Destruction involves surgical curettage of the known skin cancer site. After local anesthesia is achieved, a surgical curette is used to scrape into the surrounding and deeper skin layers. Bleeding is stopped and the wound is left open to heal without the use of stitches. Because curetted tissue cannot be adequately assessed under the microscope, no tissue is sent for microscopic evaluation and thus no pathology reports can be issued stating the margins are clear. However this service has an extremely high cure rate. In most cases, it is not an acceptable technique for removal of more aggressive skin cancers such as malignant melanoma and invasive squamous cell carcinoma. It is commonly used to treat superficial skin cancers of low metastatic potential such as superficial basal cell carcinoma and superficial or in situ squamous cell carcinoma. The decision to perform a destruction in lieu of an excision is made at the discretion of the dermatologist and with full informed consent from the patient.