Close
New

Medscape is available in 5 Language Editions – Choose your Edition here.

 

Curettage and Electrodessication

  • Author: M David Stockton, MD, MPH; Chief Editor: Dirk M Elston, MD  more...
 
Updated: Oct 26, 2015
 

Background

Curettage and electrodessication (C&D, or ED&C) is a basic skin procedure in which the technique of curettage using a sharp curette is followed by electrodessication. The technique is often performed by dermatologists, family physicians, and general surgeons in their offices on a daily basis.

C&D was once a mainstay of treatment for basal cell and squamous cell cancers long before the laser skin surgical techniques used today.

For many indications, C&D has been replaced by curettage alone, as it yields similar cure rates and a better cosmetic outcome.

Next

Indications

Curettage and electrodessication (C&D) may be used for small benign skin lesions and tumors, including warts, seborrheic keratosis, pyogenic granuloma, granulation tissue, and genital warts.[1] C&D may also be used to treat some skin cancers, including superficial basal or squamous cell carcinomas; however, primary excisional approaches are frequently required to achieve maximum cures and to obtain complete histopathologic diagnosis.

Cosmetic results may be better with other procedures such as shave removal or simple curettage. Seborrheic keratosis and genital warts may be treated with cryotherapy with superior cosmetic results. Lesions such as skin tags that have a narrow stalk may be better treated with snip excision to avoid channeling of the electric current into the underlying tissue.

C&D used to treat cancerous basal cell lesions less than 1 cm (< 0.4 in) in diameter yields an excellent cure rate, but similar results may be achieved with curettage alone. C&D should not be used for basal cell lesions larger than 2 cm, tumors with poor definitive edges, recurrent basal cells, or sclerosing basal cells.[1]

C&D is most effective on new skin cancers and is less successful for recurrent skin cancers when scar tissue has developed.

Previous
Next

Contraindications

Suspected malignant lesions larger than 2 cm and those in the "H" zone of the face are best removed using excisional technique or Mohs micrographic surgery (MMS).

The American Academy of Dermatology has established appropriate use criteria for MMS. These guidelines represent the most up-to-date evidence-based recommendations for the use of MMS.[2] MMS is a microscopically controlled method of cutaneous neoplasm removal with complete tumor eradication at the surgical borders in an area where retained carcinoma cells are often left using C&D alone.

Other contraindications to curettage and electrodessication (C&D) include obviously infected lesions, fibrotic lesions, and lesions believed to extend into the subcutaneous fat.

Previous
Next

Technical Considerations

Curettage and electrodessication (C&D) requires minimal equipment and operator time for the physician.

Previous
Next

Procedure Planning

In some cases, planning for C&D includes scheduling adequate surgical time in an appropriately sized room with the needed equipment and wound care materials. However, in many situations, small lesions can be treated during a regular office visit.

Previous
Next

Outcomes

For appropriately chosen lesions, curettage and electrodessication (C&D) provides good results with few complications.

Possible complications of C&D include pain, hypertrophic scarring, hyperpigmentation, and wound infections.[1]

Superficial multifocal basal cell carcinoma involving the temple has a high rate of recurrence following C&D, so other modalities may be more appropriate in this setting. In addition, with large basal cell cancers, C&D can leave scars larger that the tumor being removed,[2] although the technique is often useful in patients at high risk for more invasive surgical procedures.

Previous
Next

CPT Codes

17110 Benign other than skin tags or cutaneous vascular lesions, 14 or fewer

17111 Benign other than skin tags or cutaneous vascular lesions, 15 or more

17000 Destruction, premalignant, 1st

17003 Destruction, premalignant, 2-14 (use only conjunction with 17000)

17004 Destruction, premalignant, 15 or more (do not use conjunction with 17000, 17003)

17260 Destruction, malignant; trunk, arm or leg, 5 mm or smaller

17261 Destruction, malignant; trunk, arm or leg, 6-10 mm

17262 Destruction, malignant; trunk, arm or leg, 11-20 mm

17270 Destruction, malignant; scalp, neck, hand, foot, or genitalia, 5 mm or smaller

17271 Destruction, malignant; scalp, neck, hand, foot, or genitalia, 6-10 mm

17272 Destruction, malignant; scalp, neck, hand, foot, or genitalia, 11-20 mm

17280 Destruction, malignant; face, 5 mm or smaller

17281 Destruction, malignant; face, 6-10 mm

17282 Destruction, malignant; face, 11-20 mm

Previous
Next

ICD-10CM Codes

Table. (Open Table in a new window)

                                                             Malignant   
  Basal CellSquamous CellSpecified type NECUnspecified SecondaryCa in situBenignUncertain BehaviorUnspecified Behavior
Lip C44.01C44.02C44.09C44.00     
Eyelid including canthusrightC44.112C44.122C44.192C44.102C79.2D04.12D23.11D48.5D49.0
 leftC44.119C44.129C44.199C44.109C79.2D04.19D23.12D48.5D49.2
Ear including pinnarightC44.212C44.222C44.292C44.202C79.2D04.22D23.2D48.5D49.2
 leftC44.219C44.229C44.299C44.209C79.2D04.29D23.22D48.5D49.2
Nose C44.311C44.321C44.391C44.301C79.2D04.30D23.39D48.5D49.2
Face, other parts C44.319C44.329C44.399C44.309C79.2D04.39D23.39D48.5D49.2
Scalp, neck C44.41C44.42C44.49C44.40C79.2D04.4D23.4D48.5D49.2
Body, trunk C44.519C44.529C44.599C44.509C79.2D04.5D23.5D48.5D49.2
ArmrightC44.612C44.622C44.692C44.602C79.2D04.62D23.61D48.5D49.2
 leftC44.619C44.629C44.699C44.609C79.2D04.69D23.62D48.5D49.2
LegrightC44.712C44.722C44.792C44.702C79.2D04.72D23.71D48.5D49.2
 leftC44.719C44.729C44.799C44.709C79.2D04.79D23.72D48.5D49.2
Overlapping sites C44.81C44.82C44.89C44.80     
Skin, unspecified C44.91C44.92C44.99C44.90C79.2D04.8D23.9D48.5D49.2
Anus, perianal, perineum C44.510C44.520C44.590C44.500C79.2D04.5D23.5D48.5D49.0
Breast C44.511C44.521C44.591C44.501C79.2D04.5D23.5D48.5D49.2
           
