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1 Basal cell carcinoma: excision removalThis person had a basal cell carcinoma, and the epidermis and dermis were excised. The danger area where the temporal branch of the facial nerve may lie and be quite close to the undersurface of the skin is shown by the straight lines drawn from ear to forehead. The surgeon should be careful to unde...Surgical MethodsKnowledge Weavers Dermatology
2 GoodmanThis is a picture of Dr. Goodman (of Goodman & Gillman fame). I once asked him how much you should know about a medication before using it, and he said,A lot! And you can quote me on that!Knowledge Weavers Dermatology
3 Punch biopsyPunch biopsy is excellent for sampling a skin disease that has multiple essentially identical lesions, or sampling a lesion within the skin. It is designed for full thickness skin biopsy, and is not an effective tool for biopsying the fat. When using it, it should be held as shown, should be spun ve...Knowledge Weavers Dermatology
4 KeloidBefore injecting the keloid with the corticosteroid, I recommend injecting local anesthetic into the underlying fat, and waiting about five minutes for the anesthetic to take effect. The anesthetic should not be injected into the keloid as this reduces the amount of space into which one can inject t...Knowledge Weavers Dermatology
5 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
6 SuturingThe loop is then tightened with the hands in their natural position. This is done four times and then the suture is cut leaving suture ends at .5 cm long.Knowledge Weavers Dermatology
7 Tearing actionThey are then opened which creates a tearing action.Knowledge Weavers Dermatology
8 Halogenated steroidsHalogenated steroids, particularly fluorinated steroids, will often induce inflammation of the skin of the scrotum, vulvae, as well as the face. Halogenated steroids should never be used, with rare exception, on these areas, and then for the briefest period of time possible.Knowledge Weavers Dermatology
9 TicksThe maximum incubation period for the tick-borne diseases seen in Utah would be seven days. If you were asked by someone who has had a tick how long they have to wait before they are out of the woods (so to speak), the answer is one week.Knowledge Weavers Dermatology
10 ScissorsThe specimen can also be removed using scissors as one cuts beneath the dermis.Knowledge Weavers Dermatology
11 SuturingThis demonstrates the same maneuver using suture.Knowledge Weavers Dermatology
12 Basal cell carcinoma: excision removalThis demonstrates the wound one week after the surgery. The eversion will disappear within several weeks because of the downward and lateral pulling forces on the wound.Surgical MethodsKnowledge Weavers Dermatology
13 Treating mild acneThis demonstrates two approaches to treating mild acne (comedos and less than about 10 red papules and pustules). The first treatment is shown on the left,and she applies Cleocin-T lotion to her face each morning, and Cleocin-T lotion and Retin-A 0.025% cream to her face each evening. A second alter...Drug EffectsKnowledge Weavers Dermatology
14 Treatment of ScabiesTreatment of choice for scabies is to apply permethrin (Elimite) overnight from the neck down, and to ensure that everyone in the patient's family be treated at the same time. The bedding and clothing from the past week should be washed or dry cleaned, or it can be placed in a plastic bag and set as...Knowledge Weavers Dermatology
15 SuturingAfter placing four throws to create a square knot, the suture is then cut just above the knot.Knowledge Weavers Dermatology
16 SuturingThe suture is then tightened by crossing the non-dominant (left) hand over the dominant (right) hand.Knowledge Weavers Dermatology
17 SuturingThis demonstrates tightening of the double loop along the long axis of the wound using suture.Knowledge Weavers Dermatology
18 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
19 UrticariaThis patient has developed rather severe urticaria, the cause of which was unknown. In urticaria, the skin swells and initially looks red and later can blanch as the amount of fluid increases within the skin. Internal organs can be involved in the process, and we are particularly concerned about the...Knowledge Weavers Dermatology
20 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
21 Ingrown nailThe nail plate is cut from the underlying nail bed with scissors.Knowledge Weavers Dermatology
22 Excision procedureDemonstrates the same V. Summary)Knowledge Weavers Dermatology
23 Ingrown nailThis shows the nail plate just barely attached.Surgical MethodsKnowledge Weavers Dermatology
24 Excision: suturingThe double loop is tightened by pulling the hands into their natural position, but the knot cannot be adequately tightened by pulling in that direction; the knot must be tightened by pulling the suture ends along the length (long axis) of the wound. (This is shown in the following slide)Knowledge Weavers Dermatology
25 ScalpelThis is a cross-sectional view demonstrating the blade angled away from the center of the ellipse.Knowledge Weavers Dermatology
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