Excision is the surgical removal of the visible lesion plus an appropriate margin of surrounding tissue for pathological examination. The goal of surgical excision is complete removal of the lesion and cure, but excision can also be used to biopsy suspicious lesions. The procedure is performed to minimize scarring and functional impairment. Surgical excision is a standard treatment for most types of skin cancer including basal cell carcinoma, squamous cell carcinoma, malignant melanoma, and other benign or malignant cutaneous growths on most areas of the body, except for the head, face and neck. These skin cancers are typically removed through Mohs Micrographic Surgery.

Non-melanoma skin cancers (such as basal cell carcinoma and squamous cell carcinoma) and benign growths often are treated with curettage or electrosurgery. Curretage involves scraping of affected tissue with a sharp instrument) while electrosurgery uses heat from an electric current to burn, cut, and/or coagulate tissue. The combination of curettage and electrosurgery effectively treats the entire involved area by targeting the lesion and a margin of surrounding tissue.

Cryosurgery involves the application of liquid nitrogen or other agent directly to the skin to destroy skin growths. The liquid nitrogen is generally sprayed on the skin through a handheld device or is applied using a probe or cotton tipped applicator. Liquid nitrogen rapidly freezes and thaws cells which destroys areas where skin growths occur. Normal skin cells replace the damaged ones and heal the area naturally. Cryosurgery is commonly used for many benign (non-cancerous) growths (such as seborrheic keratosis, verruca vulgaris, verrucous keratosis and lentigines) and pre-cancerous growths (actinic keratosis). Basal cell carcinoma and squamous cell carcinoma can also be treated with cryosurgery, in some cases. The treated area may briefly sting and develop temporary redness and the treated lesion crusts and peels off in one to two weeks.

Non-melanoma cancerous skin growths (basal cell carcinoma and squamous cell carcinoma) and pre-cancerous growths (actinic keratosis) can often be successfully treated with topical skin cancer therapy. Topical chemotherapy agents destroy cancerous cells. Biologic topical agents stimulate your immune system to destroy cancerous cells while preserving the normal, neighboring tissue. Most chemotherapy or biologic agents are formulated as creams, gel, or lotions that are applied directly to regions of the skin for a specified period of time. Affected areas of skin may become red, scaly, or crusty and may itch, sting, or burn during the treatment but heal quickly after the treatment is complete.

Method

• Remove the visible portion of the tumor.
• A thin layer of skin is removed and divided into sections, color-coded, and frozen.
• A map is drawn of the affected area.
• Each section is examined under the microscope for evidence of remaining cancer.
• If cancer cells are found, another thin layer is removed from the mapped area and again examined. This process is repeated until there is no longer any evidence of cancer cells.

Advantages

• Offers highest cure rate.
• Has the lowest chance of regrowth.
• Minimizes removal of noncancerous tissue.
• Is the most precise means of removal.

To learn more about Mohs surgery at Pennsylvania Dermatology Group, please click here.