是否刮取：刮勺式活检在色素性皮损中的诊断和治疗价值。

To scoop or not to scoop: the diagnostic and therapeutic utility of the scoop-shave biopsy for pigmented lesions.

机构信息

*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.

出版信息

Dermatol Surg. 2014 Oct;40(10):1077-83. doi: 10.1097/01.DSS.0000452659.60130.68.

DOI:10.1097/01.DSS.0000452659.60130.68

PMID:25229784

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.

摘要

背景

由于担心黑素瘤的横断，许多医生都避免使用勺刮术来切除色素性病变。

目的

评估勺刮术在色素性病变治疗中的安全性和有效性。

材料和方法

记录了医生的临床诊断、意图（取样或完全切除）以及切除技术（切除、打孔、刮除活检或勺刮术）。随后记录了病理学结果，包括边缘（外周和深层）的状态。

结果

在 8 个月的时间里，共进行了 333 次手术。11 例（6 例原位和 5 例侵袭性）黑素瘤通过勺刮术切除，其中无 1 例深层边缘阳性，6 例（2 例原位和 4 例侵袭性）完全切除。通过勺刮术切除的 50 例发育不良痣中，有 1 例（中度发育不良）深层边缘阳性。46 例发育不良痣通过勺刮术完全切除。当医生的意图是“完全切除”时，勺刮术完全切除病变的比例为 73.1%，标准切除为 91%，刮除活检为 18.1%，打孔切除为 78.6%（p <.0001）。