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Dermatology
Cryosurgery
Built from Dermatology, 5th Edition
What’s inside
10 sections · 73 slides
Overview
- What this topic covers
- Why cryosurgery matters
History and Principles
Where cryosurgery began, and the physics and biology behind how freezing destroys tissue
- Early history of freezing as a medical treatment
- The modern cryoprobe
- Three related but different terms
- Why liquid nitrogen is the go-to cryogen
- What lies between cryogen and skin changes freezing speed
- Conductors of cold, from slowest to fastest
- Cold sensitivity differs between cell types
- Four ways a freeze-thaw cycle destroys tissue
- Cryosurgery – mechanisms of injury
- Timeline of cell death after a single freeze-thaw cycle
- Cryosurgery leaves the tumor in place
- Immunocryosurgery: adding drugs to boost the effect
Instruments and Techniques
The seven ways to deliver liquid nitrogen, and which lesions each technique suits
- Seven ways to apply liquid nitrogen
- Cryosurgical techniques
- Cryosurgical techniques (continued)
- Seven cryosurgical delivery techniques
- Open (spray) technique
- Semi-open and semi-closed techniques
- Closed (contact/probe) technique
- Tweezers, intralesional, and dipstick techniques
Preoperative Considerations
Weighing the pros and cons, preparing the skin, and using cold as an anesthetic
- Talking to patients before treatment
- Cryosurgery – advantages and disadvantages
- Preparing the skin improves results
- Using cold as an anesthetic
- Shave removal of a seborrheic keratosis after cryoanesthesia
- Shave removal of a cutaneous horn after cryoanesthesia
Treating Benign Lesions
Which benign skin growths respond to freezing, and technique tips for the most common ones
- A very wide range of benign lesions respond
- List of benign lesions reported to be amenable to cryosurgical treatment
- List of benign lesions reported to be amenable to cryosurgical treatment (continued)
- List of benign lesions reported to be amenable to cryosurgical treatment (continued)
- List of benign lesions reported to be amenable to cryosurgical treatment (continued)
- List of benign lesions reported to be amenable to cryosurgical treatment (continued)
- Technique tips for common benign lesions
- The PPPP rule for vascular lesions
- Cherry angioma treated with the closed probe technique
Premalignant Lesions and Actinic Keratoses
Treating precancerous sun-damage spots, and managing whole areas of sun-damaged skin
- Actinic keratoses: a very effective use of cryosurgery
- Actinic keratosis before and three weeks after open-spray cryosurgery
- Hypertrophic actinic keratosis frozen with the open-spray technique
- Field cancerization: when there is more than one spot
- Sequence for treating a field of sun-damaged skin
- Cryopeeling: freezing a whole area at once
- Cryopeeling of photodamaged facial skin
Treating Cutaneous Malignancies
Selecting the right lesions and techniques for skin cancer, and how imaging helps guide treatment
- Skin cancer: a real option, but only for the right lesion
- Cutaneous malignancies amenable to cryosurgery
- Choosing open versus closed technique for a tumor
- Measuring the freeze: monitoring temperature and depth
- Immunocryosurgery and lentigo maligna
- Basal cell carcinoma on the nose treated with the closed technique
- Postauricular basal cell carcinoma treated with immunocryosurgery
- Lentigo maligna on the forehead treated with cryosurgery
- Squamous cell carcinoma on the cheek treated with the closed technique
- Basal cell carcinoma on the eyelid margin treated with cryosurgery
Palliative Treatment
Using cryosurgery to ease symptoms in patients who cannot have curative treatment
- When cryosurgery is used for comfort, not cure
- Indications for palliative cryosurgery
- Two ways to treat a large tumor mass
- Choosing a technique for palliative treatment
Postoperative Care and Complications
What to expect after treatment, and how to recognize and manage true complications
- Healing is slower than after cutting a lesion out
- Cryosurgery – postoperative care and expected side effects
- Managing blisters and scabs
- Distinguishing an expected effect from a true complication
- Complications of cryosurgery
- Complications of cryosurgery (continued)
- Complications of cryosurgery (continued)
- The most important complications to know
Future Trends
How newer imaging technology is making cryosurgery more precise
- Imaging is making cryosurgery more precise
- Key takeaways
- References
- References (continued)
- References (continued)
- References (continued)
- Dermatology, 5th Edition (2-Volume Set)