Tips and Tricks in Procedural Dermatology: Efficient and Effective Approaches to Achieving Optimal Diagnostic and Therapeutic Results Robert T Brodell, Stephen E Helms, Michael T Cosulich, Jeremy D Jackson, William Abramovits, Ashish C Bhatia, Jennifer Schulmeier
INDEX
Page numbers followed by b refer to box, f refer to figure, and t refer to table
A
Acanthosis 34
Acid-fast bacilli 23
Acne
scars, treatment of 168f
vulgaris 202
Acral skin 36
Acrochordons 62
Actinic cheilitis 139, 203
Actinic keratoses 62, 139, 150f, 198, 203
Adenocystic carcinoma 105
Adenoma, sebaceous 24
Adnexal carcinoma 105
Adson forceps 71f
Allergic contact dermatitis 12, 24
Alopecia 33
nonscarring 37
Aluminum 179
chloride 43f, 46f
solution 65
American Academy of Dermatology 146
American College of Micrographic Surgery and Cutaneous Oncology 101
Aminolevulinic acid 197
Anesthesia 62, 66, 68
techniques 116
Apocrine carcinoma 105
Argyria 178
Arthropod bites 12
Aspergillosis 24
Atrophy 34
Autoimmune disease 35
B
Bacillary bacterial colonies 24
Back squeeze 81
maneuver 82f
Basal cell carcinoma 24, 36, 37, 82f, 96, 105, 109, 202
pigmented 24
sclerotic 67
superficial 42f, 62
typical superficial 202f
Basal cell nevus syndrome 105
Basaloid cells 24
Becker's nevi 178
Bees pattern, swarm of 24
Betadine 102
Bichloroacetic acid 87, 92f
Bilobed flap
original 131f
Zitelli modification of 131f
Biopsy
excisional 41
porokeratosis 35f
technique 37, 60f
with curettage, feathering of 68f
Bishop Harmon forceps 71
Black dot ringworm 6
Blastomycosis 24
Bleeding 123
Botryomycosis 24
Bowen's disease 202, 203
Bowenoid papulosis 139
Budding spores 24
Bullous impetigo 23
Bullous pemphigoid 12, 24, 26, 31
Bumpy dermal edema development 161f
Buried vertical mattress suture 76, 112
Burns 187
Burow's graft 131f
Burow's triangle 131f
Burrow ink test 14
C
Cadmium
selenide 179
seleno-sulfide 179
sulfide 179
Café au lait macules 175, 177
Candida albicans 5
Candidiasis 9, 24
Carbon 179
dioxide 95
Carcinoma
mucinous 105
sebaceous 105
Cells 23
acantholytic 23, 24
atypical 24
inflammatory 23
necrotic 24
nonkeratinocytic 24
nonnevoid 24
Cellulitis, compartmental 123
Cervix, benign erosions of 87
Chemical
matricectomy 121
nail avulsion 118
Cherry angioma 159, 160f
Chest, extensive photodamage of 192f
Chicago sky blue stain 9f
Chickenpox 26
Chlorhexidine 102
Chromium oxide 179
Cleft palate 170f
Clitoris 91
Cobalt aluminate 179
Cold agglutinin disease 144
Collagenized stroma 24
Contact dermatitis, irritant 24
Cornoid lamella 34
Cosmetic tattoos 181
Crusted scabies, scaling plaques of 17
Cryoglobulinemia 144
Cryosurgery 139, 142, 143, 144
dermatologic 139
history of 140
principles behind 140
treatment 148t
Cryotherapy 66, 121, 139
matricectomy 121
C-suture 53f
Cyst 87, 109
borders of 55f
excision of 55
punch excision of 55f
D
Darier disease 24
Daylight photodynamic therapy 200
Deep sutures 76
Dental syringe 115
Dermal melanocytosis, congenital 175
Dermal pigmented lesions 178
Dermatitis
herpetiformis 12, 31
seborrheic 12
Dermatofibroma 24, 41
Dermatofibrosarcoma protuberans 105
Dermatophyte infection 9
superficial 3
Dermatosis papulosa nigra 62, 66
curettage of 67f
Dermoscopy 18
Diabetic neuropathy 119
Dichloroacetic acid 87, 88, 93f, 94f
treatment 87
Dichotomous branching 24
Diffuse eczematous papules 12f
Digital mucous cysts 121
Digital myxoid cyst treatment 121
