Curettage

This is a simple way of removing epidermal lesions. A curette has a metal spoon shaped end with a sharp cutting edge. There are a variety of shapes and sizes suitable for different lesions, from large seborrhoeic keratoses or papillomata to smaller ones for minute keratin cysts. A specimen is provided for histology but completeness of removal cannot be accurately assessed.

Lesions suitable for curetting

• Seborrhoeic keratoses

• Solitary viral warts

Solar keratoses Cutaneous horns Small basal cell carcinomas

Local anaesthetic is used and, with the skin stretched, the curette is applied at the edge of the lesion which is then scooped off. It is advisable to work around the edges of larger or more firmly attached lesions. The dermis normally feels firm but when curetting off a keratotic horn or solar keratoses; a soft consistency may indicate dysplastic change. The base can be lightly cauterised to control bleeding, sterilise the site, and prevent recurrence.

Various types of disposable curettes are available and are easy to use.

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