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To the Editor.—
Dr. Gilbert Eade (229:23, 1974) is correct in not subjecting everyone he sees with a basal cell carcinoma to the skills and expertise of a board-certified plastic surgeon like himself. Nevertheless, I believe he is incorrect in his assumption that if the lesion is slow-growing, it is not a great concern, and that the problems that can arise with these lesions are rarely important. It is true that basal cell carcinomas rarely metastasize, but they do. What is even more important is that basal cell carcinomas notoriously can invade deeply in and around blood vessels and nerves, and even invade bone—producing no clinically significant problem until it does become necessary to call a plastic surgeon.When these lesions are found early, a 95% cure rate can be achieved quite easily by almost any dermatologist using the simple modality of curettage and desiccation. This procedure does not require hospitalization,
Schreiber MM. Treatment of Basal Cell Carcinoma. JAMA. 1974;229(12):1581. doi:10.1001/jama.1974.03230500017015
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