Skin

Question 1

Describe the technique of electrochemotherapy

Answer 1

Pre-op:

• assessment by clinical oncologist
• lung function test (as using bleomycin)
• gabapentin 2/52

Peri-op:

Anaesthetic considerations

• GA
• muscle paralysis
• cardiac monitoring

Surgical technique

• debulk tumour deposit if required
• inject bleomycin IV (typically 15000IU/m2)
• allow to circulate 8mins
• introduce probe into tumour and apply current
• “ELECTROPORATION” i.e sends pulse into tumour + increases permeability of cells > increased concentration of bleomycin within tumour cells x800
• work from centre of tumour outwards in spiral fashion to just beyond periphery of tumour
• no effect on normal tissues

Post-op:

• analgesia
• chlorpheniramine
• dress and heal by granulation

Question 2

What is rhinophyma?

Answer 2

Rhinophyma is sebaceous hyperplasia with thickening of the skin
- gives characteristic red, swollen, bulbous, irregular pitted appearance of nose.
Part of spectrum of rosacea
Usually affects males
No causal association with alcohol

Treatment:

NON-SURGICAL i.e acne/rosacea Rx

• topical retinoids
• topical antibiotics e.g metronidazole
• oral antibiotics e.g. tetracyclines
• oral isotretinoin

SURGICAL

• Surgical debulking (“shave”)
• Dermabrasion
• Laser resurfacing e.g CO2