Gary Mendese1, Mary Maloney, Jeremy Bordeaux. 1. *Mystic Valley Dermatology, Stoneham, Massachusetts; †Department of Dermatology, Boston University School of Medicine, Boston, Massachusetts; ‡Division of Dermatology, UMass Memorial Medical Center, Worcester, Massachusetts; §Department of Dermatology, University Hospitals Case Medical Center; and ‖Case Western Reserve University School of Medicine, Cleveland, Ohio.
Abstract
BACKGROUND: Concern over transection of melanomas has inhibited many practitioners from using the scoop-shave for removal of pigmented lesions. OBJECTIVE: To assess the safety and efficacy of the scoop-shave for pigmented lesions. MATERIALS AND METHODS: The practitioner's clinical diagnosis, intent (sample or completely remove), and removal technique (excision, punch, shave biopsy, or scoop-shave) were recorded. Pathology results including the status of the peripheral and deep margins were subsequently documented. RESULTS: Over an 8-month period, 333 procedures were performed. Of the 11 melanomas (6 in situ and 5 invasive) removed by the scoop-shave, none had positive deep margins and 6 (2 in situ and 4 invasive) were completely removed. One of the 50 dysplastic nevi removed by scoop-shave had a positive deep margin (moderately dysplastic). Forty-six dysplastic nevi were completely removed by the scoop-shave. When the practitioner's intent was "complete removal," the lesion was completely removed 73.1% of the time by scoop-shave, 91% by standard excision, 18.1% by shave biopsy, and 78.6% by punch excision (p < .0001). CONCLUSION: The scoop-shave is a safe and effective technique for diagnosis and treatment of melanocytic lesions.
BACKGROUND: Concern over transection of melanomas has inhibited many practitioners from using the scoop-shave for removal of pigmented lesions. OBJECTIVE: To assess the safety and efficacy of the scoop-shave for pigmented lesions. MATERIALS AND METHODS: The practitioner's clinical diagnosis, intent (sample or completely remove), and removal technique (excision, punch, shave biopsy, or scoop-shave) were recorded. Pathology results including the status of the peripheral and deep margins were subsequently documented. RESULTS: Over an 8-month period, 333 procedures were performed. Of the 11 melanomas (6 in situ and 5 invasive) removed by the scoop-shave, none had positive deep margins and 6 (2 in situ and 4 invasive) were completely removed. One of the 50 dysplastic nevi removed by scoop-shave had a positive deep margin (moderately dysplastic). Forty-six dysplastic nevi were completely removed by the scoop-shave. When the practitioner's intent was "complete removal," the lesion was completely removed 73.1% of the time by scoop-shave, 91% by standard excision, 18.1% by shave biopsy, and 78.6% by punch excision (p < .0001). CONCLUSION: The scoop-shave is a safe and effective technique for diagnosis and treatment of melanocytic lesions.
Authors: Steven Hoseong Yang; Ji Qi; Jessica Esandrio; Sherry Leung; Janis M Taube; Luis A Garza; Robert Allen; Sewon Kang; Anna L Chien Journal: Dermatol Surg Date: 2015-11 Impact factor: 3.398