Advanced Certificate of Skin Cancer Medicine

DAY ONE

DAY TWO

Session 1: Suturing

• simple interrupted
• buried dermal
• sliding dermal
• vertical horizontal mattress
• Mirini
• pulley dermal
• half buried horizontal mattress
• continous.

Session 5: Ellipse Planning

 
Session 1b: Perfecting the Ellipse

Students will learn how to mark out a lesion using a dermatoscope with appropriate margins for both non-melanoma and melanoma skin cancers. This session includes marking a standard ellipse and S-plasty, designing your ellipse for optimal scar results, working with ellipses around joints, and facial skin tension lines.  We also cover tips for optimum wound apposition and undermining. The session includes video and clinical images of ellipses on a variety of anatomical areas.

Session 6: Chaos and Clues

Using a dermatoscope improves diagnostic accuracy for all types of skin malignancy, but only if the operator is trained. Chaos and Clues is a method designed for use in routine practice on multiple lesions without mathematical calculations.

Session 2: Local Anaesthetics

We will go into detail on local anaesthetics with both theory and practical components. We will cover pharmacology, toxicity, buffering, needles, nerve blocks, injection techniques, and risk areas and specific sites for injection. We will demonstrate how to prepare buffered lignocaine, practice use of Luer Lock and Luer Slip syringes with injection and infiltration on pig skin, and demonstrate injection sites with clinical video clips. We will also cover surface anatomy of trigeminal nerve branches and blocking these nerves.

Session 6b: Topical Treatments

Topical treatments are becoming more and more effective for certain lesions. In this session, we look at what works and what doesn't. We will review Fluorouracil, Imiquimod and Ingenol Mebutate, and look at the indications, application, contraindications and tips for use. We will also cover field versus specific lesion treatment. Clinical case studies will make up a key part of this session.

Session 3: Incision/Haemostasis

In this practical hands-on session, we will be covering punch and shave biopsies and use clinical videos to demonstrate proper techniques. As part of the practicals, we will cover mono and bipolar cautery with hands-on practicals and video demonstrations for effective cautery. We will cover the fire risk of cautery with alcohol and the safety aspects of pacemakers and other implanted electrical devices. We will also extend the proper shave technique to the HALO graft including marking out, dressing and aftercare.

Session 7: The Big Three

In this session, we look at the big three: BCC, SCC and melanoma. We look at the main types of BCC, their dermatoscopic features, margins, perineural invasion, radiotherapy treatment and other treatment modalities available. With SCC, we cover IEC differentiation, biopsy, aggressive and tame types, and the treatment modalities available. We also cover the various types of melanoma and look at margins, Breslow thickness, various biopsy methods, and when and what to refer.

Session 4:  Curettage/Cautery

Continuing from session 3, we will cover curettage and cautery with theory, clinical video and student practicals. We will look at appropriate sites, and discuss keloid and hypertrophic scar risks and appropriate lesions for this modality. Practicals for this session will be done on pig skin models. We will also cover dressings and aftercare for curettage and cautery, and cover the Medicare item numbers used. The cryotherapy segment will include safe handling of liquid nitrogen, clinical video, and consideration of appropriate sites for this modality.

Session 8: Case Management

In the final session, we summarise the learning outcomes with a series of case studies. Each case study includes clinical images from different locations and types of lesions. This session includes group discussion on the appropriate modality such as topical treatments, cautery, curettage, type of biopsy to be used, and excision.