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Electrosurgery — SCE Dermatology MCQ

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HardDermatological SurgeryElectrosurgerySCE Dermatology

A 35-year-old woman is counselled about electrosurgery for a skin lesion. Her surgeon explains the difference between electrodesiccation and electrosection. What is the key difference?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: A — A full-length nail-unit cross-section including matrix, bed, folds and hyponychium

The best answer is “A full-length nail-unit cross-section including matrix, bed, folds and hyponychium”. Dermatological surgery should preserve diagnostic architecture, orient closure with local tension and cosmetic units, and select reconstruction by defect depth, size, subunit and functional distortion risk. The alternatives “Electrodesiccation is colder than electrosection, within an appropriate UK pathway”, “Electrosection works on bone, after clinicopathological correlation, after specialist assessment”, “No practical difference, after specialist assessment, when the full phenotype supports it”, “Electrodesiccation requires general anaesthesia, when the full phenotype supports it” are clinically adjacent possibilities, but they do not fit the defining morphology, distribution, histopathology, risk signal or management sequence in this stem.

Reference: NICE HTG388 melanoma diagnostic practice: https://www.nice.org.uk/guidance/htg388/chapter/3-Clinical-need-and-practice