In this week's edition
- ✍️ Letter from P'Fella
Support your local dermatologist — they’re about to be replaced. - 🤓 The Sunday Quiz
How well do you know Lipoma? - 🖼️ Image of the Week
Identifying Seb K (with a syndrome) - 🚑 Technique Tip
Dermoscopy: Sebaceous hyperplasia vs BCC. - 🎓 JPRAS Journal Club
A 20-year overview of upper limb nec fasc in England. - 🎈 Upcoming Events
This calendar isn’t just ours, it’s yours too! - 🔥 Articles of the Week
PRS CME on benign lesions, graft vs flap, & don't punch biopsy a pigmented lesion: with 1-sentence summaries. - 💕 Feedback
Suggest ideas & give feedback!
A Letter from P'Fella
Support Your Local Dermatologist — They’re About to Be Replaced
The NHS is already trialling them to triage skin lesions. Five minutes per mole. No complaints, no clinics running late, no pre-coffee tantrums. And unlike your derm mate, the algorithm doesn’t mind reviewing 400 seborrhoeic keratoses a day.
This Is a Layoff Letter, Lightly Wrapped in ‘Innovation’
We dress it up as “augmenting clinical care,” but let’s not kid ourselves. It’s about cost and convenience. If you don’t operate, you are, in the eyes of the system, replaceable. Not next year. Now.
First, it’s derm. Then maybe path. Then radiology (unless they touch a needle). It’s not a wave, it’s a quiet restructuring. And the bots don’t need office space.
Second-Order Effect: Hands-On Jobs Just Got More Competitive
Here’s the twist nobody’s talking about: when non-operative specialties get hollowed out, guess where all those smart, ambitious doctors will pivot? Yep, surgery. Plastics. Hands-on work. The stuff AI can’t touch YET...
That’s more CVs. More competition. More people scrubbing in who weren’t even in the room two years ago.
Takeaway
If you work with your hands, you’re safe... for now. But don’t relax. The floodgates are opening, and the OR is about to get crowded.
With love,
Support your derm colleagues. Give them a smile. Maybe lend them a suture kit.
P Fella ❤️
The Sunday Quiz
How Well Do You Know Lipoma
Join The Weekly Quiz in each edition of thePlasticsPaper. Tackle one question per week for seven rounds!
The top scorer wins a copy of our upcoming textbook, Foundations.
Image of the Week
Identifying Seb K
This week’s image highlights seborrhoeic keratoses (Seb K) — benign, pigmented lesions with a characteristic “stuck-on” appearance.
Often mistaken for melanoma, they can appear in large numbers in older adults and occasionally erupt suddenly (Leser–Trélat sign), warranting further investigation.
Technique Tip
Dermoscopy: Sebaceous Hyperplasia vs BCC
Look for crown vessels: Groups of bending, scarcely branching vessels extending toward the center without crossing it.
This pattern is classic for sebaceous hyperplasia, helping distinguish it from BCC, which shows arborising vessels and lacks this central symmetry.
JPRAS Journal Club
A 20-Year Overview of Upper Limb Nec Fasc in England
👉 The takeaway? Recognise early. Act fast.
📚 This large UK study (728 patients) sheds light on who gets upper limb NF and why prompt intervention is still our best shot.
🔍 Read the full Journal Club breakdown below.
Journal Club: Upper Limb Necrotising Fasciitis
Upcoming Events
This Calendar Isn’t Just Ours, It’s Yours Too!
You’ll find them here — all curated to be practical, relevant, and genuinely useful.
📣 Running something yourself?
Your next journal club, teaching session, or hands-on course, we’d love to feature it. Because this calendar isn’t just ours, it’s yours too.
See what’s coming up, or submit your own event below:
Articles of the Week
3 Interesting Articles with One-Sentence Summaries
Benign and premalignant skin lesions require careful clinical and histologic assessment to determine when surgical treatment is necessary.
Local flaps offer better cosmetic and functional outcomes than skin grafts for facial reconstruction after non-melanoma skin cancer surgery.
Incisional biopsies can misjudge melanoma depth, leading to flawed staging and potentially misguided treatment decisions.
