Principles of Skin surgery and skin tumour management Flashcards
Describe the appearance of dermatofibroma
Firm to touch
Often increased pigment around the rim
Describe the appearance of a basal cell papilloma
Black - cookie like
What is the problem with taking a biopsy of a rash
It may not provide a diagnosis as different skin conditions may have the same histology e.g. different types of eczema etc
How do we treat non-melanoma skin cancer
Traditionally surgery but now there are some new treatments such as topical treatments
What are some of the treatment options for common precancers
cryotherapy solaraze 5FU PDT imiquimod cream resurfacing
What are some questions to be asked in preoperative planning
nature of procedure medical Hx Drug Hx Bleeding disorder Allergies Other - pacemaker, valve defect, epilepsy, diabetes
What are some of the problems with surgery on a patient on prednisolone
Might reduce the bodies capacity to with infection and slows down the wound healing
What are the effects of smoking on wound healing
Blood supply is massively reduced to the wound if you are a smoker.
How do we treat metastatic melanoma
Initially surgery
further surgery, radiotherapy or chemotherapy may be needed
Where is Erbs point ?
point half way along the posterior border of the sternocleidomastoid muscle from which all cutaneous branches of the cervical plexus exit to become superficial.
What are the 5 layers of the scalp
Skin Connective tissue Aponeurosis Loose connective tissue Parietal bone
What is shingles also known as
Herpes Zoster
What are the 3 branches of the trigeminal nerve
Opthalmic (1)
Maxillary (2)
Mandibular (3)
What are the 4 methods of local anaesthesia
Topical
Local infiltration
Nerve block
Field block
Why is adrenaline useful with surgery
Prolongs anaesthesia and reduces bleeding
In what patients should adrenaline be avoided
Patients with cardiac disease
Those on psychotropic drugs
How can you reduce the pain of a during local anaethetic
Relax patient topical local fine needle warm the local omit adrenaline neutralise acidity massage skin slow injection subcutaneous injection follicle opening nerve blocks
What are some complications of skin biopsies
Bleeding wound dehiscence infection scarring motor or sensory nerve damage loss of function
Where are the most common sites of metastatic melanoma
Brain, lungs
liver
lymph nodes
