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

Abstract

Concern over transection of melanomas has inhibited many practitioners from using the scoop-shave for removal of pigmented lesions. To assess the safety and efficacy of the scoop-shave for pigmented lesions. 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. 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). The scoop-shave is a safe and effective technique for diagnosis and treatment of melanocytic lesions.