Prior to most dermatologic surgery, a biopsy of the lesion is performed. Three methods used include:

• Shave biopsy
• Excision
• Curettage or scraping

Once the tissue specimen is available, it is placed under a microscope and studied by an expert in pathology. At North Valley Dermatology Center, Dr. Richey, a Board Certified Histopathologist, and Dr. Vannucci, who has just completed a highly specialized course of study in pathology,read slides from biopsies. If indicated, the specimens are sent to the Melanoma Center at University of California, San Francisco for a second opinion.

Dermatologic surgery is almost always performed in a medical office. Local anesthetic is used. Minimal to no discomfort will be experienced during and after the procedure.

There are various methods of performing dermatologic surgery, including:

·        Surgical excision followed by wound closure using one of the following techniques:

 Simple or intermediate closure with sutures

 Grafts or flaps if the wound is more extensive

·        Curettage and electrodessication

A sharp instrument called a curette is used to scrape away the malignant tissue.

An electrosurgical unit is used to stop bleeding and burn away additional tissue.

Wound healing is by secondary intention, meaning it is not closed with sutures.

·        Cryosurgery

Liquid nitrogen is sprayed on the lesion, freezing and destroying the malignant tissue. Healing will occur with minimal scarring

The procedures described above are used for the following skin conditions:

·        Skin cancers

·        Benign lesions such as cysts, moles, actinic keratoses, seborrheic keratoses, warts