Excision of Skin Lesion

A skin lesion is an area of the skin that is different than the surrounding skin. This can be a lump, sore, or an area of skin that is not normal. It may also be a skin cancer.

Skin lesion removal is a procedure to remove the lesion.

What to Expect:

Most lesion removal procedures are easily done in your doctor’s office or an outpatient medical office. You may need to see your primary care provider, a skin doctor (dermatologist), or a surgeon.

Which procedure you have depends on the location, size, and type of lesion. The removed lesion is sent to the lab where it is examined under a microscope.

You will receive some type of numbing medicine (anesthetic) before the procedure.

The different types of skin removal techniques are described below.

SHAVE EXCISION

This technique is used for skin lesions that rise above the skin.

Your doctor uses a small blade to remove the outermost layers of skin after the area is made numb. The area removed includes all or part of the lesion.

You often do not need stitches. At the end of the procedure, medicine is applied to the area to stop any bleeding. Or the area may be burned with a cautery. Neither of these will hurt.

SIMPLE SCISSOR EXCISION

This technique is also used for skin lesions that rise above the skin level.

Your provider will grab the skin lesion with a small forceps and lightly pull up. Small, curved scissors will be used to carefully cut around and under the lesion. A curette (an instrument used to clean or scrape skin) maybe used to cut any remaining parts of the lesion.

You will rarely need stitches. At the end of the procedure, medicine is applied to the area to stop any bleeding. Or the area may be burned with a cautery.

SKIN EXCISION – FULL THICKNESS

This technique involves removing a skin lesion in the deeper levels of the skin down to the fatty layer under the skin. A small amount of normal tissue surrounding the lesion may be removed to ensure it is clear of any possible cancer cells (clear margins). It is more likely to be done when there is a concern about a skin cancer.

• Most often, an area the shape of an ellipse is removed, as this makes it easier to close with stitches.
• The entire lesion is removed, going as deep as the fat, if needed, to get the whole area. A margin of about 3 to 4 millimeters (mm) surrounding the tumor may also be removed to ensure clear margins.

The area is closed with stitches. If a large area is removed, a skin graft or flap of normal skin may be used to replace the skin that was removed.

CURETTAGE AND ELECTRODESICCATION

This procedure involves scraping or scooping out a skin lesion. A technique that uses high-frequency electrical current may be used before or after. This is called electrodesiccation.

It may be used for superficial lesions that do not need a full-thickness excision.

LASER EXCISION

A laser is a light beam that can be focused on a very small area. The laser heats the cells in the area being treated until they “burst.” There are several types of lasers. Each laser has specific uses.