Digital nerve block 116, 117
Dimethyl sulfoxide 3, 5, 7f, 9f
Diphenhydramine 68
Direct fluorescent antibody 26
Disazodiarylide 179
Disazopyrazolone 179
Distal interphalangeal joint 117
Distal nail avulsion 118
Distal subungual onychomycosis 4, 4f
Dorsal nasal rotation flap 129f
Double action nail nippers 115
Double trephine punch 54, 55
method 54
technique 54f, 59
Dynamic cooling device 155, 157
Dysplastic nevus 109
E
Ear lesions, cryosurgery of 145
Ecchymosis 164f
postprocedural 163, 164b
Eccrine carcinoma 105
Ectopic sebaceous glands 91
Electrodesiccation 6265
Electrofulguration 64
Electrosurgery matricectomy 121
Elliptical excision 109
Eosinophils 24
Ephelides 175
Epidermal
disk 34
pigmented lesions 177, 178
Epidermis, full-thickness necrosis of 24
Epidermolysis bullosa acquisita 31
Epinephrine 63f, 117
Epitheliocytes, necrotic 24
Erbium: yttrium aluminum garnet laser 96, 166
Erythema 48, 162
annulare centrifugum 4
multiforme 24, 25f
Erythematous reticular footprinting, severe 192f
Erythroplasia of Queyrat 24
Excess potassium hydroxide, removing 8f
Eyebrows 126, 127f
Eyelids 76
F
Facial
molluscum 95
tumors 105
Fascial structures, use of 83
Feathering technique 45
Felon 123
Ferric
cyanide 179
hydrate 179
oxide 177, 179
subsulfate 47
Fibrin filaments 24
Fibroblasts 24
spindle-shaped 24
Fibroxanthoma, atypical 105
Fitzpatrick skin 156, 173, 180, 187
Flaccid blister 37
Flap donor site, scarring of 133
Fordyce spots 91, 92f
Fungal
elements 9t
infections, superficial 4f
type 9
G
Genodermatoses 22, 24
Giant cells, multinucleated 23, 25f, 26
Ginkgo biloba 156
Gland, sebaceous 91, 93f
Glass slide and cover slip 15
Glove technique 115
Glucose transporter 1 158
Granular immunoglobulin G 35
Granules, pigmented 24
Grossing technique 59
Guarnieri bodies 23
H
Hailey-Hailey disease 24
Hand-foot-mouth disease 23
Hemangiomas 146, 158
proliferating 159
superficial 159
Hematoma 114f
Hematoporphyrin derivative 197
Hemorrhagic bullae 149f
Hemostasis 47f, 112
Henderson-Patterson bodies 23, 65
Herpes
infection 22, 25f
polymerase chain reaction 25
simplex 23
disseminated 25f
vesicopustules 22f
Hidradenitis suppurativa 203
Histiocytoma, malignant fibrous 105
Horizontal mattress suture 80, 81f
Horny cysts 24
Hovert technique 34, 34f
Human papillomavirus 66
Hyperkeratosis 13f, 24
Hyperkeratotic disorders 13f
Hyperpigmentation, postinflammatory 156, 159
Hyperplasia, sebaceous 87, 88, 91, 92, 94f, 203
Hypertrichosis 178
Hyphae 9
Hypopigmentation, postinflammatory 150f
I
Immune disorders 22, 24
Impetigo 12
Infantile hemangiomas 158
laser treatment 159b
Infectious diseases 22, 23
Ingrown nails 87
Instrument tamponade 53, 53f
Intense pulsed light 155, 186, 187f, 188f
Iron oxide 179
Island pedicle flap 128f
Isopropyl alcohol swab 187f
J
Joint stiffness 124
K
Keratinocytes
acantholytic 23
necrotic 24
pigmented 24
Keratinous cyst, small 145f
Keratosis, seborrheic 24, 46f, 62, 66, 87, 175
Keratotic papule 46f
Knee bend 83
Koilocytes 24
L
Labia majora 91
Large macrophages, cytoplasm of 24
Large oval lesions, excision of 56
Laser
beam profile, square-shaped 167f
hypertrophic scars 163
treatment 163
Lead chromate 179
Leiomyosarcoma 105
Leishman-donovan bodies 24
Leishmaniasis 24, 203
Lentigines 175, 180f, 182f, 190t
treatment of 177f, 180f
Leprosy 23
Lesions, dermal pigmented 178
Leukemias 144
Leukocytes 24
