Electrodesiccation - A Medical Procedure for Tissue Removal

Introduction

Skin lesions occur in the form of a lump, sore, or an overgrowth of skin. These skin lesions can be noncancerous or cancerous. There are different types of procedures for the removal of these lesions. One such procedure is electrodesiccation (ED). It is called electrodesiccation because electric currents are used for the removal of the lesions. This procedure is very useful in treating superficial lesions of the skin.

What Is Electrodesiccation?

Electrodesiccation is a procedure that uses an electric current for the removal of various skin lesions including cancerous and noncancerous skin lesions. Electrodesiccation is the best choice in cases where treatment is confined to the epidermis (the outermost skin layer) only because it causes very less or no scarring of the skin.

How Does Electrodesiccation Work?

Electrodesiccation procedures produce a high-voltage spark which results in the dehydration of the tissues in the target area and this is achieved through direct contact with the affected tissue. In this procedure, electrodes are used for generating currents, and these electrodes are inserted or touched to the skin which destroys affected tissues.

What Are the Uses of Electrodesiccation?

Electrodesiccation is used for the removal of various noncancerous and cancerous skin lesions. These lesions are listed below:

• Basal cell carcinoma (BCC) which is a common skin cancer originating from basal cells. Nodular and superficial BCC can be treated with this procedure.

• Acrochordon (small, benign skin growth or skin tag).

• Cherry angioma (benign, red or purple skin growth caused by blood vessels).

• Condyloma acuminatum (genital warts caused by human papillomavirus).

• Dermatosis papulosa nigra (small, dark raised growths, often on the face).

• Molluscum contagiosum (contagious viral skin infection with small, raised bumps).

• Mucous cysts (fluid-filled sacs usually occurring on fingers or toes).

• Oral fibroma (benign fibrous growth in the mouth).

• Papilloma (benign skin tumor, often resembling a wart).

• Seborrheic keratosis (non-cancerous skin growth with waxy appearance).

• Syringoma (benign sweat gland tumors).

• Verruca Vulgaris (common warts caused by HPV).

• Verruca plana (flat warts usually found on the face or back of hands).

• Actinic keratosis (precancerous skin growth due to sun damage).

• Squamous cell carcinoma (a type of cancer).

What Are the Contraindications of Electrodesiccation?

There are some conditions where electrodesiccation can not be used. These conditions are:

• Fibrotic lesions.

• Lesions extended into subcutaneous fat.

• Infected lesions.

• Large cancerous lesions which are greater than two centimeters in size.

• Skin lesions which are present in the “H” zone of the face which includes parts of the nose, scalp, ears, lips, and embryonic fusion planes.

What Is the Procedure of Electrodesiccation?

Electrodesiccation is often done with curettage The procedure of electrodesiccation is listed below:

• Local anesthesia is injected into the target area to achieve numbness so that the patient would have pain free experience.

• The skin lesion is scraped off with an instrument called a curette. This curette is a long and thin instrument having a sharp looped edge at one end.

• The scrapping of the lesion with curettage is done with smooth scraping motions in three different directions. This results in slight bleeding.

• After the curettage is done, the remaining skin lesion is treated with electrodesiccation. For that, the tip of a needle-shaped instrument called an electrode is placed directly on the skin lesion and it is moved gently across the lesion. A short burst of electrodesiccation is given and is repeated in three different directions, the same as that of curettage.

• These electrodes produce an electric current that dries out the cells of skin lesions and as a result, slight contraction of the tissue occurs along with superficial skin dehydration. The carbonization of the epidermis occurs which gives a charred appearance. In addition, this carbonized epidermis is removed to promote healing.

• The process of curettage and electrodesiccation is performed three times and usually during the third and final time, the hemostasis (stopping of blood) is achieved.

After the procedure, the treated area is covered with a bandaid or petroleum pressure dressing.

• The procedure of electrodesiccation takes around five to 20 minutes. The patient can go back home after the procedure.

What Are Postoperative Care After Electrodesiccation?

After the procedure of electrodesiccation, some postoperative measures have to be taken by the patient. These are listed below:

• Patients are advised to use mild soap for cleaning wounds. Apart from this, soap with fragrance can irritate the wound sometimes. Therefore, harsh soap with fragrance should be avoided.

• Healing takes one to six weeks and is dependent on the size and location of the wound.

• Topical antibiotic creams such as Neomycin or Mupirocin are prescribed to prevent infection. These creams are useful for patients who have undergone electrodesiccation for larger lesions as the larger wounds take extended healing time by secondary intention.

• Periodic follow-ups are scheduled to look for any signs of recurrence of the lesion.

What Are the Complications of Electrodesiccation?

Although electrodesiccation does not result in serious complications. The complications are minimal and are listed below:

• Pain.

• Hyperpigmentation.

• Infection of the wound.

• Hypertrophic scarring.

• Recurrence of the lesion in some cases has been reported. This is especially seen in superficial multifocal basal cell carcinoma (BCC) which involves the temple.

• Skin lesions like large basal cell carcinoma can leave large scars on the skin.

What Are the Other Methods For the Removal of Skin Lesions?

Apart from electrodesiccation, there are other methods also by which skin lesions can be treated or removed. These methods are listed below:

1. Shave Excision:

The method is applied to the skin lesions that are present on the upper layer of the skin or emerge above the skin.

2. Simple Scissor Excision:

This method is also useful for the skin lesions that emerge above the skin or are confined to the upper layer of the skin.

3. Skin Excision- Full Thickness:

This method is useful for the skin lesions that are present in the deeper layer of the skin down to the fatty layer.

4. Laser Excision:

The laser excision helps remove moles, warts, hair, tattoos, cancerous and noncancerous skin lesions, sunspots, small blood vessels in the skin, etc.

5. Cryotherapy:

Cryotherapy is a technique that involves extremely freezing of tissues so that they could be destroyed. It is commonly used for the removal of warts, actinic keratoses (precancerous patches of thick, scaly, or crusty skin caused by sun exposure), seborrheic keratoses (non-cancerous growths with a waxy, stuck-on appearance), and molluscum contagiosum (a viral skin infection resulting in small, raised bumps with a central dimple).

6. MOHS Surgery:

This surgery is done for the treatment of skin cancer. In this method, skin cancerous lesions are removed in such a way that the surrounding healthy skin undergoes the least damage.

What Are the Advantages of Electrodesiccation?

Electrodesiccation has the following advantages:

• The duration of this procedure is shorter and can be done quickly.

• Less bleeding occurs than in other surgeries.

• No stitches are required in this procedure.

• The aesthetic outcome is generally good.

Conclusion:

Electrodesiccation is considered a safe procedure for the removal of skin lesions. The complications are minimal with this procedure and a lot of cancerous and noncancerous skin lesions can be removed with this procedure.