stretch test in basal cell carcinoma (BCC)
Last reviewed 01/2018
- technique can aid tissue sparing and avoid repeat excisions for low-risk
tumours
- skin stretching technique was developed to improve the complete excision
of basal cell carcinomas (BCCs)
- stretching the skin aids in defining the borders of a BCC by emptying
microvessels within the lesion
- which reveals a pearly colour and tumour borders that contrast with
the peripheral skin
- which reveals a pearly colour and tumour borders that contrast with
the peripheral skin
- study evidence (1) compared rates of complete excision in 596 patients
who received conventional excision surgery for BCC before the stretching
technique began to be employed (the control group) and 249 patients who
received a pre-excision stretch test
- rate of margin positivity after excision decreased from 6.4% in the control group to 1.7% in the stretch group
- this study validates a procedure that many dermatologists already
perform
- stretching and pressing and stretching the tumourr skin, possibly with a glass slide, can help delineate the tumor boundaries
- dermoscopy is preferred by some clinicians to see a magnified view of the tumor and its boundaries
- stretching the skin aids in defining the borders of a BCC by emptying
microvessels within the lesion
The "stretch" test is useful in two ways: it aids diagnosis of BCC, and makes the tumour boundaries more obvious, helping to determine the margins for surgical excision (2).
For more information about the "stretch test" then see http://www.jprasurg.com/article/S0007-1226(02)93919-6/pdf
Reference:
- Shalom A et al. Stretch test: Effectiveness in identifying basal cell carcinoma borders. Ann Plast Surg 2012 Jan; 68:72
- Mellor RH et al. The stretch test in basal cell carcinoma: a clinical indicator of tumour. Br J Plast Surg. 2002 Oct;55(7):594-5.