Leukocytoclastic vasculitis 36, 37
Leukoplakia 139
Lichen planus 4, 24
erosive 26
Lichenoid tissue reaction 34
Lidocaine 42, 56, 63f, 116
Light electrodesiccation 66f
Linear IgA bullous dermatosis 31
Lipoma 109
excision of 56
multiple painful 56
punch excision of 57f
Lips, herpes simplex of 22f
Liquid nitrogen 140
Luer-lock syringe 115
Lupus erythematosus 33, 35, 37
Lymphangitis 123
Lymphocyte 24
predominance 24
Lymphomas 144
Lymphoproliferative disease 144
M
Malassezia furfur 5
Malignant lesions 187
Manganese 179
Mantle cells 24
Mastocytoma 24
Mastoid interpolation flap 133
Maximal skin tension lines 110
Mayo stand 42
Melanocytes 140
Melanocytic lesion 120
Melanocytic nevi 24
Melanocytoses, dermal 175
Melanoma 24, 109, 147
Melasma, laser treatment of 178
Melolabial interpolation interpolation flap 1133
Mercury sulfide 179
Merkel cell carcinomas 24, 105, 147
Methanol burner 5
Methyl aminolevulinate 197
Meticulous intraoperative hemostasis 126
Microcystic adenexal carcinoma 105
Microscope 5, 15
Mohs map 103
Mohs micrographic surgery 67, 101, 113, 126
Mohs surgery 80, 101, 104, 105, 105b, 106
Molluscum contagiosum 23, 62, 65, 95
curettage of 66f
Mongolian spots 175
Monochloroacetic acid 87
Monsel's solution 47, 65
Montgomery tubercles 91
Mosquito hemostat 115
Mucormycosis 24
Myeloma, multiple 144f
N
Nail
avulsion 117
partial 119f
techniques 118f
clippings 122
diseases 203
dystrophy 120, 123
matricectomy 120
matrix
biopsy 119
excisional 120
plate elevator 115
procedures 115, 116
history of 115
spatula 116
splitter 115
Neck, extensive photodamage of 192f
Needle driver 70
jaws 71f
Neodymium-doped yttrium aluminum garnet 155
Neutrophil predominance 24
Nevoid cells
atypical 24
dermal type 24
epidermal type 24
Nodular basal cell carcinoma 62
Nodules
multiple 13
subdermal 36
Nonsteroidal anti-inflammatory drugs 201
O
Onychocryptosis 117
Onycholysis 4f
Onychomycosis 4f
Oral therapy 158
Osteitis, terminal 123
Osteomyelitis 123
O-z flap 128
P
Paget cells 24
Paget's disease 24
extra-mammary 105
pigmented mammary 24
Pain 123
Palm, pigmented lesion of 36
Palmar direction 117
Palms and soles, hyperkeratosis of 13f
Panniculitis 36, 37, 54, 54f
Papules, erythematous 25f
Paramedian forehead flap 133
Parapsoriasis 4
Patient observer self-assessment scale 112
Pemphigus
foliaceus 24
herpetiformis 24
vulgaris 24
Pencil technique 64f
Perfluorodecalin 181
transparent 181f
Periodic acid-schiff 9
stain 10, 10f, 122
Peripheral vascular disease 119
Photodynamic therapy 197, 201f, 202, 203
Photodynamic therapy, history of 197
Photosensitizers 197
Phthalocyanine dyes 179
Picosecond laser 179
Pigmented lesion lasers 174
Pityriasis versicolor 5f
Plantar direction 117
Plastic jaeger lid plate 145f
Poikiloderma of civatte 160
Poikilokaryosis 24
Polydioxanone 72
Polymerase chain reaction 26
Porokeratosis 34, 36
Porphyria cutanea tarda 31
Port-wine stain 157f
birthmarks 155, 156
laser treatment 159b
Potassium hydroxide 3, 4f, 7f, 9, 122
preparation 3, 6f, 7f
solution, application of 8f
Potassium titanyl phosphate 155
Potato peeler technique 64f
Povidone-iodine 102
Proper scraping technique 6f
Prophylactic antibiotics 101
Propionibacterium acnes 202
Proximal nail
avulsion 117
matrix 119f
Pseudohyphae 24
Pulsed dye laser 155, 159161, 162f
treatment 157f, 160f, 161f, 163f, 164f
Punch biopsies 51, 54f, 59
Punch incision 57f
