Surgical excision is commonly reported as the treatment of choice for BD, although no RCTs and only this small series were found to support its use. The unmatched efficacy ascribed to surgical excision probably relates to the notion that excision of an in situ neoplasm is, by definition, curative. The predominance of BD in elderly populations and its slow progression to SCC suggest that additional outcomes such as healing, scarring and patient preferences should be considered in determining the choice of treatment. The large series investigating ED&C demonstrated high efficacy, with tolerable recurrence rates during a sufficiently long follow up. ED&C may thus be a highly useful procedure for patients with small solitary lesions.
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