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29 Cards in this Set

  • Front
  • Back
What if the purpose of cryotherapy?
Destroy the skin!

Don't do this for malignancies!
How do people usually apply liquid nitrogen?
Q tips

Guns!
What do you use cryotherapy for?
Benign lesions
Premalignant lesions
What are some types of benign lesions treated with cryotherapy?
Viral verruca (warts)
Suborrheic keratosis
Lentigo
What are some premalignant lesions treated by cryotherapy?
Actinic keratosis
When should you use cryotherapy to treat malignant lesions?
When surgery is contraindicated
What are some limitations for cryotherapy?
PAIN! - it's painful!
Depth of penetration: you can only treat the top of the skin
Lack of margin control
What are some acute complications of cryotherapy?
Inflammation
Blisters!
What are some chronic complications of cryotherapy?
Hypopigmentation
Hyperpigmentation
Scarring!
What are some different kinds of anasthesia used in dermatologic surgery?
Local infiltration
Nerve blocks
Tumescent anesthesia
What are some local anesthetics used in dermatologic surgeries?
#1: Lidocaine- fast onset!
What are some of the different kinds of local anesthetics?
Amides (2 i's)
Esters (1 i)
What are some of the more long-lastinglocalanesthetics?
Bupivacaine
Tetracaine
What are some of the most common complications of local anesthetics?
Allergic reactions to the preservatives in the anesthetics (methylparaben)
What's the purpose of using Epi in dermatologic surgery?
Vasoconstriction --> reduces bleeding
Slows removal
-Prolonged effect
-Decreased volume needed
-Lower toxicity
What is the effect of most local anesthetics?
Vasodilation
What are the contraindications to epinephrine?
Absolute:
Hyperthyroidism
Pheochromocytoma
In places with 1 blood supply (penis, fingers)

Caution:
HTN
Narrow angle claucoma
What do you do in electrodessication and curettage?
Fry and srape the tissue
What are indications for electrodessication and curettage?
Small, superficial malignant lesions
Premalignant lesions
Benign lesions
What are some small, superficial malignant lesions well treated by electrodessication and curettage?
Noninvasive/in situ
BCC
SCC
What are some premalignant lesions that you can treat with electrodessication and curettage?
Stubborn actinic keratoses
What are the limitations to electrodessication and curettage?
Lack of penetration
Lack of margin control
Lack of healing (lower legs)
Cosmetic concerns!
What are the complications to electrodessication and curettage?
Immediate:
-wounds
-infection

Late:
-poor cosmesis
-hypertrophic scar
What's the standard of care for derm surgery?
Standard ellpitical excision
What are the indications for standard elliptical excision?
Everything in dermatology
What are the limitations to standard elliptical excision?
Patient related factors (CV problems, etc.)

Wound related factors

Limited margin control for things that are more aggressive
What is the idea behind mohs micrographic surgery?
Fixate the live tissue with zinc chloride during the opeeration so that you can get instant feedback about the margins of the tumor
What are indications for mohs?
High risk BCC/SCC
Location where you want to conserve tissue
Larger
What are the different ways that you can let things reconstruct after derm surgery?
Granulation
Linear closure
H-plasty
Island pedicle flaps
Bilobe flaps