Pustular dermatoses 22f
Pyogenic granuloma 62
Q
Q-switched ruby laser 174
R
Raynaud's disease 144
Raynaud's syndrome 144
Reflex sympathetic dystrophy 124
Rheumatoid arthritis 144
Rhombic flap 130, 130f
Rhytides, treatment of 169f
Rieger dorsal nasal rotation flap 128, 129f
Ropivacaine 116, 123
Rosacea 160, 190t
Rotation flap
bilateral 129f
unilateral 128f
Rule of halves 127f
S
Salicylic acid 66
Sanguinaria canadensis 101
Sarcoma, pleomorphic 105
Sarcoptes scabiei 12, 16
infestation 12
Saucerization 41
approaches 59
biopsies 41, 59
technique 48, 59
Scabies 12, 12f, 13
diagnosis of 14
mite 17f
preparation 12
treatment of 18t
Scabietic nodules 17
Scalp
alopecia 34f
wound, closure of 83f
Scalpel dermabrasion 46
Scarring 187
alopecia 37
Scars 162
treatment of 163b
Scleroderma 144
Sclerotherapy 121
Seborrheic keratosis
curettage of 67f
treatment of 66
Sentinel lymph node biopsy 105
Septate hyphae 24
Sertoli rosettes 24
Shave and saucerization techniques 41
Shoulder
extensive photodamage of 192f
flexion 81
maneuver 82f
Skin
biopsy 10f, 37t
cancer, non-melanoma 105
disease 23, 23t
graft
full-thickness 125, 132f
split-thickness 131
hooks 71
single- and double-pronged 116
lesions 62t
pigmented 22, 24
whitening 176f
Smooth jaws 71f
Sole, pigmented lesion of 36
Spencer suture scissors 72f
Spider angiomas 159, 160b
Spongiotic dermatitis 22, 24
Spores 9, 24
Squamous cell carcinoma 24, 36, 62, 104, 109, 142, 143f, 202
cutaneous 105
in-situ 62
Standard punch biopsy technique 51
Staphylococcal scalded skin syndrome 23, 26
Staphylococcus aureus 113
Stevens-Johnson syndrome 24, 26
Stratum corneum 10f
Streptocytes 24
Striae distensae 162
Subepidermal blistering diseases 31
Surgery, dermatologic 109
Suture 72
absorbable 73t
grasp trailing end of 78f
needle 74
nonabsorbable 72, 74t
running subcuticular 80, 80f
scissors 72
superficial 79
thread 72
Suturing technique 76
Syncytial nuclei 23
Systemic lupus erythematosus 144
T
Tadpole cells 24
Tattoo pigments 179t
Tattoo removal 179
treatment tips 180
T-cell lymphoma, cutaneous 4, 203
Telangiectasia 160, 162b, 190t
over right nasal ala 162f
residual 159
Tense blister 37
Tinea
capitis infection 9
corporis 4, 4f
faciei 4f
versicolor 9, 10f
Tissue
adhesives 75
necrosis 123
Titanium oxide 179
Toluidine blue stain 103
Tongue
blade 145f
depressor 187f
Topical 5-aminolevulinic acid, application of 202f
Toxic epidermal necrolysis 24, 26
Trichloroacetic acid 87
Trichophyton tonsurans 3, 5
Tuberculosis 23
Tumors 22, 24, 105
recurrent 105
Tyler technique 33f
Tyson's glands 91
Tzanck cells 24
Tzanck preparation 21, 25f
techniques 23t
Tzanck smear 21, 22, 22t, 26, 27
utility of 22
Tzanck test, modified 23
U
Ulceration 159
Ulcers, nonhealing 109
Upper cutaneous lip 133f
V
Vagal reactions 123
Vaginal mucosa 91
Vandenbos procedure 120
Varicella 12
zoster 23
Vascular lesion lasers 155
surgery of 155
Verrucae 66, 87
Verrucae vulgaris 62, 203
Verrucous hyperplasia 34
Vertical mattress suture 80, 81f
Vesicopustules, herpes simplex cluster of 22f
Vitamin E 156
W
Waldenström's macroglobulinemia 144
Warts 24, 66
White onychomycosis, superficial 4
Wound
care 122
closure 112
materials 72
management 104
X
Xanthelasma 8789, 90f
lesions 96
palpebrarum 89
Xeroderma pigmentosa 105
Y
Yellow papules, patch of 93f
Z
Zinc
chloride 101
oxide 179
Z-plasties 130
×
Chapter Notes

Save Clear