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Mohs Micrographic Surgery

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https://www.readbyqxmd.com/read/28736885/cutaneous-squamous-cell-carcinoma-of-the-scalp-extending-to-the-skull-a-case-report-and-review-of-the-literature
#1
Marc Z Handler, David J Goldberg
Squamous cell carcinoma (SCC) of the scalp has increased prevalence in older patients and often presents later in life. Mohs micrographic surgery remains the most effective treatment in most cases. Delayed presentation may result in localized bony invasion or distant metastases. We present a case of an elderly woman presenting with extension of SCC into the parietal bone of the skull.
July 23, 2017: Journal of Cosmetic Dermatology
https://www.readbyqxmd.com/read/28728328/reconstruction-of-large-facial-defects-via-excision-of-skin-cancer-using-two-or-more-regional-flaps
#2
Dong Min Lee, Yong Chan Bae, Su Bong Nam, Seong Hwan Bae, June Seok Choi
BACKGROUND: Free-flap surgery and skin grafting can be used to reconstruct large facial defects that may result after skin cancer removal by Mohs micrographic surgery (MMS). However, these two methods may produce low postsurgical patient satisfaction with aesthetics, and free-flap surgery may produce an undue burden for the majority of skin cancer patients, who are of advanced age. Hence, the authors examined outcomes of large facial defect reconstruction using multiple flaps. METHODS: Among patients undergoing MMS for skin cancer at Pusan National University Hospital between January 2013 and December 2015, we evaluated 7 patients (2 males, 5 females; average age, 73...
July 2017: Archives of Plastic Surgery
https://www.readbyqxmd.com/read/28722451/-basal-cell-carcinoma-and-the-modalities-of-its-therapy
#3
Petr Arenberger, Jiří Ettler
Basal cell carcinoma (BCC) also known as basalioma or basal cell cancer, is the most common skin cancer. BCC has a very low metastatic risk. This tumor can cause significant disfigurement by invading surrounding tissues. It occurs mainly in fair-skinned patients with a family history of this cancer. Sunlight is a factor in about two-thirds of these cancers. Standard surgical excision is the treatment of choice. Mohs micrographic surgery is an outpatient or inpatient procedure in which the tumor is surgically excised and then immediately examined under a microscope...
2017: Casopís Lékar̆ů C̆eských
https://www.readbyqxmd.com/read/28707326/perineural-invasion-present-exclusively-in-central-tissue-blocks-of-mohs-surgical-excisions-of-basal-cell-carcinoma
#4
Lauren Young, Dougal Coates, John Pagliaro, David Francis, Richard Williamson, Zoran Gaspar
Perineural invasion (PNI) may be present in basal cell carcinomas (BCC) treated with Mohs micrographic surgery. This single-centre, non-randomised, prospective study demonstrates the potential for PNI to exist exclusively within the central tissue blocks of Mohs specimens.
July 14, 2017: Australasian Journal of Dermatology
https://www.readbyqxmd.com/read/28685596/amelanotic-lentigo-maligna-melanoma-mohs-surgery-as-the-definitive-treatment-of-an-invisible-tumour
#5
Marisa Grace Ponzo, Richard Ian Crawford, Irèn Kossintseva
Amelanotic lentigo maligna melanoma represents <2% of melanomas. Diagnosis is delayed owing to the lack of lesion pigmentation and advanced disease at presentation. Excision with appropriate margins is the treatment standard, but the starting point for such margins is often unclear. We describe 2 patients with amelanotic melanoma treated by Mohs micrographic surgery (MMS) that would not have been cleared by wide local excision alone and provide an extensive review of the literature. Both patients presented with histologic diagnoses of malignant melanoma, one with a barely perceptible biopsy site scar on the left infraorbital cheek/lower eyelid (Breslow 1...
July 1, 2017: Journal of Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/28681210/sebaceous-carcinoma-a-review-of-the-scientific-literature
#6
REVIEW
Thomas Knackstedt, Faramarz H Samie
Sebaceous carcinoma is a rare and potentially aggressive cutaneous malignancy. Commonly reported in the periocular area and the head and neck region, sebaceous carcinoma can arise from any sebaceous gland in the skin. The clinical presentation may be nonspecific, and a biopsy is important to establish a diagnosis and to differentiate from mimickers including benign sebaceous neoplasms, other adnexal tumors, and basal cell carcinoma. A diagnosis of Muir Torre syndrome should be considered in patients presenting with a sebaceous neoplasm...
