Mohs surgery. Technique, indications, applications, and the future

Abstract

Each year, it is estimated, more than 500,000 new cases of nonmelanoma skin cancer develop. The majority of these cutaneous neoplasms are treated by various modalities that include excision, electrodesiccation and curettage, cryosurgery, and irradiation, with greater than 90% success. Certain of the remaining primary tumors, as well as recurrent carcinomas, present a demanding therapeutic challenge. For these lesions, Mohs surgery has evolved as the most reliable and cost-effective treatment modality, offering maximal preservation of normal tissue and therefore the lowest functional and cosmetic morbidity. In this review, the history and evolution of Mohs surgery and the technique itself will be briefly outlined. The indications for Mohs surgery, together with methods of handling the postoperative wound and future applications of the technique, will be discussed in detail.

Assessment of Incompletely Excised Basal Cell Carcinomas in Six Facial Areas: Influence of Elastosis

“…This is consistent with other studies in which tumors situated in these regions presented a higher rate of positive margins compared to other localizations [9,10,11]. These two areas are part of the so-called H-zone of the face (fig.…”

Recurrence Rates of Treated Basal Cell Carcinomas: Part 2: Curettage‐Electrodesiccation

“…The high‐, middle‐, and low‐risk sites are shown schematically in Figure 7. The high‐risk areas that were defined by our results are very similar to the high‐risk areas discussed and displayed schematically by Swanson in his review article on Mohs'surgery 19 …”

High Recurrence Rates of Basal Cell Carcinoma After Mohs Surgery in Patients With Chronic Lymphocytic Leukemia

“…[3][4][5] Our BCC control group had a 2% recurrence rate, which is similar to prior reported estimates. [3][4][5] Numerous factors contribute to impaired host immune function in patients with CLL, 9 including hypogammaglobulinemia, low levels of complement, impaired granulocyte function, altered leukemic cell expression of class II major histocompatibility complex antigens, altered expression of T-cell receptor variable region genes, and functional defects in bystander and other T-cell subsets. B cells in patients with CLL also contribute to impaired host immune function by elaborating immunosuppressive factors.…”