Skin Deep
Dermatologist Specializes in Fighting Melanoma
By David Blackburn
Messenger-Inquirer
Dr. Johnathon Edge was leaning toward dermatology by his third year in medical school after doing a rotation observing two local dermatologists.
The Knottsville native, who knew he wanted to return to Daviess County to practice, didn’t decide on a sub-specialty until dealing with the black dot-size mole by his left biceps.
Edge was in his fourth year at the University of Louisville Medical School when he found the mole that defied diagnosis by seven pathologists and led to two surgeries.
The “very ugly, very atypical mole” was deemed benign, said Edge, 31, but it gave him an idea that grew.
“It steered me toward skin cancer and skin cncer surgery,” said Edge, who opened Dermatology & Skin Cancer Specialists PSC in The Springs on East Parrish Avenue in October.
“It gave me a greater appreciation for how difficult the job can be,” Edge said. “It’s not a real exact science. We’re trying to predict biological behavior.”
Like many living in an area with a high rate of skin cancer, Edge worked on his family’s farm, often without a shirt.
After graduating from Whitesville Trinity High School and Eastern Kentucky University, Edge went to U of L, where he also did his dermatology residency.
Edge decided on dermatology after observing Drs. Michael Crowe and Artis Truett at Owensboro Dermatology Associates PSC on New Hartford Road.
He enjoyed watching them treat patients of all ages and the fact that they did surgery, which he has always liked, Edge said.
He later talked to a Mohs micrographic surgeon, and “that was the icing on the cake,” said Edge, who did a one year Mohs Fellowship at U of L.
The Mohs technique involves mapping and microscopically examining a skin cancer, usually non-melanoma and some of the bordering tissue removed in surgery.
Edge said he liked the precision of a labor intensive effort that offers a high cure rate and spares more healthy flesh around the cancer sight.
It is especially important to minimize damage when those areas are on noses, ears and hands, he said.
“I think I have the best job in the field of medicine,” said Edge, who used to work on at least 500 complex skin care cases as part of the fellowship.
About half of the 100 applicants for a Mohs Fellowship each year are chosen, said Dr. Michael McCall of Associates in Dermatology, part of U of L’s dermatology program.
“You’re looking at the select of the very select,” said McCall, with whom Edge worked.
Edge “is a quick learner, very bright and intelligent,” McCall said. “He interacts with patients extremely well” and is “intuitive” when it comes to surgery.
“He has a knack for reconstructing defects” or the wounds left after tumors are removed, McCall said.
But sustaining a practice with such skills can be difficult in sparsely populated areas, which is why few specialists locate in those areas, Edge said.
“It’s much easier to carve out your niche in a larger population,” he said. “I knew I wanted to do something that was needed in a rural area, which is where I wanted to live.”
Edge said he isn’t worried about making it here.
“There is a log of skin cancer in this area,” Edge said. In one month of practice, he has found two confirmed cases of melanoma and some probable cases, he said.
Daviess County is home to seven months of sunny weather and many outdoor laborers, including light-complexioned workers of north European descent, he said.
According to the National Cancer Institute, Daviess County has a higher-than-average rate of skin cancer cases and deaths.
Between 1999 and 2003, Daviess County had 20.6 new cases of melanoma per 100,000 populations, he said. The state average was 20.3, while the national average was 18.3, he said.
In that same span, Daviess average 4.3 deaths, compared to a state rate of 3.4 and national rate of 3.0, he said.
“One person dies from melanoma every hour in the United States,” Edge said. In addition to lifestyle choices — such as playing or working outdoors — people rarely get routine checkups, Edge said.
“Traditionally people don’t go to a doctor unless they have a problem,” he said. So melanomas end up being diagnosed in later stages, which increases the chances of death, he said.
Edge put off having his mole examined for more than a year. It grew but never met the warning-flag criteria for possible melanoma.
“It was a bit of a scar,” he said. “It gave me a nice scar.”
And a career.
