Curriculum standards
Curriculum standards
Completion requirements
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Advanced Training in Dermatology
Knowledge guides
LG14: Procedural dermatology
Clinical sciences
Advanced Trainees will describe the principles of the foundational sciences.
Less common or more complex patient considerations
Advanced Trainees will understand the resources that should be used to help manage patients.
Undertaking therapy
Advanced Trainees will monitor the progress of patients during the therapy.
Post therapy
Advanced Trainees will know how to monitor and manage patients post-therapy.
Important specific issues
Advanced Trainees will identify important specialty-specific issues and the impact of these on diagnosis and management, and integrate these into care.
- For each procedure, describe:
- alternatives
- complications
- consent
- contraindications
- cure rates
- indications
- instrumentation
- principles
- risks
- safety factors
- techniques
Anaesthesia
-
Pharmacology of local anaesthetics, such as:
- anatomy relevant to regional blocks around face and digits
- buffering and tumescent formulations
- infiltration techniques, including techniques to ameliorate injection discomfort
- Toxicities and monitoring
Cryotherapy
- Cellular effects
- Different cryogens
- Mechanisms
- Physical factors
- Physiological factors
Curettage
- Immunopathology
- Microscope operation
- Specimen processing
Electrosurgery
- Electrocautery
- Electrodessication
Laser surgery
- Clinical indications, complications, and contraindications
- Physics of lasers, and how this impacts the skin
- Principles of laser delivery and devices
Photodynamic therapy (PDT)
- Principles and techniques of PDT
Phototherapy
-
Management of special populations, including:
- children
- mobility impaired
- pregnant women
-
Phototherapy devices, mechanism of action, and treatment protocols for:
- broadband ultraviolet radiation (UV) B
- narrowband UVB
- psoralen plus ultraviolet-A radiation (PUVA)
- UVA1
- Treatment initiation and assessment of minimal erythema dose
Scalpel surgery
-
Biopsy, such as:
- incisional
- punch
- shave
- Excision
- Flaps
- Grafts
Surgical anatomy
-
General considerations:
- anatomy of skin:
- deep fascia, including structures that may be injured during surgery, such as lymph nodes
- head and neck anatomy
- anatomy of skin:
- Regional anatomy
-
Surface anatomy:
- aesthetics and the anatomy of skin ageing
- skin tension lines
- topographic anatomy and surface projections of deep anatomical structures
- Complications
- Determining and assessing patients who are not surgical candidates
- Practical aspects of procedure
Anaesthesia
- Anatomy relevant to advanced regional blocks
- Principles of tumescent anaesthesia
Cosmetic procedural dermatology
- Basic knowledge of:
- chemical peels
- cosmetic dermatological procedures
- injectables
- topical therapies
Surgery
- Mohs micrographic surgery, including methods and techniques of:
- lesion removal
- mapping
- microscopic assessment and interpretation
- potential complications
- specimen preparation and processing
Anaesthesia
- Understanding of topical and local anaesthesia
Cryotherapy
- Techniques
Disease-specific treatment protocols for scalpel surgery
-
Biopsy:
- contraindications, indications, and instrumentation
-
types:
- excisional
- incisional
- punch
- shave
-
Excision:
- cosmetic unit principles
- lines of excision
- margins of excision for different skin tumours
- suturing techniques
- techniques of haemostasis
- wound closure
-
Flaps:
- principles of tissue movement and flap dynamics
-
specific flaps, such as:
- advancement
- rotation
- Z-plasty
-
Grafts:
- full and split thickness
- mechanisms of graft survival
Electrosurgery
- Diathermy
- Electrocoagulation
- Electrosection (cutting)
Injection therapy
- Intralesional corticosteroid injections
Photodynamic therapy
- Narrowband UVB phototherapy
- Phototesting
- Solar simulator and monochromator testing
Phototherapy
- Assess treatment response and completion
- Identify and manage common issues and potential complications:
- burns
- missed doses
- non-response
- Treatment thresholds
- Manage all post-operative care and complications of procedural work, including:
- complications
- postoperative healing
- safety
- Resuscitation procedures
Postoperative wound care
- Dressings
- Management of complications, such as:
- haematoma
- hypertrophic scarring
- infection
- necrosis
- Second intention healing
Essential practical skills
- Appropriate incision lines
- Excision – elliptical
- Respect for cosmetic units
- Suture
- Wound closures
Hair and nail
- Adequate samples sent for scalp biopsy
- Techniques for nail biopsies
Infection control / sterilisation
- Disinfection and sterilisation procedures, and sharps and contaminated waste disposal
- Legislative requirements for office and day stay surgical facilities
- Standards for:
- aseptic techniques
- operating room protocol
- sharp injuries protocol
- sterilisation
PCH
- Altered wound healing in young people
- Appropriate anaesthesia, distraction, and procedural techniques to minimise pain and distress
- Informed consent / assent for procedures in paediatric and adolescent patients
- Risk of toxicity with anaesthetic agents in children