Treatment of Skin Cancer

Curettage, electrosurgery and skin cancer

“…Following satisfactory curettage, electrodesiccation is applied to the base and rim of the resultant defect and a safety margin of 2 mm ‘normal’ skin. 6,12,15,17,19,20,22,26,30,43,44 This further extends the field of destruction towards the 4 mm margin marked out pre‐operatively (see step 2 above).…”

“…The initial specimen is submitted for histopathological examination. 6,12,17,19,20,22–27 Few advocate routine biopsy prior to curettage; 20 most consider this necessary only when confident clinical diagnosis is impossible 4,12,26 or when the operator is inexperienced. 17,26 …”

“…22 Furthermore, the histological basis for ease of curettage of certain skin cancers is well established ( Table 2). 18–20,39–42 The exceptions are morphoeic BCC and poorly differentiated, infiltrating SCC.…”

“…52 Although unproven, these claims are echoed throughout the literature and form the basis for a widespread preference for electrodesiccation (superficially destructive) over electrocautery (deeply destructive) following curettage. 10,19,27,36,50,52 …”

“… 30 The proper setting for electrodesiccation lies just beyond that required for haemostasis. 30 A dry contracted area 19,50 involving a minimum safety margin of 2 mm 6,15,17,20,26,30,43,44 signifies adequate electrodesiccation.…”