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25 Cards in this Set

  • Front
  • Back
Indications for shave biopsy
sebhorric keratoses
verrucous lesions
molluscum contangiosum
superficial basal cell carcinoma
benign nevi of the face where cosmetic result is impt
Snip excisions for:
acrochordons (skin tags)
predunculated nevi
Curettage may be performed on:
molluscum contangiosum
Verruca vulgaris
seborrhic keratosis
Contraindications for shave biopsy
pigmented lesions except benign nevi
Dx of infiltrative dermatosis
suspected sclerosing basal cell carcinoma
any lesion with dermal component
Complications of shave biopsy
How to stop bleeding in shave biopsy
20% aluminum chloride
hand held cautery
Monsel's solution or silver nitrate (but they tattoo, so be careful)
Place suture lines in parallel to:
Wrinkles and Langer's lines
Pt prep for shave biopsy
explain procedure
topical anesthetic 20-60m before
F/U for shave biopsy
Written instructions on wound care
keep clean and dry 24h
after that remove bandage and clean c soap and water
if bre-bandage, use atbx ointment
caution about infection
Indications for punch biopsy
lesion or dermatosis that covers a large surface area and dx needs confirmed b4 tx is started
Contraindications for punch biopsy
any lesion with highly malignant potential
Complications of punch biopsy
bleeding > than shave biopsy
infection rate is higher
scarring will occur
Pt prep punch biopsy
informed consent
topical anesthetic
F/U instructions punch biopsy
same as shave except:
F/U apt in 5-21d
no heavy lifting
inform of results of path exam
Indications excisional biopsy
Lesions larger than 1cm
Suspected melanoma
epidermal inclusion cyst
larger BCC and SCC
Complications of excisional biopsy
same as others but:
use cautery to stop bleeding
pay special attention to Langer's lines
Don't use elliptic technique on:
face esp on forehead near eyes or lips
Pt prep for excisional
same as others
F/U excisional
same as punch
high volt, low amp damped current.
generates heat in the tissues causing coagulation and dehydration
Indications for electrosurg
Pyogenic granulomas and other vascular lesions
Verruca vulgaris
Condyloma acuminata
Actinic keratosis
zuperficial multicentric BCC in combo with curretage
Contrindications for electrosurg
Not near a pacemaker
Not if flammable material is present
Complications for electrosurg
Delayed bleeding
Pigment alterations
Alcohol to clean skin could lead to fire
Viral particles can be aerosolized during surg.
Pt prep electrosurg
same as others
F/U electrosurg
same but no return apt necessary