Electrodesiccation and curettage (ED&C) are techniques that work together to clear the skin of a lesion. First, a sharp loop called a curette is used as a scraping device to grossly remove most of the abnormal cells. Electrosurgery is then employed to rid the patient of the remaining abnormal cells.
ED&C is most commonly used for low-risk skin cancers, such as superficial and nodular basal cell carcinoma. It is also used to treat low-risk squamous cell carcinoma, seborrheic keratosis, molluscum contagiosum, nongenital cutaneous warts, pearly penile papules, actinic keratosis, and recalcitrant psoriatic plaques.
There are two commonly used techniques: the pen technique and the potato peeler technique. The pen technique is more suitable for small lesions, while the potato peeler technique is better suited for large lesions.
Wound care after ED&C is simple, involving only daily gentle cleansing with soap and water and the application of petroleum jelly. Topical antibiotics may be prescribed for larger areas that require prolonged healing.
Although they are not absolute contraindications, cardiac pacemakers and implantable cardiac defibrillators can be affected by electrosurgery. The presence of these devices should be ascertained to avoid potential interference.
ED&C should be avoided in lesions larger than 2 cm in diameter or those with malignant features, such as pigmented lesions with irregular borders or those with a rapidly changing appearance.
Tumor cells have a softer, more fragile texture compared with healthy skin tissue, and thus when the curette reaches healthy skin below the tumor during a scrape, a “gritty” resistance is often felt.
If at any point the curette penetrates into the subcutaneous fat, scraping should be stopped because it indicates that the tumor is likely to have spread deeply and the ability to distinguish between normal skin and tumor is lost beyond that point.
PATIENT EDUCATION POINTS
Scraping or burning-off skin growths (also known as electrodesiccation and curettage) can be used for less serious skin cancers, pre-cancers and benign growths.
A local anesthetic is injected, and then the abnormal tissue is scraped off with a special tool. The area is then cauterized until bleeding stops.
The wound will need to be dressed until it heals, and it usually leaves a small white mark.
Curettage is a medical procedure commonly used in dermatology to remove skin lesions by surgically scraping the affected portion of the skin off with a sharp loop (curette). It is often performed with electrodesiccation, the superficial ablation of a lesion with an electric current. The combination of these procedures is referred to as electrodesiccation and curettage (ED&C). The use of curettage dates back to the 1870s, when it was originally used for the removal of endometrial tissue during uterine procedures. Its application to treat skin lesions came about in 1876, when its use on certain skin lesions was reported to yield superior ...