Health Education Assets Library (HEAL)
 
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TitleDescriptionSubjectCollection
251 Shave biopsyIf the skin eruption is vesicular, the shave or punch biopsy should be done of apparently normal skin that is next to the edge of the blister. The 4 mm diameter specimen can be cut in half, and half submitted for standard stains, and half submitted for immunofluorescent staining.Shave BiopsyKnowledge Weavers Dermatology
252 Shave biopsyDiagnosis of basal or squamous cell carcinoma can be achieved usually by using a shave biopsy. The double-edged blade is held between the thumb and third finger to ensure stability.Shave BiopsyKnowledge Weavers Dermatology
253 Shave techniqueThis demonstrates a shave technique on a pig's foot. Because there are no protruding lesions, I start by angling the blade at about 45 degrees from the skin surface, and while advancing the blade forward, I have a slight side to side sawing motion, and when I am about halfway through the target, I t...Shave BiopsyKnowledge Weavers Dermatology
254 Shave techniqueThis demonstrates the shave technique. Local anesthetic can be injected into the fat beneath the target lesion, or within the lesion itself. One should be extremely careful to inject as little anesthetic as necessary to anesthetize the skin, because the anesthetic will artifactually enlarge and dist...Knowledge Weavers Dermatology
255 Shave techniqueThe blade is held between the thumb and third finger using the index finger for curvature. Of course, gloves should always be used. The lesion should be shaved flush with the surrounding skin.Shave BiopsyKnowledge Weavers Dermatology
256 SilvadeneI placed Silvadene on the wound. Silvadene is an excellent antibacterial cream to apply to a wound after debridement. One must insure that an 1/8 inch to 1/4 inch coat is applied to help insure that the dressing doesn't absorb all the cream and allow the wound to subsequently dry out.Knowledge Weavers Dermatology
257 Skin tagsSkin tags. They are rather small, and have a pedunculated base giving them the appearance of a teardrop.Skin TagsKnowledge Weavers Dermatology
258 Skin tagsThis shows Drysol being applied to the site of the skin tag removal to staunch bleeding. The Drysol hurts more than the snipping in my estimation.Skin TagsKnowledge Weavers Dermatology
259 Skin tagsSkin tags can be snipped off with scissors.Knowledge Weavers Dermatology
260 Skin TumorTumors of various sorts can be produced by anything that grows within the dermis.This demonstrates that the tumor was within the skin, and moves freely with the skin.Knowledge Weavers Dermatology
261 Specimen removalThe specimen of skin that is removed should be the same thickness throughout so that there is not an uneven appearance of the skin when the skin is closed with suture.Knowledge Weavers Dermatology
262 Spider telangiectasiaThe red lesion on the nose is a spider telangiectasia.Knowledge Weavers Dermatology
263 Spider telangiectasiaA spider telangiectasia is compressible and blanchable with adequate pressure. Generally, as the pressure is released the central feeding vessel can be seen and often pulsates.Knowledge Weavers Dermatology
264 Stasis dermatitisThe area should then be wrapped with the gauze that is impregnated with zinc oxide ointment. The wrap should be started just above the toes, and continue to just below the knee.Knowledge Weavers Dermatology
265 Stasis dermatitisAn elastic wrap is then applied on top of the gauze. The elastic wrap should be applied as tightly as the patient can stand around the foot and ankle, and the pressure is gradually reduced as the wrap is continued up to below the knee.Knowledge Weavers Dermatology
266 Stasis dermatitisStasis dermatitis (shown here) that is not oozing, is best treated with a support hose. The optimum ankle pressure is around 30 to 40 mm Hg, and generally a hose that comes to just below the knee is adequate. The hose should be worn at all times when the extremity is in the dependent position, such ...Knowledge Weavers Dermatology
267 Stasis dermatitisIf the patient has acute stasis dermatitis, then an Unna boot can be applied. This consists of a roll of gauze that is saturated with zinc oxide ointment, and an elastic wrap that is applied on top of it.Knowledge Weavers Dermatology
268 Stasis dermatitisThe area should be first cleansed with sterile saline or soap and water.Knowledge Weavers Dermatology
269 Stratum corneumThe thick stratum corneum of the palms and soles prevents chemicals from readily entering those areas. This patient worked around a chemical to which he became allergic, and you can see the line of demarcation along the sides of his hands indicating the thinner stratum corneum on the dorsum of the h...Knowledge Weavers Dermatology
270 Stratum corneumThe stratum corneum, the barrier layer, is very thin, and can be removed with scotch tape and by applying scotch tape to the skin repeatedly for 15 or 20 times. Even though it is physically thin it is a very resilient and effective barrier layer.Stratum CorneumKnowledge Weavers Dermatology
271 Striae formation in the groinStriae formation in the groin secondary to the use of topical steroids. Striae formation, often calledfracturesof the skin, are currently considered irreversible.StriaeKnowledge Weavers Dermatology
272 SuturingAfter placing four throws to create a square knot, the suture is then cut just above the knot.Knowledge Weavers Dermatology
273 SuturingThe suture is then tightened by crossing the non-dominant (left) hand over the dominant (right) hand.Knowledge Weavers Dermatology
274 SuturingThis demonstrates tightening of the double loop along the long axis of the wound using suture.Knowledge Weavers Dermatology
275 SuturingThis demonstrates the deep dermal suture properly placed with the loop, which will be just on the under-surface of the dermis, and the knot will be buried well within the fat. This will prevent the knot from extruding through the dermis and out through the wound.Knowledge Weavers Dermatology
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