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29 Cards in this Set
- Front
- Back
What if the purpose of cryotherapy?
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Destroy the skin!
Don't do this for malignancies! |
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How do people usually apply liquid nitrogen?
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Q tips
Guns! |
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What do you use cryotherapy for?
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Benign lesions
Premalignant lesions |
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What are some types of benign lesions treated with cryotherapy?
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Viral verruca (warts)
Suborrheic keratosis Lentigo |
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What are some premalignant lesions treated by cryotherapy?
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Actinic keratosis
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When should you use cryotherapy to treat malignant lesions?
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When surgery is contraindicated
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What are some limitations for cryotherapy?
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PAIN! - it's painful!
Depth of penetration: you can only treat the top of the skin Lack of margin control |
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What are some acute complications of cryotherapy?
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Inflammation
Blisters! |
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What are some chronic complications of cryotherapy?
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Hypopigmentation
Hyperpigmentation Scarring! |
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What are some different kinds of anasthesia used in dermatologic surgery?
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Local infiltration
Nerve blocks Tumescent anesthesia |
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What are some local anesthetics used in dermatologic surgeries?
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#1: Lidocaine- fast onset!
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What are some of the different kinds of local anesthetics?
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Amides (2 i's)
Esters (1 i) |
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What are some of the more long-lastinglocalanesthetics?
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Bupivacaine
Tetracaine |
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What are some of the most common complications of local anesthetics?
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Allergic reactions to the preservatives in the anesthetics (methylparaben)
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What's the purpose of using Epi in dermatologic surgery?
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Vasoconstriction --> reduces bleeding
Slows removal -Prolonged effect -Decreased volume needed -Lower toxicity |
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What is the effect of most local anesthetics?
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Vasodilation
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What are the contraindications to epinephrine?
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Absolute:
Hyperthyroidism Pheochromocytoma In places with 1 blood supply (penis, fingers) Caution: HTN Narrow angle claucoma |
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What do you do in electrodessication and curettage?
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Fry and srape the tissue
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What are indications for electrodessication and curettage?
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Small, superficial malignant lesions
Premalignant lesions Benign lesions |
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What are some small, superficial malignant lesions well treated by electrodessication and curettage?
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Noninvasive/in situ
BCC SCC |
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What are some premalignant lesions that you can treat with electrodessication and curettage?
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Stubborn actinic keratoses
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What are the limitations to electrodessication and curettage?
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Lack of penetration
Lack of margin control Lack of healing (lower legs) Cosmetic concerns! |
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What are the complications to electrodessication and curettage?
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Immediate:
-wounds -infection Late: -poor cosmesis -hypertrophic scar |
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What's the standard of care for derm surgery?
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Standard ellpitical excision
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What are the indications for standard elliptical excision?
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Everything in dermatology
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What are the limitations to standard elliptical excision?
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Patient related factors (CV problems, etc.)
Wound related factors Limited margin control for things that are more aggressive |
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What is the idea behind mohs micrographic surgery?
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Fixate the live tissue with zinc chloride during the opeeration so that you can get instant feedback about the margins of the tumor
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What are indications for mohs?
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High risk BCC/SCC
Location where you want to conserve tissue Larger |
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What are the different ways that you can let things reconstruct after derm surgery?
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Granulation
Linear closure H-plasty Island pedicle flaps Bilobe flaps |