Top videos
The first step is to see if you have pigmentation issues -not really classed as acne scars, but this is controversial, or if you have contour changes. The best thing to do is to examine under tangential or angled lighting, as this will reveal all. Once this is done, scars can be subtyped and mapped, with high resolution photos. The second aspect, which is equally as important is to examine scars upon animanation, namely when you speak, smile and move your face. This will give me an idea of the amount of tethering and anchored acne scars. Time and time again I get request for ‘what is the treatment’ with static photos, an impossible task to answer correctly. Acne scar assessment has to be done live- with the patient in front of you, and lighting from all angles. Photos do not map scars as well a real time examination under magnification and lighting.
If you have been diagnosed with a bulging disc, you are not alone. Bulging discs, also known as a disc protrusion, are a very common occurrence. They usually remain asymptomatic; however, they can cause discomfort and disability in various parts of the body if the disc compresses an adjacent nerve root or the spinal cord. As we age, the outer fibrous portion of our discs can weaken. Pressure from the central core of the disc can then stretch to the outer rim, causing the disc to bulge. If left untreated, the disc can continue to bulge until it tears, which is classified as a herniated disc. Because a bulging disc does not always show symptoms, many people have bulging discs without realizing it. As long as the bulging area does not press against a nearby nerve, no symptoms occur. When the bulging disc does cause a pinched nerve, however, you may begin to experience symptoms. In the lower back, the damaged disc can cause pain to travel to the hips, buttocks, legs and feet. In the cervical spine, pain can radiate from the neck, down the arm and to the fingers.
Mohs surgery is a procedure used to remove skin cancers (most commonly basal and squamous cell carcinoma and melanoma) in a way that preserves a maximum amount of healthy tissue. It is useful for skin cancers when:
(1) the location of the cancer is near sensitive areas, like the fingers or face;
(2) earlier treatments have not worked;
(3) a skin cancer is large; and
(4) regular surgery is less likely to remove the cancer.
This procedure video illustrates the procedure on 2 patients with basal cell carcinoma. Click https://ja.ma/3b4scuY to learn more.
0:00 Disclaimer
0:07 Introduction
0:28 What this video will cover
0:43 Mohs "stage" steps
1:09 Marking surgical sites
1:27 Stage 1: skin layer resection (patient 1)
1:59 Maintaining skin layer orientation
2:55 Stage 1: processing layer onto slides (patient 1)
3:53 Stage 1: histology review for cancer (patient 1)
4:31 Discussion on wound closure
5:10 Wound closure (patient 1)
5:47 Stage 1: histology review for cancer (patient 2)
6:24 Stage 2: skin layer resection (patient 2)
6:38 Stage 2: histology review for cancer (patient 2)
6:56 Stage 3: skin layer resection (patient 2)
7:07 Stage 3: histology review for cancer (patient 2)
7:20 Wound closure (patient 2)
7:57 1-week follow-up before-and-after wound healing