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Skin cancer surgery on referral

Pre workshop survey for face and ear workshop

2 case studies on the face

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A 50 year old female school teacher sees you regarding a crusty lesion on her upper lip, to the left of the midline. She first saw her own doctor, who was not keen on undertaking any biopsy or tests herself. So her GP suggested that patient see you to manage this lip lesion. She did not request that you manage any other skin lesion. You examine the patient and find a small (10mm X 12 mm) crusty non pigmented lesion on the upper lip. Dermoscopy shows a keratin surface but little else. Palpation reveals there is some thickness to the lesion. Elsewhere her face has marked solar damage but no other lesion of note.
Your two preferred diagnoses are





Your preferred method of gaining histology for this lesion is*





In the consent for procedure process, you would usually*


Estimate on average how long it would take you to take a history, examine this lesion, explain your procedure and obtain consent (Do NOT include procedure time)*










You then effect the procedure in your procedure room. Your preferred anaesthetic choice would be*




Comments ?
Later that day another female patient sees you with a referral from their usual family doctor. This time the concern is a possible BCC on the dorsum of her nose. You examine the 70 year old patient and note a small nodule on the nasal dorsum near the midline. However, dermoscopy reveals arborizing vessels extending far beyond this nodule and the true extent of the pathology is difficult to determine. It appears, that at the very least, the lesion involves much of the nasal tip and midline nasal dorsum.
Your preferred diagnosis is*





Your preferred management of this lesion in this location is*






At that time your procedure room is free and nursing staff and equipment are available and you have time immediately available.
With regards timing of a surgical procedure



Would you offer a non surgical option for this tumour?*

Estimate your average likely consultation time for a person with this lesion in this location and to explain the procedure you are planning and to obtain consent. (Do NOT include procedure time)*











Regarding Slow Mohs procedures, would you normally


Most commonly, your anaesthetic for such surgery would be*




Consent for your planned procedure on this patient's nose would*


With regards a skin cancer service that can provide surgery the same day as initial consultation, click all that match your views










What has all this made you think about? Comments?
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