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Malignant Neoplasms
Published in Ayşe Serap Karadağ, Lawrence Charles Parish, Jordan V. Wang, Roxburgh's Common Skin Diseases, 2022
Mark Biro, Vesna Petronic-Rosic
Management: Standard excision, Mohs micrographic surgery, or electrodessication and curettage are frequently used in the treatment of SCC. For standard excision, 4–6-mm margins are recommended and for tumors with high-risk features or cosmetically sensitive locations Mohs micrographic surgery is completed. For patients with low-risk tumors in areas without terminal hair growth, electrodessication and curettage may be used for SCC. If surgical therapy is not feasible, radiation therapy or cryosurgery may be considered.
Basal Cell Carcinoma
Published in Debjani Sahni, Adam Lerner, Bilal Fawaz, Advanced Skin Cancer, 2022
Alternative treatments for BCC include electrodessication and curettage (ED&C), cryotherapy, photodynamic therapy (PDT), and topical creams utilizing imiquimod or 5-fluorouracil (5-FU). These modalities are typically reserved for low-risk, small or superficial BCC and careful patient selection is of high importance. The NCCN recommends ED&C for certain low-risk BCCs, excluding tumors located in terminal hair-bearing areas due to the risk of deep tumor extension along hair follicles.7 ED&C is considered a cost-effective and quick approach. The main disadvantages of ED&C is that it does not offer margin assessment, is operator-dependent, and tends to heal with worse scarring compared with excision or MMS. The 5-year recurrence rate ranges between 3.3% and 22.7%, depending on the tumor size and location.4
Photodynamic Therapy
Published in Henry W. Lim, Nicholas A. Soter, Clinical Photomedicine, 2018
We have treated eight patients with basal cell nevus syndrome at our institution, with generally excellent results. We have been able to treat as many as 20–40 sites in a 2-day treatment session. Compared to other destructive modalities such as cryotherapy or electrodesiccation and curettage, there is generally more rapid healing and much less scarring. Our experience is that patients with basal cell nevus syndrome report significantly less perioperative and postoperative pain and prefer photodynamic therapy over other modalities.
An update on local and systemic therapies for nonmelanoma skin cancer
Published in Expert Review of Anticancer Therapy, 2022
Kelly M Elleson, Danielle K DePalo, Jonathan S Zager
Electrodessication and curettage (ED&C) is the most common method used by dermatologists to treat nodular BCC and superficial BCC tumors <1.5 cm as it is a quick and simple procedure; however, the one drawback is that with ED&C, complete tumor excision is not able to be confirmed histologically [16,17]. After the tumor is scraped with a curette, the area is treated with electrosurgery to control bleeding and eliminate cancer cells around the wound margin. Typically, 2–3 cycles are recommended. Recurrence was higher in nasal, paranasal, and forehead areas. Another study of 2,314 primary BCC tumors treated with ED&C also showed significantly higher recurrence rates for tumors in the mask area of the face and for tumors ≥6 mm in diameter located on the cheek, forehead, scalp, and neck [17]. A key disadvantage to ED&C is risk for scarring since there is no primary closure of the defect.
Diagnosis and treatment of low-risk superficial basal cell carcinoma in a single visit
Published in Journal of Dermatological Treatment, 2022
Georgette A. Hattier, Robert F. Duffy, Mitchell J. Finkelstein, Sarah M. Beggs, Jason B. Lee
Electrodesiccation and curettage or curettage alone represents an underutilized treatment modality in the battle against the rising incidence of nonmelanoma skin cancers. Performed by a properly trained clinician, the cure rate of 91–99% rivals that of standard excision (1,13). Reaching a depth of typically less than 3 mm, sBCCs are particularly amenable to ED&C, a quick, cost-effective office-based procedure (13–16). Though a combination of electrodesiccation and curettage has been traditionally taught and performed, similar cure rate has been observed when curettage alone was performed (17,18). In the study by Barlow et al., a wider margin of normal skin was curetted anywhere between 2 and 5 mm beyond the clinically visible lesion. Their study, however, did not stratify low- and high-risk lesions in contrast to the current study in which only those lesions that were confidently clinically diagnosed as low-risk sBCC were curetted with narrow margins (17). Electrodesiccation is associated with interference with cardiac devices, a higher degree of hypopigmentation and hypertrophic scarring, and presence of carcinogens and viral particles in the generated smoke plume. All of these can be avoided with curettage alone (17).
Value of Dermatology Nights at a student-run free clinic
Published in Baylor University Medical Center Proceedings, 2021
Christine P. Lin, Sydney Loy, William D. Boothe, Kelly Bennett, Michelle B. Tarbox, Fiona Prabhu, Ashley Sturgeon
The Free Clinic at Lubbock Impact, a student-run free clinic affiliated with the Texas Tech University Health Sciences Center in Lubbock, Texas, has provided free health services to uninsured patients 19 to 64 years old in Lubbock and the surrounding West Texas regions for the past 11 years. In 2018, 16.1% of 19- to 64-year-olds in Lubbock County were uninsured,1 indicating the need for affordable and accessible primary care and specialty services for this population. Once a month, patients receive comprehensive dermatologic care by volunteer dermatologists on “Dermatology Night.” Various procedures such as shave biopsies, electrodessication and curettage (ED&C), and skin excisions may be performed. These procedures are imperative in assessing and treating nonmelanoma skin cancers (NMSCs) in uninsured patients because they may be at higher risk of skin cancer due to lack of access to medical services and increased sun exposure from insecure housing.2 Though studies have been published regarding the operating costs of certain specialty services at free clinics, no studies exist regarding the value of dermatologic procedures performed at a free clinic.