> ## Content Index > Fetch the complete content index at: https://www.theplasticsfella.com/llms.txt > Use this file to discover other available public pages before exploring further. # AI Replaces Dermatology, Benign Lesions & Diagnostic Tips. - URL: https://www.theplasticsfella.com/june-15th/ - Published: 2025-06-13T21:26:27.000Z - Updated: 2025-06-14T20:18:10.000Z - Description: Also: Why flaps beat grafts, punch biopsy pitfalls, & the Sunday quiz. - Author: PlasticsFella - Tags: thePlasticsPaper #### In this week's edition 1. ****✍️** [****Letter from P'Fella**](https://www.theplasticsfella.com/june-15th/#a-letter-from-pfella) Support your local dermatologist — they’re about to be replaced. 2. ****🤓** [****The Sunday Quiz**](https://www.theplasticsfella.com/june-15th/#the-sunday-quiz) How well do you know **Lipoma*? 3. 🖼️ [****Image of the Week**](https://www.theplasticsfella.com/june-15th/#image-of-the-week) Identifying Seb K (with a syndrome) 4. ****🚑** [****Technique Tip**](https://www.theplasticsfella.com/june-15th/#technique-tip) Dermoscopy: Sebaceous hyperplasia vs BCC. 5. 🎓 [****JPRAS Journal Club**](https://www.theplasticsfella.com/june-15th/#jpras-journal-club) A 20-year overview of upper limb nec fasc in England. 6. ****🎈** [****Upcoming Events**](https://www.theplasticsfella.com/june-15th/#upcoming-events) This calendar isn’t just ours, it’s yours too! 7. ****🔥** [****Articles of the Week**](https://www.theplasticsfella.com/june-15th/#articles-of-the-week) PRS CME on benign lesions, graft vs flap, & don't punch biopsy a pigmented lesion: with 1-sentence summaries. 8. 💕 [****Feedback**](https://www.theplasticsfella.com/june-15th/#feedback) Suggest ideas & give feedback! ## A Letter from P'Fella **Support Your Local Dermatologist — They’re About to Be Replaced* 👋 Let’s be honest: Dermatologists who don’t operate are on borrowed time. The AI bots are here, they’re clinically safe (ish), and most importantly… they’re **cheap*. 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* ****Ready to climb the leaderboard?** 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*](https://foundations.theplasticsfella.com/?ref=theplasticsfella.com). ## Image of the Week **Identifying Seb K* 🖼️ ****Image of the Week** 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. ![Identifying Seborrhoeic Keratoses](https://storage.ghost.io/c/a0/9f/a09fd7b4-d396-4b28-aed3-b87e20483292/content/images/2025/06/images--4--1.jpeg) Identifying Seborrhoeic Keratoses ## Technique Tip Dermoscopy: Sebaceous Hyperplasia vs BCC 🚑 ****Technique Tip of the Week** 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. ![Dermoscopy: Sebaceous Hyperplasia vs BCC](https://storage.ghost.io/c/a0/9f/a09fd7b4-d396-4b28-aed3-b87e20483292/content/images/2025/06/SHcrown1.png) Dermoscopy: Sebaceous Hyperplasia vs BCC ## JPRAS Journal Club A 20-Year Overview of Upper Limb Nec Fasc in England 📑 ****Summary: Upper limb necrotising fasciitis** cases tripled between 1998 and 2013, and then flatlined. Most patients were healthy, working-age men from deprived areas. Despite surgery, 16% didn’t survive past 90 days. 👉 ****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. ![](https://storage.ghost.io/c/a0/9f/a09fd7b4-d396-4b28-aed3-b87e20483292/content/images/2025/06/Your-paragraph-text--5-.png) ![](https://storage.ghost.io/c/a0/9f/a09fd7b4-d396-4b28-aed3-b87e20483292/content/images/2025/06/Your-paragraph-text--6-.png) Journal Club: Upper Limb Necrotising Fasciitis [Read the Article](https://www.theplasticsfella.com/journal-upper-limb-necrotising-fasciitis/) ## Upcoming Events **This Calendar Isn’t Just Ours, It’s Yours Too!* ![Upcoming Events Calendar](https://storage.ghost.io/c/a0/9f/a09fd7b4-d396-4b28-aed3-b87e20483292/content/images/2025/06/Your-paragraph-text--4--1.png) Upcoming Events Calendar 📅 ****Looking for webinars, courses, or upcoming conferences in plastic surgery?** 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* ✅ ****How Should Plastic Surgeons Approach Skin Lesions?** ([Lee](https://journals.lww.com/plasreconsurg/abstract/2010/05000/benign%5Fand%5Fpremalignant%5Fskin%5Flesions.31.aspx?ref=theplasticsfella.com), 2010) Benign and premalignant skin lesions require careful clinical and histologic assessment to determine when surgical treatment is necessary. ✅ ****Grafts or Flaps for Facial Skin Cancer?** ([Faenza](https://pubmed.ncbi.nlm.nih.gov/39308747/?ref=theplasticsfella.com), 2024) Local flaps offer better cosmetic and functional outcomes than skin grafts for facial reconstruction after non-melanoma skin cancer surgery. ✅ ****The Pitfalls of Punch Biopsies in Melanoma** ([Lorusso](https://pubmed.ncbi.nlm.nih.gov/15748548/?ref=theplasticsfella.com), 2005) Incisional biopsies can misjudge melanoma depth, leading to flawed staging and potentially misguided treatment decisions. ## Feedback ### I hope you enjoyed it 😄 ---