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The Skin Trade


I went to a dermatologist a few weeks ago. (On a Sunday! How weird is that?) The guy was an idiot.

One of the first things I said to him was, "Do you have any experience with hiv positive patients?" A reasonable question, I thought.

He looked down at some papers, started laughing, and said, "Not if I can help it! ~hahahahehehehohohosnortsnort~" Then he cheerfully blathered on about how, statistically speaking, he was unlikely to come across hiv in his practice. He implied it was only those in the lower echelons of society who had hiv and well, "I don't see patients like that". Then he looked back up at me and said, "Why?"

"Because," I said, "you have a statistic standing right in front of you and this statistic wants to make sure you know what the hell you're doing before I let you anywhere near me." I thought he was going to faint!


He bumbled through a flustered speech about how he would refer me on to a "more experienced colleague" if there were anything he was unsure about. Well goodie-goodie-goo! Sheesh! I figured I might as well let him have a look as my Sunday morning - and that of my friend who drove me to the appointment - was already buggered.

After he composed himself, I showed him all the different spots my GP and I were concerned about. He identified them, and said while none of them was anything to worry about, he could freeze the bigger ones off my back. Then he gave me several info sheets detailing what types of spots I have. They all had thumbnail photos and one looked just like a clit nestled in pubic hair - and I told him so. He peered closely at it and said, "Oh my God! You're right! Nobody pointed that out before - but it really, really does look like that!"


"Well," I said, "I tend to speak my mind - even when it's something people don't necessarily want to hear." He looked up at me and grimaced. LOL

Next, he got the nitrogen bottle out and sat down on the exam table and instructed me to stand in front of him. Yep, I  had to stand while he sat. It wasn't easy standing still; it hurt like hell and it would have been much easier if he'd had me lay face-down on the table. When he was finished, I told him that if his hands were shaking that much (and they were) that he had to sit down instead of me while he performed a treatment, maybe he should find another line of work were he wouldn't run into statistics like me. He did a pretty good imitation of a fish out of water - gasping for air - but didn't reply.

I'm sure he had to go lie down after I left! And NO, if I need the attention of a dermatologist again, it WON'T be him! 

Oh, and by the way... I showed my 21 y/o daughter the info sheets, but said nothing about that certain photo. When she got to the relevant page the first thing she said was, "Why is there a rude photo on this one?" hehehe... so it wasn't just me and my over-active, over-sexed imagination!


Show Comment(s)

Comments on Ann Smith's blog entry "The Skin Trade"

Hi Ann,

Thanks for your entertaining, if somewhat disturbing post. I'm going to see a dermatologist next week, and will be watching out for sub-standard care in relation to my status. I have to admit, the level and proficiency of care here in the UK is pretty low in relation to HIV. It's almost a cinderella case, with the assumption that because of the advent of HAART everything is okay and less focus can be given to the medical and psychological needs of us HIVers. My own health care provider speaks in an unintelligible monologue and is inaudible! Well enough of that, I'm going to upgrade to business class and get better care! I wonder what other UK HIVers feel about their care.
Thanks again Ann, and good luck.


Can you scan that nasty photo and share it with the rest of the class? Sounds like a very unusual dermporn example. More importantly, you have likely given Dr. Skin the most memorable appointment he's ever had! Yes, he should have had you lying down. I suspect he didn't want to risk your drool on his exam table liner paper, that is assuming he's mindful enough to use it. What a creep.


Hi Michael,

Good luck with your derm appointment next week! I hope you have a better experience than I did. Please feel free to come back here and let me know how it went for you. (Or tell us in the forums! If you're not a member yet, please do join us.)

I think the level of care we receive in the UK has a lot to do with location. People in London get the best care, followed by people in other big cities, while people in more rural areas are pretty much shit-out-of-luck unless they can travel.

A lot of the problems in the UK today as regards hiv have a lot to do with the removal of the hiv funding "ring-fence". I think it was back in 2003 or 04 when they did this. Money used to be allocated for hiv concerns and hiv concerns ONLY - hence the term "ring-fence". When they removed this protection, each individual NHS Trust could put as much or as little funding into hiv as they deemed appropriate. In my experience, hiv services have most definitely suffered as a result.

Here on the Isle of Man, they bring over a consultant from Manchester once a month and, well, he's not very well respected in hiv circles. I'm lucky enough to go to Liverpool for my care and my doctor there is one of the best in the country. The only draw-back is since the Home Secretary (was it when Jack Straw held the post?) decided to disperse asylum seekers around the country a few years ago (instead of concentrating them in London), our clinic has been inundated with new patients. As a result, I see an ever-changing registrar more often than my consultant. I make a point of seeing him at least once a year - but it's not always easy as he's often away at some hiv conference "being brilliant", as the nursing staff likes to say.

The dermatologist I saw is another consultant who is brought in from the mainland and that's why my appointment was on a Sunday. So, those of us with hiv aren't the only ones who don't have a specialist in our area of concern who is resident on the island. HOWEVER, we SHOULD have an Infectious Disease doctor here 24/7 as such a specialist could also deal with our hep C and B patients, our TB patients and of course, hiv patients amongst others. The nature of these illnesses is that we need a doctor who is readily available. I remember resenting having to travel once a month to Liverpool during my hep C treatment - I felt like hell all the time and I would be flat on my back for a week after every clinic appointment.

Mind you, cancer patients usually have to make the same journey... it isn't ideal, but I suppose I should be grateful that we are permitted to travel, on the NHS, to get the care we need.

