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Physical leads to excision of "Ugly Duckling" lesion

Derm ECHO, a program connecting primary care physicians with dermatologic best practices, helps identify a patient’s ‘ugly duckling’ lesion leading to a critical surgical excision.

Daniel's story

Daniel Kessler
Daniel Fessler – Fulton, Missouri
Normally, I’m not someone who goes to the doctor on a regular basis, or even gets annual physicals. In early 2016, I had a severe nosebleed, and when I went in to have it checked out, I got a nice but stern lecture to set up a physical. I grew up on a farm, and I protected my back and legs from the sun, but over the last 10 years, I’ve been out in the sun a lot more. 

During the physical, Dr. Robert Pierce of Fulton Family Health Associates took a look at my back, where he noticed a lesion on my skin. He excised it. The pathology report suggested the lesion was bordering on melanoma, so he helped set me up with Dr. Luke Welch of Central Missouri Dermatology, and worked with the clinic to get me a timely appointment. I had a procedure in August to remove the lesion, and with Dr. Welch’s advice, I’m now getting check-ups on regular basis. I’m also now signed up for annual physicals. I don’t generally like going to the doctor, but thanks to the hard work of both Dr. Pierce and Dr. Welch, I’m free and clear.

The dermatologist's perspective

Robert Pierce

“We changed our practice based on dermatologic information we learned from participating in the Extension for Community Healthcare Outcomes program at the University of Missouri, also known as the ‘Derm ECHO.’ We started having men over 50 take off their shirts for their annual exams, including Daniel, to check for skin cancers. I found an ‘ugly duckling’ lesion on his back, which I excised. The pathology report indicated the lesion was bordering on early melanoma. I connected him with Dr. Welch, who completely excised the lesion. The Derm ECHO program may have saved Daniel’s life. ”

─ Robert Pierce, MD, MSPH, FAAFP Fulton Family Health Associates

Patient & physician stories

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