Patient Preparation

Anesthesia

Injectable lidocaine is administered before most destruction techniques. Lidocaine plus epinephrine prolongs the anesthetic effect and further reduces blood loss.

An alternative for small lesions is to use a eutectic mixture of local anesthetics (EMLA) cream, which contains 2.5% lidocaine and 2.5% prilocaine. EMLA cream under occlusion should be applied to the skin at least one hour before the procedure to achieve topical anesthesia.

In patients who are allergic to "caine," diphenhydramine (25 mg/mL) solution is diluted in 1-5 mL of sterile normal saline and injected intradermally. This is effective for most small skin lesions.

Monitoring & Follow-up

Gentle daily washing of the wound with mild soap and water is recommended. The wound may be left exposed to air or covered with a light bandage for comfort.

Larger-area wounds that require more prolonged healing by secondary intention may benefit from application of a topical antibiotic such as neomycin or mupirocin to prevent infection.

Careful chart notes regarding the location of the lesion allow for periodic re-examination of the area to observe for signs of any recurrence.

Technique

Media Gallery

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

of 6

Table. ICD-10CM

Table. ICD-10CM

		Malignant
		Basal Cell	Squamous Cell	Specified type NEC	Unspecified	Secondary	Ca in situ	Benign	Uncertain Behavior	Unspecified Behavior
Lip		C44.01	C44.02	C44.09	C44.00
Eyelid including canthus	right	C44.112	C44.122	C44.192	C44.102	C79.2	D04.12	D23.11	D48.5	D49.0
	left	C44.119	C44.129	C44.199	C44.109	C79.2	D04.19	D23.12	D48.5	D49.2
Ear including pinna	right	C44.212	C44.222	C44.292	C44.202	C79.2	D04.22	D23.2	D48.5	D49.2
	left	C44.219	C44.229	C44.299	C44.209	C79.2	D04.29	D23.22	D48.5	D49.2
Nose		C44.311	C44.321	C44.391	C44.301	C79.2	D04.30	D23.39	D48.5	D49.2
Face, other parts		C44.319	C44.329	C44.399	C44.309	C79.2	D04.39	D23.39	D48.5	D49.2
Scalp, neck		C44.41	C44.42	C44.49	C44.40	C79.2	D04.4	D23.4	D48.5	D49.2
Body, trunk		C44.519	C44.529	C44.599	C44.509	C79.2	D04.5	D23.5	D48.5	D49.2
Arm	right	C44.612	C44.622	C44.692	C44.602	C79.2	D04.62	D23.61	D48.5	D49.2
	left	C44.619	C44.629	C44.699	C44.609	C79.2	D04.69	D23.62	D48.5	D49.2
Leg	right	C44.712	C44.722	C44.792	C44.702	C79.2	D04.72	D23.71	D48.5	D49.2
	left	C44.719	C44.729	C44.799	C44.709	C79.2	D04.79	D23.72	D48.5	D49.2
Overlapping sites		C44.81	C44.82	C44.89	C44.80
Skin, unspecified		C44.91	C44.92	C44.99	C44.90	C79.2	D04.8	D23.9	D48.5	D49.2
Anus, perianal, perineum		C44.510	C44.520	C44.590	C44.500	C79.2	D04.5	D23.5	D48.5	D49.0
Breast		C44.511	C44.521	C44.591	C44.501	C79.2	D04.5	D23.5	D48.5	D49.2

Labia Majora				C51.0		C79.82	D07.1	D28.0	D39.8	D49.5
Labia Minora				C51.1		C79.82	D07.1	D28.0	D39.8	D49.5
Clitoris				C51.2		C79.82	D07.1	D28.0	D39.8	D49.5
Female genitalia, NEC				C51.9		C79.82	D07.1	D28.0	D39.8	D49.5

Prepuce				C60.0		C79.82	D07.4	D29.4	D40.8	D49.5
Penis				C60.1	C60.9	C79.82	D07.4	D29.4	D40.8	D49.5
Scrotum				C63.2		C79.82	D07.61	D29.4	D40.8	D49.5
Male genitalia, NEC				C63.9		C79.82	D07.60	D29.4	D40.8	D49.5