Anyway, good to hear from you. You've inspired me to write a blog on the subject of the NHS and hiv, so watch this space. I'll look forward to hearing additional comments from you.


Hi Em!

I'm having trouble with my scanner, but I'll try to get it working in the next few days and then I'll edit my blog to include it.

In a nutshell, the photo is of an ordinary cyst, but it's a cyst on someone's scalp. That's where the hair comes in - it's pulled aside so you can see the cyst. On close inspection of the photo (after reading the info) you can tell what it's actually supposed to be, but when you first glance at the page it really does give you the impression you're looking at a clit. hehehe! Who'da thought a dermatologist would be handing out porn?

And yes, I don't expect Dr Hepburn (hehehe, named and shamed!) will forget me in a hurry. One of the other things I said to him, which I neglected to mention above, was following my crack about finding another line of work. I pointed out to him that he very likely HAS worked on other hiv positive patients, but they probably didn't disclose that information due to past experience of unprofessional attitudes [i]just like his.[/i] He said, "No, it would be in their chart and I'd know."

"Ha!" I said, "Is that information in MY chart?" (it isn't) He started turning a rather fetching shade of puce and again, didn't reply.

And I really don't think his insensitive and unprofessional error of sitting down (instead of the patient) was due to any concern over my drool on the table - after all, it's not actually [i]his[/i] exam room, it's just a facility he's borrowing. (see my comments to Michael)

It was totally due to the fact that he was shaking. He must have been weak in the knees as well.

And like I said, I'm sure he had to go have a lie-down by the time I was finished with him! I can hear it now... "Nurse, cancel the rest of my appointments for the day. I feel rather odd..."

Thanks for your comments Em, and be sure to check back for the photo in a few days time.



You stupid bitch. All I have to do is call up my ISP and have them change my IP address. You fucking whore. I will be back soon. TTFN.

Well golly, JamieDustforbrains, aka butterbear4444, aka dearestgrandson, aka poz4afewyears, I'm shaking in my boots! I thought about simply deleting your nasty, childish comment, but I figure I'd leave it in place to show you up for the bitter, twisted, duplicitous and extremely immature individual you are.

We can call your ISP too you know, and report your online abuse. Ever hear of a two-way street? You might be back soon, but I guarantee you won't be back for long.


Why is she so mad about you? Anyway, going back to your funny story, I just hope the spots were gone now somehow! ;)

Thank you so much for posting this Ann

As it is very similar from what I have had to endure in the UK with the NHS from medical professionals - specialists in other areas because I have a few conditions unrelated to me HIV or only vaguely related ( carpal Tunnel, which I am to have an operation for in a month or so, optic neuritis and an ankle fusion,

and I too have a dermatological condition - priosis - which apparently is not due to my HIV but made worse by it)

but I too want to be sure that if a specialist treats me they are aware I have HIV and of how HIV might implicate on the condition they are treating me for or exasperate it or to be sure their treatment will not interfear with my HIV meds.

So I have been in situations like you describe several times recently under the NHS

I am so glad it is not just me!!!!
All we can do I guess is educate when we can and insist we see another Dr if we can not

Love to you


And Ann please write that blog about the NHS and HIV

I have been a 'victim' of that ring fencing you talk about.
Maybe more because I too live in a very rural and 'cut off' - probably not as cut off as the IOM but cut off just the same. As I live in Cornwall, UK

Hi Ann
I unfortunatly have had more than one experiences with so called professionals Who were no so professional. I have actually left a few doctors office because of the lack of knowledge of the hiv virus and tramission. I have been positive for 27 years now. Its a shame that 27 years later. We still have to put up with the stigma and hummiliation. Be strong, and know that there are people out here that know what you go through on a daily basis.
Take Care

Ann, hi new to your post. I would have walked out on him but i don't always think whole thing out before i act, that is after i gave HIM a lecture. But way back in 90 or so I went to a dermatolgist that told and showed me that at least 24 condtions were prelevelent in hiv + people. I was stunned. I don't know if that has changed but this Dr. was not only arrogant,and condisending but ignorant as well. That is why I would have left. Best to you.

though i'm new on here but i think its time people should learn to understand that hiv carriers are humans too

Hi Ann,
First of all sorry for abusing this section for totally unrelated subject(request) to this subject. Nut I don't know another way to do this.

I have a request for you. I have been trying to register in the to get some of my question answered. But my registration does not go through ( id used is When I click on cnfirnation the link sent by Poz forum, it says wrong activation code (request to resend activation code also does not work) and I am struck.
I see lot of people registering and not sure why mine does not go through. I have no other way of reaching you guys without registration

You have been kind and helpful to somany people. Would you extend it me as well..?
If there is a id to reach moderator please let me know


Dear Ann,

You are such a wonderful Nazi, following orders no matter what their merit might be. You have to adhere to the humorless Tim Horn's edicts even though you've made minuscule attempts to evade them, all without success. A coward with a coward's persona.

I can't imagine the joy you glean from excluding me from the AIDSMEDS forums but you know technology is on my side. You can label my registrations any way you wish but the fact is I will always return if I want to, and only my refusal to mask myself allows you to intervene.

For such a strong feminist it's always confounded me you cannot exist without a male partner to validate your existence.

Jesus, I really must get a breathalyzer for my PC. After ingesting a 5th of Absolut raspberry vodka (it's delish) it's a wonder I was able to type at all.

I'd ask you to delete my diatribe but don't give a shit. I apologize for posting it but can't claim I don't mean every word.

I dreamed I sent you an ugly email message but hope that's not the case.



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This page contains a single entry by Ann published on April 16, 2009 12:24 PM.

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