BACKGROUND As the US population ages, safe surgical procedures are necessary for treatment of cutaneous neoplasms in very elderly patients. OBJECTIVE To determine the incidence of complications associated with Mohs micrographic surgery (MMS) in patients aged 85 and older, and the risk factors that predispose to complications. METHODS A 9-year retrospective chart review of patients aged 85 and older who underwent MMS at our institution between 07/2007 and 11/2016 was performed. Six types of complications associated with scalpel-based cutaneous surgery were recorded, as well as patient, tumor, and repair characteristics. RESULTS This study included 949 patients totaling in 1683 MMS cases. There were 30 complications: infection (N = 11), wound dehiscence (N = 6), hematoma (N = 6), hemorrhage (N = 5), flap necrosis (N = 1), and graft necrosis (N = 1), resulting in an overall complication rate of 1.78%. Independent risk factors associated with a statistically higher incidence of complications were anticoagulant use (odds ratio [OR], 2.78; 95% confidence interval [CI], 1.26–6.13; p = .012), extremity location (OR, 2.80; 95% CI, 1.19–6.54; p = .018), greater than 2 MMS stages (OR, 2.43; 95% CI, 1.08–5.46; p = .032), and flap repair (OR, 2.27; 95% CI, 1.05–4.90; p = .036). CONCLUSION Mohs micrographic surgery is a safe procedure for treatment of cutaneous neoplasms in the very elderly.

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electrocardiogram to rule out cardiac comorbidities. If remission of the granulomatous dermatitis occurs, consider dose reduction to control the skin disease. In our experience, other aspects of Blau syndrome including joint and ocular disease are not controlled with erythromycin, raising the possibility that the mechanism of granuloma formation or tissue levels of erythromycin are different in the skin than in other organs affected by Blau syndrome.

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