Indication: pyogenic granulomas, some filiform warts, and larger seborrhoeic keratosis that catch and bleed. A deep curettage (into the dermis) can also be used for cutaneous horns without a base ie that are believed to be benign or actinic, but histology is required to exclude a squamous cell carcinoma (any papule/nodule/induration under a horn should be regarded as probable SCC and referred urgently as a 2-week wait).
Technique: use the correct side of the curette - the sharper side is usually marked. Good control is needed to avoid shearing the surrounding skin - the skin should be stretched tight and the curette held similar to a pen. Curette deep to the lesion, although for benign lesions try and avoid going into the fat otherwise healing will be delayed, and the resulting scar more unsightly. Gentle cautery is usually needed for haemostasis.
For detailed information refer to the PCDS surgical guidelines.
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