Mohs micrographic surgery is safe, with a very low rate of adverse events, an exceedingly low rate of serious adverse events, and an undetectable mortality rate. Common complications include infections, followed by impaired wound healing and bleeding. Bleeding and wound-healing issues are often associated with preexisting anticoagulation therapy, which is nonetheless managed safely during MMS. We are not certain whether the small effects seen with the use of sterile gloves and antiseptics and antibiotics are clinically significant and whether wide-scale practice changes would be cost-effective given the small risk reductions.

Nonmelanoma skin cancers are the most common malignancies in the United States, with over 1.3 million patients diagnosed yearly. Several types of nonmelanoma skin cancer and precancerous lesions have an associated viral pathogenesis, including epidermodysplasia verruciformis, verrucous carcinoma, bowenoid papulosis, Kaposi sarcoma, squamous cell carcinoma, and, most recently, Merkel cell carcinoma. It is now widely accepted that high-risk human papillomaviruses (HPVs) play a key role in pathogenesis of cervical and anogenital cancer. Currently, 108 types of HPV have been discovered. They can be divided into genera including alpha, beta, and gamma HPVs, which comprise the majority of cutaneous HPVs. The relationship between viruses and cancer is a popular focus of research in an era of AIDS and organ transplantation, where immunosuppression is not uncommon. The incidence of viral-related malignancies in these populations is increasing. Because of the widespread nature of these cutaneous malignancies, an evaluation of these conditions is valuable. This review of the literature will focus on the histologic aspects of viral-associated skin malignancies, as well as the epidemiology, etiology, and clinical aspects of these diseases.

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EditorialEffect of patient satisfaction on outcomes of care Expert Rev. Pharmacoeconomics Outcomes Res. 9(5), 393-395 (2009) "Compliments on the physician's inter personal skills, concern for the patient's health and quality of explanations and answers to questions correlate with a higher rate of patient satisfaction."Patient satisfaction with care is a common treatment goal in all areas of medicine. Patients' satisfaction with their physicians depends on a variety of factors. A strong doctor-patient relationship based on adequate communication and good interpersonal skills is vital. In one study, insufficient communication was recognized by psoriasis patients as a major cause of dissatisfaction with psoriasis treatment [1]. Inadequate patient education serves as another barrier to patient satisfaction [2].

Glabella and forehead lines can be effectively and safely reduced with neurotoxin alone as well as neurotoxin in combination with fillers. Combination treatment may provide a slightly better cumulative benefit and also increase the persistence of effect.