Mohs surgery

Mohs surgery, also known as Mohs micrographic surgery, is a precise surgical technique used to treat skin cancer. During Mohs surgery, layers of cancer-containing skin are progressively removed and examined until only cancer-free tissue remains.

Mohs ear

Introduction

Mohs surgery is named after Dr. Frederic E. Mohs, who developed the procedure in the 1930s. It is a gold-standard treatment for many types of skin cancer, particularly basal cell carcinomas and squamous cell carcinomas, due to its high cure rate and tissue-sparing nature.<ref>Tierney, E. P., & Hanke, C. W. (2011). Mohs micrographic surgery: a cost analysis. Journal of drugs in dermatology: JDD, 10(12), 1373-1379.</ref>

Procedure

The procedure involves removing a layer of skin and examining it under a microscope while the patient waits. If cancer cells are seen, another layer is removed and examined. This process is repeated until no cancer cells are found. As a result, Mohs surgery spares as much healthy skin as possible and reduces the need for a larger, more invasive surgery.<ref>Malhotra, R., Huilgol, S. C., Huynh, N. T., & Selva, D. (2004). The Australian Mohs database, part II: periocular basal cell carcinoma outcome at 5-year follow-up. Ophthalmology, 111(4), 631-636.</ref>

Indications

• Mohs surgery is typically used for skin cancers that:
• Have a high risk of recurrence or that have recurred after previous treatment.
• Are located in areas where it is important to preserve healthy tissue for cosmetic and functional reasons, such as eyelids, nose, ears, lips, fingers, toes, and genitals.
• Are large or aggressive.
• Have edges that are hard to define.<ref>Rogers, H. W., Weinstock, M. A., Feldman, S. R., & Coldiron, B. M. (2015). Incidence Estimate of Nonmelanoma Skin Cancer (Keratinocyte Carcinomas) in the US Population, 2012. JAMA dermatology, 151(10), 1081-1086.</ref>

Advantages

• The main advantages of Mohs surgery include:
• High cure rate: Mohs surgery has the highest success rate of all treatments for skin cancer.
• Tissue-sparing: It's the most exact and precise method of tumor removal, minimizing the chance of regrowth and lessening the potential for scarring or disfigurement.<ref>Mosterd, K., Krekels, G. A., Nieman, F. H., Ostertag, J. U., Essers, B. A., Dirksen, C. D., ... & Vermeulen, A. (2008). Surgical excision versus Mohs' micrographic surgery for primary and recurrent basal-cell carcinoma of the face: a prospective randomised controlled trial with 5-years' follow-up. The Lancet Oncology, 9(12), 1149-1156.</ref>

Potential Complications

Although Mohs surgery is generally well-tolerated, potential complications can include infection, bleeding, and a delayed wound healing. The risk of any surgical complications is generally low.

See Also

• Skin Cancer
• Basal Cell Carcinoma
• Squamous Cell Carcinoma
• Dermatology

References

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