Controversies in Skin Surgery: Electrodessication and Curettage Versus Excision for Low-risk, Small, Well-differentiated Squamous Cell Carcinomas

Background: Electrodesiccation and curettage (ED&C) of low-risk, cutaneous squamous cell carcinoma (SCC) generally consumes less time and resources than excision. Review of the literature reveals few recent studies examining cure rates for ED&C in the treatment of low risk cutaneous SCC. Objective: To evaluate via two retrospective studies the efficacy of ED&C in the treatment of low risk cutaneous SCC. Methods: A small controlled study in a Veterans Administration teaching hospital dermatology clinic compared cure rates of low risk SCC at one year by ED&C to those of surgical excision. A second study examined the cure rate of low risk lesions treated by curettage and electrodesiccation in a private practice. Results: The first study found no significant difference in cure rates between ED&C (14 of 14 cases successfully treated) and excision (15 of 16 successfully treated and one recurrence) (P=0.1711). The second study found the ED&C cure rate (106 of 106 successfully treated) to be significantly greater than an arbitrary cure rate of 95 percent (P=0.0091). Conclusion: These findings support the efficacy of ED&C as a treatment modality for low-risk cutaneous SCC.