Plastic Surgery

In the course of the 4 week rotation, you will be expected to:

1. Master basic dermatologic procedures (ask one of the dermatology residents to train you) – see Procedure Orientation below.

2. Master dermatology topics relevant to Plastic Surgery. Review all the lectures in this tab by Week 3 of the month rotation. The order of lecture priority follows immediately below:

By end of Week 1:

How to Avoid Errors in the Dermatology Practice [PDF]

• • This lecture is given by Dr. Lebwohl and is mandatory before rotating through the FPA Dermatology Practice. It describes how to avoid common errors in patient care. In this case, you need to download the lecture to get the audio version.

Medical Student Dermatology Pathophysiology Course – All lectures

Derm Medical Student Curriculum

• • This powerpoint reviews succinctly the basic information needed to follow along in my dermatology clinic. Ideally, it should be read before rotating in a dermatology clinic.

Dermatology History, Physical Exam, Differential Diagnosis

• • This lecture is the Sinai MSII ASM course on how to do a dermatology physical exam. Essentially, it functions as a lecture on regional differential diagnosis.

By end of Week 2 (i.e., the weekend after Week 1 will be intensive for studying):

Dermatology Procedural Safety: A Survey (AAD Focus Session 2-5-11)

• This is my lecture given at the AAD on dermatology procedural safety. The lecture outlines ways to avoid physician injury in a number of common procedures in dermatology.

Intralesional Triamcinolone (ILTAC)

• • This document describes how to mix different concentrations of intralesional triamcinolone and when to use which concentration on what lesion.

Making Patients Feel Comfortable with Medical Student Participation

• • This is an article I published with Dr. Golant on how to integrate medical students into a dermatology practice. Please read this before rotating with me.

Corticosteroid Potency Grid

Kusch Manual of Differential Diagnosis

• This booklet is invaluable to the first-year dermatology resident in helping to formulate lists of differential diagnoses based upon primary lesions, rash distributions, and some unique patient subsets.

Suture Mnemonics [Photo 1] [Photo 2]

• This lecture provides silly memory techniques to remember the generic and brand names of sutures and some of their characteristics.

ALL of the Cosmetic Clinic lectures

• Topics to review: Acne, Flaps, Botox, Fillers, allergic contact dermatitis, psoriasis, eczema, dysplastic nevi, therapeutics including retinoids, topical steroids, photodynamic therapy, chemical peels, and TNF-blocking biologics

By the first week of your rotation, I expect everyone to learn how to do various basic procedures in dermatology. As there is no official standard for doing these procedures, I have created a series of videos.

There will be a certification by the end of the first week for each incoming resident. Each incoming resident will be paired with a senior resident, who will show them how to do the procedures. In addition, please use the resources listed here: Resident Certification.

Specifically, these procedures:

a) triamcinolone - video on handling needle and syringe; word document on Intralesional Triamcinolone (linked above); main points: shake the vial, check to see there is no residue at the bottom of the bottle, understand how to make the different dilutions

c) IM injection - video

d) anesthetizing a lesion - part of punch biopsy video; main points: only the bevel enters, don't torque the needle, finger places traction behind the needle insertion, raise an intradermal bleb

e) shave biopsy - the video is only half right. To get the shave off the lesion at the end, use a forceps or cut into an AlCl3-soaked cotton swab tip

f) punch biopsy - watch video (but it is a long video - the one where I punch out a lipoma)

g) simple suture - 7 minute video

j) cryotherapy - video

k) cotton applicator for hemostasis - first spread the lesion --> blot with stick perpendicular, translate in orthogonal directions, or roll with pressure near the tip

l) tourniquet - see venipuncture video

m) venipuncture - see venipuncture video

If everyone prepares and practices, the certification process should go very quickly.