Facial Plastics

Question 1

What is the prognosis of malignant melanoma based on?

Answer 1

Tumour thickness

Question 2

Where does malignant melanoma arise from?

Answer 2

30% develop from pre existing neavus

70% develop in de novo

Question 3

Risk factors for malignant melanoma

Answer 3

Fair skin 
Previous atypical naevi
Sun exposure 
FH of melanoma 
History of melanoma or other skin cancer
Weak immune system 
Increasing age
Xeroderma Pigmentosum

Question 4

What is lentigo maligna?

Answer 4

Melanoma in situ

Question 5

Acral melanoma is seen on…..

Answer 5

Hands

Feet

Question 6

The thicker the tumour is…..

Answer 6

The worse it is

Question 7

What does a PET scan do?

Answer 7

Metabolise glucose

Question 8

Risk factors for Basal cell carcinoma (BCC)

Answer 8

Immunosuppression
Fair skin
Sun exposure
Inherited

Question 9

Growth speed of BCC

Answer 9

Slow growing

Question 10

How much of BCC do we cut out?

Answer 10

90%

Question 11

What does BCC look like?

Answer 11

Raised pearlea with central exposure

Varies in person

Question 12

Do BCC usually metastases?

Answer 12

No

Question 13

Where is the first place SCC metastasises to?

Answer 13

The neck

Question 14

Where are common sites for SCC?

Answer 14

Pinna
Bald head
Etc

Question 15

How long is radiotherapy used for skin malignancies?

Answer 15

1 week

Question 16

What is cryotherapy generally reserved for?

Answer 16

Premalignant condition

Question 17

What is secondary intention?

Answer 17

The hole will fix itself

Question 18

Pros of secondary intention

Answer 18

Dont need to intervene

Low risk of infection

Question 19

Con of secondary intention

Answer 19

Can get scarring

Question 20

When are skin grafts used?

Answer 20

When struggle to control primarily

Question 21

How does rotation flaps work?

Answer 21

Rotate the skin around

Gathering loose skin over a big area so that it is tension free

Question 22

How many rotation flaps would be needed on a scalp?

Answer 22

2

Question 23

How do transposition flaps work?

Answer 23

Lifting over an adjacent area

Question 24

Where would bilobed transposition flaps be used?

Answer 24

Where area of skin is tight but looser skin further up

Question 25

Where is bilobed transposition flaps usually used?

Answer 25

Nasal tip

Question 26

How do island flaps work?

Answer 26

Cut the skin around it but keep what is underneath

Question 27

Where are island flaps commonly used?

Answer 27

Around lip / cheek

Question 28

Metabolic need of skin

Answer 28

Very low

Question 29

What is done in a full thickness skin graft?

Answer 29

Tie overdressing to put pressure on it and to prevent haematoma

Question 30

Where do split thickness grafts cut across?

Answer 30

The basement membrane

Question 31

What do split thickness grafts leave?

Answer 31

An awkward scar