hyperkeratosis soles - 25% urea emollient
Skin care - emollients before/after shower
Eczema - intermittent potent topical steroid od, e.g. mometasone (ointment better than creams / lotions); 2.line: phototherapy, methotrexate, mycophenolate mofetil, (dupilumab)
Senile Pruritus- ? Skin ? drugs, FBC, U+C, LFT, ferritin, ESR, CXR; Non-sedating antihistamines x4 updosed, stop if ineffective. Gabapentin, amitriptyline, SSRI, mirtazepine; phototherapy
Dermatoporosis - gentle handling, low adherent dressings, protective clothing.
Dissecting haematomas - surgery
Skin cancer - treat patient, not lesion
Actinic keratoses / field cancerization - treat chronically sun-exposed sites yearly: Remove crusts scales; +/- cryotherapy; (oral Vitamin D3 10,0FBC, 00 IU od 5/7), calcipotriol + 5-fluorouracil cream bd 4/7 face, 10/7 body, chemowrap-occlusion limbs.
Basal cell carcinoma - imiquimod od 6-12/52
Stasis / Dermatoliposclerosis - postural drainage (leg/bed elevation), compression, emollients, potent topical steroids.
Cellulitis - never bilateral, ALT70 score, skin temperature difference >3oC
Incontinence/ moisture irritant dermatitis - hair dryer after shower, avoid talcum. Emollients, zinc-oxide - dimeticone barrier creams, low potency combined anti-biotic/yeast/topical steroid. Avoid wet-wipes, scented products (contact allergy)
Genital lichen sclerosus, Zoons balanitis / vulvitis - avoid urine contact. Emollients as soap, barrier ointments, intermittent (super-) potent topical steroids. In men, circumcision can cure.
Onychogryphosis/onychomycosis - Chiropody, 20-40% urea cream; control with topical terbinafine / 3% citric acid in soft paraffin. Cure difficult (oral terbinafine 6-12/12)
Hyperkeratosis soles - 25% urea emollient