Procedural Derm, Surgery & Cosmetology

A 46-year-old with a 7-mm pearly papule on the nasal ala (clinically BCC) requests tissue-sparing treatment. Which modality best maximizes margin control on the H-zone of the face?

You suspect melanoma in a 9-mm irregularly pigmented macule on the shoulder. Best initial biopsy?

A 70-year-old on apixaban needs Mohs for a nasal BCC. Perioperative anticoagulation plan?

Lidocaine dosing question: What is the maximum safe dose of lidocaine with epinephrine for local infiltration in healthy adults?

A 2-cm well-differentiated SCC on the forearm (low-risk). Recommended standard surgical margin?

A patient undergoes shave removal of a symptomatic dermal nevus on the cheek. Best suture choice for epidermal closure if needed?

You plan a bilobed flap for a 9-mm nasal tip defect. Key design principle?

A 1.2-cm superficial BCC on the trunk is scheduled for curettage & electrodesiccation. Which setting combination optimizes tissue destruction with hemostasis?

A patient on 40 mg prednisone daily is booked for patch testing. Concern?

A 24-year-old wants laser hair removal; phototype V with coarse facial hair. Safest effective laser?

Tattoo removal planning: which wavelength targets green ink most effectively?

Cryotherapy for actinic keratoses on the scalp: optimal technique?

A 31-year-old receiving isotretinoin asks about microneedling for acne scars. Evidence-based counsel?

Botulinum toxin for glabellar complex: which muscle pair is primarily targeted besides corrugators?

After glabellar botulinum injection, patient develops mild unilateral eyelid ptosis. Quick pharmacologic aid?

A filler complication: blanching pain over nasal ala immediately after hyaluronic acid injection. First step?

Which filler is reversible with hyaluronidase?

A 3-cm cheek defect reaches the SMAS after BCC excision. Which closure principle reduces tension and improves scar?

Suture removal timing for a 3-cm linear cheek repair?

You plan PUVA. Eye protection guidance?

A hypertrophic scar 6 months post-laceration on the deltoid is pruritic. First-line treatment?

Keloid management after excision on earlobe to minimize recurrence?

Vascular laser settings for port-wine stain in a child?

A 1.5-cm melanoma (Breslow 1.6 mm) on the upper back after complete excisional biopsy. Recommended definitive margin?

A patient with a pacemaker requires electrosurgery. Best practice?

HSV prophylaxis around perioral ablative laser resurfacing?

Chemical peel depth matching: Which agent/settings is classic for medium-depth peel?

Sclerotherapy for leg telangiectasias—common agent and complication?

A woman with rosacea seeks laser for erythema/telangiectasias. Best device?

Tumescent anesthesia for liposuction—what lidocaine principle is correct?

A lower leg wedge excision is planned in a diabetic with edema. Antibiotic strategy?

An 8-mm lentigo maligna (MIS) on the cheek—definitive margin with staged excision?

Post-biopsy hemorrhage control in an anticoagulated patient: most effective local step?

Acne scars in phototype IV desire minimal downtime. Best initial device approach?

Paradoxical darkening during cosmetic tattoo laser removal is most associated with which pigment?

A 1.1-cm well-circumscribed DFSP on the trunk (histology-proven) is scheduled for treatment. Best surgical approach?

Pain reduction for local anesthetic infiltration on the face?

A 5-mm vascular papule on the lip bleeds with trauma. Best office treatment?

A patient with atrophic rolling acne scars asks about fillers. Which option is best for immediate, reversible lift?

After a large cheek Mohs repair, the patient requests scar optimization. Evidence-based early adjuvants?