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To the Editor.—
I have a comment concerning William McDaniel's article in the October Archives (114:1491-1492, 1978). He recommended curettage only in the treatment of basal cell carcinomas. My usual surgical procedure is to firmly curette the tumor, then excise the curetted area. I almost always find residual tumor in the excised specimen. His follow-up is too short for many of the patients to have shown their recurrences. Remember, a basal cell carcinoma may recur by perforation of the cheek or nose instead of coming through the surface of the scar. If he has guessed right, the patients may indeed have better cosmetic results; however, if he is wrong, the tumors may become very large before they are discovered.
Chappler RR. Treatment of Basal Cell Carcinomas. Arch Dermatol. 1979;115(5):637–638. doi:10.1001/archderm.1979.04010050061031
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