Dermatologic Procedures Lecture Powerpoint Flashcards
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Spots of superficial basal cell carcinomas that remain low in the dermis and continue to replicate even after excision of all the visible lesion - can be avoided by performing mohs procedure to ensure excising what is missed
Important pre-existing factors when considering dermatologic procedure (4)
- anticoagulant/bleeding
- immunosuppression
- diabetes
- cardiovascular disease (the epi injection can be a big deal)
Cryotherapy
Use of liquid nitrogen in a very compressed container that makes it very cold to apply it to freeze the tissue in a freeze thaw freeze thaw pattern (each time will take less time to freeze) to death while taking proper PPE for any aerosolized disease molecules
Shave vs punch vs excisional biopsy
- A shave takes a superficial layer and says nothing about the depth of the lesion, but can allow for wide excision, does not scar
- A punch biopsy is a deep incision all the way to the fatty layer of tissue to see how deep a lesion is
- excisional is removal of the entire lesion (diff from incisional which is partial), done in the case of suspect of melanoma within a few cm margins of extra spacing
UVB phototherapy
Treatment for skin eruptions using artificial UV light, carefully controlled and extremely effective for significant skin disease
PUVA
Combination of psoralen and UVA therapy used to treat skin conditions, with the psoralen making it more sensitive to the UV allowing for deep penetrating work on the skin
Intralesional injections
A direct placement of medication into a lesion of skin with a fine needle, often a dilute solution of triamicalone (kenalog)
Dysplastic nevi
Nevi that appear physically or histologically as high potential for conversion to melanoma
Actinic keratosis, if left untreated, can degranulate and turn into…
….squamous cell carcinoma
Langer lines
Lines of skin folds that naturally occur that plastic surgeons try to cut and suture following allowing for minimal scarring
Epinephrine assists lidocaine in these 2 ways
1) increases the length of effect
2) decreases bleeding
The key to painless lidocaine injections is….
….slow speed of injection with a small diameter needle
Trichloroacetic acid mech of action (derm procedures)
Used to treat warts or actinic keratosis or other lesions through activating the immune response to be drawn to the area, often in conjunction with duct tape therapy
Podophyllin (derm procedures)
Liquid therapy used to treat genital warts and molluscum alongside petrolium jelly around the lesion
Cantharidin mech of action (derm procedures)
forms a blister under the wart, cutting off the blood supply, the blister may be painful and itch