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Dermatology > Skin Exam & Dermatology Procedures > Flashcards

Skin Exam & Dermatology Procedures Flashcards

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Dermatology Board Prep flashcards
1
Q

Goals of a Skin Exam

A

Determine general skin color & number of nevi

Screen for melanoma

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2
Q

ABC’s of Screening for Melanoma

A 
A: asymmetry
B: border irregularities
C: color variation
D: diameter
E: enlargement & evolution
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3
Q

Indications to Perform a Biopsy

A

All suspected neoplasms
All bullous disorders
Clarify a diagnosis when a limited number of entities are under consideration

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4
Q

Things to Known Before a Biopsy

A

Ask about allergies/reactions to topical antibiotics, local anesthetics, & tape
Know if a bleeding disorder, on aspirin or on warfarin

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5
Q

Biopsy Danger Zones

A

Areas overlying highly vascular structures

Areas associated with exit points of superficial nerves

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6
Q

Site Selection for Inflammatory Lesions

A

Biopsy those with characteristic inflammatory changes first

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7
Q

Site Selection for Blistering disease

A

Biopsy only newest vesicles or blisters

Remove vesicle intact with adjacent normal skin

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8
Q

Site Selection for Nonbullous Lesions

A

Maximal lesions skin & minimal normal skin
1-4 mm excise completely
Larger lesions: bx the edge, thickest portion or area that is most abnormal color

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9
Q

Site Selection for Bullae

A

Edge including small part of blister with adjacent intact skin

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10
Q

Considerations of Biopsies

A

Leave scars
Avoid cosmetic areas & areas with poor healing
Cosmetic areas: refer to derm or plastic surgeon

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11
Q

Anesthetic Used for Dermatology Procedures

A

Lidocaine 1%
Lidacaine 1% with epinephrine
Lidocaine 2.5% + Prilocaine 2.5%

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12
Q

Lidocaine 1%

A

Procedures including fingers, toes, nose, penis, or ear

May need to increase the pH

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13
Q

Lidocaine 1% with Epinephrine

A

NOT for procedures of the fingers, toes, nose, penis, or earlobes; or patients on non-selective beta blockers

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14
Q

Advantages of Epinephrine

A

Less bleeding
Prolongs anesthetic action
Allows larger volumes of anesthetic to be used safely

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15
Q

Local Anesthesia

A

Watch total dose administered
Insert needle through area just anesthetized
Lightly test skin or wound margins for adequate anesthesia

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16
Q

Field Block

A

For heavily contaminated wounds or when anesthetizing for I&D of a skin abscess
In a diamond formation

17
Q

Langer’s Lines

A

Pull wounds open in the direction of skin tension lines

Parallel the direction of the collagen n the dermis

18
Q

Shave Biopsy

A

Small, depressed scar

19
Q

Lesions Suitable for Shave Biopsies

A

Elevated & confined to the epidermis
Seborrheic or actinic keratoses
Skin tags
Small superficial lesions

20
Q

Punch Biopsies

A

Special tool in different sizes
Inject anesthetic
Stabilize skin with the thumb & forefinger

21
Q

Excisional Biopsy

A

Draw ellipse around lesion
Length 3x the width
Grab edge of area to be excised; dissect biopsy tissue
Undermine edges of the wound

22
Q

Closing an Excisional Biopsy

A

Interrupted non absorbable sutures

Needle points defined: cutting, tapered, blunt

23
Q

Needles FS

A

For skin

Thick skin

24
Q

Needles CE

A

Cutting needles

Thick skin

25
Q

Needles P

A

Plastic

Cosmetic

26
Q

Needles PS

A

Plastic skin

Cosmetic closures

27
Q

Suturing Elliptical Excisions

A

“Rule of halves”

28
Q

Wound Care

A

Dressed with thin film of antibiotic ointment
Adhesive bandage
Shower after 24 hours
No baths or hot tubs until sutures out

29
Q

Days for Suture Removal of Face, Back & Legs, Remainder of Body

A

Face: 3-5 days
Back & Legs: 10-14 days
Remainder of Body: 7-10 days

30
Q

Post-op Complications

A

Bleeding
Infection
Allergic reactions to tape

31
Q

Common Infections as a Post-op Complication

A

Staph
Strep
Candida
Culture & start antibiotics or anti-fungal ointment

32
Q

Wood’s Light Exam

A

Fungus: blue-green
Tinea versicolor: pale white-yellow fluorescence
Erythrasma: brilliant coral-red
Accentuates hypo pigmented areas in vitiligo

33
Q

Test is you Suspect Fungal Infection

A

KOH skin scrapings

34
Q

Tzanck’s Smear

A

Confirms HSV infection

Gently rupture vesicle & scrape debris from vesicle base

35
Q

Cryotherapy Indications

A

Warts
Actinic keratosis
Seborrheic keratosis

36
Q

Cryotherapy

A

Cautious on the digits especially where nerves are located
Prevent severe pain & neuropathy
Avoid over-freezing in periungual region

37
Q

Short Term Complications of Cryotherapy

A

Pain variable
Lesions painful after freezing as a result of pressure
Hemorrhage common
Infection

38
Q

Long Term Complications of Cryotherapy

A 
Nerve damage
Pigmentary changes
Hypertrophic scar formation
Permanent nail dystrophy
Recurrence of a lesion

Dermatology (13 decks)

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