Labia Majora   C51.0 C79.82D07.1D28.0D39.8D49.5
Labia Minora   C51.1 C79.82D07.1D28.0D39.8D49.5
Clitoris   C51.2 C79.82D07.1D28.0D39.8D49.5
Female genitalia, NEC   C51.9 C79.82D07.1D28.0D39.8D49.5
           
Prepuce   C60.0 C79.82D07.4D29.4D40.8D49.5
Penis   C60.1C60.9C79.82D07.4D29.4D40.8D49.5
Scrotum   C63.2 C79.82D07.61D29.4D40.8D49.5
Male genitalia, NEC   C63.9 C79.82D07.60D29.4D40.8D49.5
Previous
 
 
Contributor Information and Disclosures
Author

M David Stockton, MD, MPH Professor, Department of Family Medicine, University of Tennessee Health Science Center College of Medicine

Disclosure: Nothing to disclose.

Coauthor(s)

Julie Jeter, MD Assistant Professor, Department of Family Medicine, University of Tennessee Health Science Center College of Medicine; Active Staff, University of Tennessee Medical Center

Julie Jeter, MD is a member of the following medical societies: American Academy of Family Physicians, Society of Teachers of Family Medicine

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD Professor and Chairman, Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina College of Medicine

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

References
  1. Habif TP. Dermatologic Surgical Procedures. Clinical Dermatology. 5th Ed. St. Louis, Mo: Mosby; 2010. 1002-10.

  2. Muhnanatoli-Frieman CY, Carey WD. Mohs Surgery. Is currettage and electrodessication a thing of the past?. Dermatol Rounds. Mar 2003. 2(3):1-4.

  3. Carucci JA, Leffell DJ. Basal Cell Carcinoma. Wolff K, et al, eds. Fitzpatrick's Dermatolgy in General Medicine. 7th Ed. New York, NY: McGraw-Hill Medical; 2008. 1: 1036-42.

  4. Marks Jr JG, Miller JJ. Principles of Dermatology (Lookingbill). 4th Ed. Philadelphia, Pa: Saunders; 69.

Previous
Next
 
Raise irritated lesion on cheek
Fox dermal curette
Firm scraping pressure in proximal direction to "gitty" tissue
Lesion completely removed
Electrodessication of base of lesion
Completed electodessication
Table.
                                                             Malignant   
  Basal CellSquamous CellSpecified type NECUnspecified SecondaryCa in situBenignUncertain BehaviorUnspecified Behavior
Lip C44.01C44.02C44.09C44.00     
Eyelid including canthusrightC44.112C44.122C44.192C44.102C79.2D04.12D23.11D48.5D49.0
 leftC44.119C44.129C44.199C44.109C79.2D04.19D23.12D48.5D49.2
Ear including pinnarightC44.212C44.222C44.292C44.202C79.2D04.22D23.2D48.5D49.2
 leftC44.219C44.229C44.299C44.209C79.2D04.29D23.22D48.5D49.2
Nose C44.311C44.321C44.391C44.301C79.2D04.30D23.39D48.5D49.2
Face, other parts C44.319C44.329C44.399C44.309C79.2D04.39D23.39D48.5D49.2
Scalp, neck C44.41C44.42C44.49C44.40C79.2D04.4D23.4D48.5D49.2
Body, trunk C44.519C44.529C44.599C44.509C79.2D04.5D23.5D48.5D49.2
ArmrightC44.612C44.622C44.692C44.602C79.2D04.62D23.61D48.5D49.2
 leftC44.619C44.629C44.699C44.609C79.2D04.69D23.62D48.5D49.2
LegrightC44.712C44.722C44.792C44.702C79.2D04.72D23.71D48.5D49.2
 leftC44.719C44.729C44.799C44.709C79.2D04.79D23.72D48.5D49.2
Overlapping sites C44.81C44.82C44.89C44.80     
Skin, unspecified C44.91C44.92C44.99C44.90C79.2D04.8D23.9D48.5D49.2
Anus, perianal, perineum C44.510C44.520C44.590C44.500C79.2D04.5D23.5D48.5D49.0
Breast C44.511C44.521C44.591C44.501C79.2D04.5D23.5D48.5D49.2
           
Labia Majora   C51.0 C79.82D07.1D28.0D39.8D49.5
Labia Minora   C51.1 C79.82D07.1D28.0D39.8D49.5
Clitoris   C51.2 C79.82D07.1D28.0D39.8D49.5
Female genitalia, NEC   C51.9 C79.82D07.1D28.0D39.8D49.5
           
Prepuce   C60.0 C79.82D07.4D29.4D40.8D49.5
Penis   C60.1C60.9C79.82D07.4D29.4D40.8D49.5
Scrotum   C63.2 C79.82D07.61D29.4D40.8D49.5
Male genitalia, NEC   C63.9 C79.82D07.60D29.4D40.8D49.5
Previous
Next
 
 
 
 
 
All material on this website is protected by copyright, Copyright © 1994-2016 by WebMD LLC. This website also contains material copyrighted by 3rd parties.