Dermal electrosurgical shave excision.

The dermal electrosurgical shave excision is a fast and inexpensive method of removing epidermal and dermal lesions. The procedure is ideally suited for pedunculated lesions raised above the level of the surrounding skin. It consists of repetitive, unidirectional, horizontal slicing of a cutaneous lesion with a no. 15 blade followed by electrosurgical feathering to smooth out the wound edges. A smoke evacuator is used during electrosurgery to prevent inhalation of heat-disseminated viral particles. The procedure is followed by histologic evaluation of the shaved specimen. Suspicious pigmented lesions should not be shaved because the long-term prognosis of a malignancy may depend on the thickness of the lesion on histologic analysis. Administration of adequate local anesthesia should make this a painless procedure. Basic general surgery skills are required, and formal training in electrosurgery is highly recommended.