Electrodesiccation and curettage

Electrodesiccation and curettage (EDC, ED & C, or ED+C) is a medical procedure commonly performed by dermatologists, surgeons and general practitioners for the treatment of basal cell cancers and squamous cell cancers of the skin. It provides desiccation, coagulation/cauterization, and curettage to remove lesions from the skin. A round dull instrument (curette) of varying sizes (1 mm to 6 mm) is used to scrape off the cancer down to the dermis. The scraping is then paused while an electrosurgical device like a hyfrecator is used next. Electrocoagulation (electrodesiccation) is performed over the raw surgical ulcer to denature a layer of the dermis and the curette is used again over the surgical ulcer to remove denatured dermis down to living tissue. In the case of skin cancers, the cautery and electrodesiccation is usually performed three times, or until the surgeon is confident that reasonable margins have been achieved. Seborrheic keratosis Viral warts Bowens disease (in situ squamous cell carcinoma) Pyogenic granuloma Actinic keratoses Basal cell carcinoma Keratoacanthoma Skin tags The cure rate is highly user dependent. The more aggressive the surgeon is at performing EDC, the higher the cure rate. Like standard excision, the wider the surgical margin, the higher the cure rate. Cure rate for small cancer is higher than cure rate for larger cancers. Cure rate for nodular basal cell cancer is higher than for infiltrative basal cell cancer. Essentially, all the prognostic factors that apply to Mohs surgery and standard surgical excision will also apply to EDC. The method is quick and easy to perform under local anesthetic. Used correctly, it can allow for adequate to good cosmetic result on small tumor in certain area. No sutures are used, so a follow-up visit might not be necessary. Minimal expense is required. If recurrence occur, rapid diagnosis is possible as the roots are exposed to the surface, and not buried by surgical closure methods (flaps, etc.).

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Mohs surgery

Mohs surgery, developed in 1938 by a general surgeon, Frederic E. Mohs, is microscopically controlled surgery used to treat both common and rare types of skin cancer. During the surgery, after each removal of tissue and while the patient waits, the tissue is examined for cancer cells. That examination dictates the decision for additional tissue removal. Mohs surgery is the gold standard method for obtaining complete margin control during removal of a skin cancer (complete circumferential peripheral and deep margin assessment - CCPDMA) using frozen section histology.

Basal-cell carcinoma

Basal-cell carcinoma (BCC), also known as basal-cell cancer, is the most common type of skin cancer. It often appears as a painless raised area of skin, which may be shiny with small blood vessels running over it. It may also present as a raised area with ulceration. Basal-cell cancer grows slowly and can damage the tissue around it, but it is unlikely to spread to distant areas or result in death. Risk factors include exposure to ultraviolet light, having lighter skin, radiation therapy, long-term exposure to arsenic and poor immune-system function.

Seborrheic keratosis

A seborrheic keratosis is a non-cancerous (benign) skin tumour that originates from cells, namely keratinocytes, in the outer layer of the skin called the epidermis. Like liver spots, seborrheic keratoses are seen more often as people age. The tumours (also called lesions) appear in various colours, from light tan to black. They are round or oval, feel flat or slightly elevated, like the scab from a healing wound, and range in size from very small to more than across.