Nonmelanoma of the Skin and Mohs Surgery

Pennington, Brent E.; Moody, Brent R.

doi:10.1097/01.prs.0000123625.76158.73

Cited by 4 publications

(2 citation statements)

References 5 publications

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“…Traditional surgical excision method is not as complete as Mohs' surgery in tumor control, but it also has many advantages: the operation time is short, it can be done under local anesthesia without hospitalization, and the defect can be reconstructed immediately. The recurrence rate of our study was slightly higher than that of Mohs' surgery (18, 19), but similar to the result of other conventional surgical method (11, 12). Confirmation of the surgical margin with frozen section biopsies and excision of the lesion with enough safety margins can contribute to the lower recurrence rate.…”

Section: Discussionsupporting

confidence: 86%

Primary Facial Skin Cancer: Clinical Characteristics and Surgical Outcome in Chungbuk Province, Korea

Jin

Lee

et al. 2005

J Korean Med Sci

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Clinical features of facial skin cancer in Asian population including Korean are not readily available. In the present study, we analyzed the clinical characteristics and the surgical results of primary facial skin cancer in Chungbuk Province, Korea. Eighty-six cases of primary facial skin cancer collected during a 10-yr period (1994-2003) were retrospectively reviewed about the clinical characteristics including age, sex, annual diagnostic rate, types of tumor, specific sites of occurrence, and the surgical results. The average age at the diagnosis was 67 and male to female ratio was 1 to 1.05. The average annual diagnostic rate was 0.73% and the rate surged during the period 2001-2003 compared with the period 1994 to 2000. Basal cell carcinoma was the most common tumor and the nose was the most frequent site. Traditional surgical excision with immediate reconstruction was performed in 81 cases. During the 23 months of average follow-up, three patients had recurrences (3.7%) and three patients had secondary skin cancers. Facial skin cancer is increasing in the province and basal cell carcinoma is most frequent. Traditional surgical excision and immediate reconstruction with local flap are a good therapeutic modality with an acceptable recurrence rate.

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Section: Discussionsupporting

confidence: 86%

Primary Facial Skin Cancer: Clinical Characteristics and Surgical Outcome in Chungbuk Province, Korea

Jin

Lee

et al. 2005

J Korean Med Sci

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“…7 With bread-loaf sectioning, 2 to 4 mm of tissue is left unexamined at each interval so less than 1% of the excised margin is examined. 8,9 This is particularly inadequate with tumor types that have irregular, finger-like projections. Residual tumor may be left behind if the tumor should extend to areas that are not examined, and recurrence is likely.…”

Section: Techniquementioning

confidence: 99%

Management of Cutaneous Tumors with Mohs Micrographic Surgery

Dim-Jamora

Perone²

2008

Seminars in Plastic Surgery

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Since the inception of Mohs micrographic surgery in the 1930s, this technique has proved its utility in the treatment of cutaneous tumors. This review describes the technique of Mohs micrographic surgery and the various indications for which it is used. We discuss the use of Mohs micrographic surgery for the following cutaneous tumors: basal cell carcinoma, squamous cell carcinoma, melanoma in situ, dermatofibrosarcoma protuberans, Merkel cell carcinoma, microcystic adnexal carcinoma, atypical fibroxanthoma, and sebaceous carcinoma. Mohs micrographic surgery is cost effective in the U.S. health care system because billing for the surgeon-pathologist and laboratory processing is bundled together. However, Mohs micrographic surgery may be more expensive in European systems because the Mohs technique surgeon, pathologist, and laboratory fees may be billed separately. KEYWORDS: Mohs micrographic surgery, cutaneous oncology, skin cancerIn the early 1930s, Dr. Frederic Mohs developed the procedure that bears his name while working as an assistant in a cancer research laboratory during medical school. 1 While studying rats implanted with skin cancer, he noticed that the carcinomatous tissue, when fixed in 20% zinc chloride, maintained its histologic architecture after extirpation, thus aiding in microscopic examination. 2 To ensure margin clearance, he formulated the technique of chemical fixation, excision by saucerization, and microscopic examination of horizontal sections. 2 In 1936, he started using this technique in patients deemed incurable. He would apply the 20% zinc chloride paste on the skin cancer in vivo and leave it overnight to fixate the skin. While painful for the patient, this was quite effective in preserving the microscopic anatomy of the skin. Only one stage could be taken per day because the tissue was processed using paraffin sections. Subsequent stages could be taken depending on the microscopic results. The presence of zinc chloride on the skin forced Dr. Mohs to allow the wounds to heal by secondary intention as the inflammation left the wound bed inhospitable to reconstructive techniques. With this protocol, he was able to successfully treat most of his patients.Because Dr. Mohs was formally trained as a general surgeon, he first reported his success in using this technique in 440 patients in the Archives of Surgery in 1941. 3 However, the reception within the surgical community was modest at best. His technique diverged so dramatically from the accepted procedure that the presence of purulent-looking, open wounds and the associated pain served to confirm the suspicion of his colleagues that this technique was unacceptable. 2 Over time, the impressive cure rate and acceptable cosmetic outcome of granulation slowly improved the medical community's impression of his technique.In 1946, Dr. Mohs presented his technique at the American Academy of Dermatology annual meeting in

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Mohs Micrographic Surgery: A Brief Overview

Gamret,

Roberts,

Srivastava

et al. 2024

Semin Plast Surg

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Mohs micrographic surgery (MMS) is a tissue-sparing skin cancer resection technique that involves 100% margin analysis. This procedure is performed in the outpatient setting under local anesthesia by dermatologic surgeons who act as both the surgeon and the pathologist. The technique allows for prompt reconstruction immediately after cancer clearance and offers the highest cure rate for many skin malignancies, including basal and squamous cell carcinoma, as well as more rare tumors. Mohs surgery effectively ensures cancer clearance while minimizing defect size and optimizing cosmetic and functional outcomes for patients. Herein we will discuss the evolution, procedure, and indications of MMS.

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Nonmelanoma of the Skin and Mohs Surgery

Cited by 4 publications

References 5 publications

Primary Facial Skin Cancer: Clinical Characteristics and Surgical Outcome in Chungbuk Province, Korea

Primary Facial Skin Cancer: Clinical Characteristics and Surgical Outcome in Chungbuk Province, Korea

Management of Cutaneous Tumors with Mohs Micrographic Surgery

Mohs Micrographic Surgery: A Brief Overview

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