Electrodessication and curettage

Question 1

What is electrodessication and curettage (E&C)?

Answer 1

Minimally invasive technique used to treat superficial skin lesions.

Question 2

What are the indications for E&C?

Answer 2

Superficial lesions mostly in the epidermis with little or no dermal component:

• Benign e.g. seborrhoeic keratoses, sebaceous hyperplasia, verrucae, skin tags, angiomas
• Premalignant and malignant e.g. actinic keratoses, cutaneous SCC in situ (Bowen’s), BCC

Question 3

What are the contraindications for E&C?

Answer 3

• Infection
• Fibrosis
• Malignancy with significant dermal or deeper component and recurrent malignant lesions
• ICDs such as pacemakers and defibrillaters - electrodessication is contraindicated

Question 4

What are the complications of E&C?

Answer 4

• Scarring - due to damage to the dermis
• Infection
• Bleeding

Question 5

How do you excise milia?

Answer 5

Scalpel to nick the epidermis and then comedone extractor to remove the milia
Usually no scarring occurs

Question 6

How are epidermoid cysts excised?

Answer 6

Various e.g. conventional incision technique, milia excision technique, punch technique, and elliptical excision

NB: lining needs to be completely removed to reduce the risk of recurrence.