August 2017: Current Treatment Options in Oncology
https://www.readbyqxmd.com/read/28681209/microcystic-adnexal-carcinoma-and-a-summary-of-other-rare-malignant-adnexal-tumours
#7
REVIEW
Arif Aslam
Microcystic adnexal carcinoma (MAC) is a rare, slow-growing, infiltrative malignant tumour most commonly found on the head and neck. It often presents as a solitary skin-coloured or yellow papule, plaque or nodule. Ultraviolet radiation, immunosuppression and ionising radiation are possible risk factors. Clinical and histological differential diagnoses include morpheaform basal cell carcinoma and desmoplastic trichoepithelioma. The diagnosis is usually made by skin biopsy, and the characteristic features are small keratin-filled cysts with nests and cords which resemble ductal structures...
August 2017: Current Treatment Options in Oncology
https://www.readbyqxmd.com/read/28676167/reconstruction-of-mohs-defects-of-the-lips-and-chin
#8
REVIEW
Yuna C Larrabee, Jeffrey S Moyer
Reconstruction of defects of the lips after Mohs micrographic surgery should encompass functional and aesthetic concerns. The lower lip and chin compose two-thirds of the lower portion of the face. The focus of this article is local tissue transfer for primarily cutaneous defects after Mohs surgery. Various flaps exist for repair. For small defects, elliptical excision with primary closure is a viable option. During reconstruction of the lip, all of the involved layers need to be addressed, including mucosa, muscle, and the vermillion or cutaneous lip...
August 2017: Facial Plastic Surgery Clinics of North America
https://www.readbyqxmd.com/read/28676166/reconstruction-of-cutaneous-nasal-defects
#9
REVIEW
Gregory S Dibelius, Dean M Toriumi
Mohs micrographic surgery has become the standard of care for the treatment of cutaneous malignancies. Reconstructing cutaneous defects of the nose can be challenging, as form and function must be respected to the greatest extent possible. A wide range of reconstructive techniques are used. Secondary intent, primary closure, skin grafts, local flaps, and the interpolated workhorse flaps represent the spectrum of options, each with specific advantages and disadvantages. Vigilant postoperative care, including judicious use of adjunctive procedures, can improve outcomes...
August 2017: Facial Plastic Surgery Clinics of North America
https://www.readbyqxmd.com/read/28676163/scalp-and-forehead-defects-in-the-post-mohs-surgery-patient
#10
REVIEW
Michael D Olson, Grant S Hamilton
Scalp and forehead reconstruction after Mohs micrographic surgery can encompass subcentimeter defects to entire scalp reconstruction. Knowledge of anatomy, flap design, and execution will prepare surgeons who operate in the head and neck area to confidently approach a variety of reconstructive challenges in this area.
August 2017: Facial Plastic Surgery Clinics of North America
https://www.readbyqxmd.com/read/28676158/the-physiology-and-biomechanics-of-skin-flaps
#11
REVIEW
James B Lucas
Facial skin defects created by Mohs micrographic surgery are commonly reconstructed using local cutaneous flaps from surrounding skin. To provide optimal survival and aesthetic outcomes, the cutaneous surgeon must command a thorough understanding of the complex vascular anatomy and physiology of the skin as well as the imperative physiologic and biomechanical considerations when elevating and transferring tissue via local skin flaps.
August 2017: Facial Plastic Surgery Clinics of North America
https://www.readbyqxmd.com/read/28676157/mohs-micrographic-surgery-for-the-management-of-cutaneous-malignancies
#12
REVIEW
Bobbak Mansouri, Lindsay M Bicknell, Dane Hill, Gregory D Walker, Katherine Fiala, Chad Housewright
Mohs micrographic surgery is a specialized form of skin cancer surgery in which the Mohs surgeon acts as both surgeon and pathologist. The procedure is characterized by its histopathologic margin control and ability to spare tissue, particularly in cosmetically sensitive locations. Mohs surgery is known for both limiting the size of the final defect and its high cure rate. In this review, the authors highlight indications for the procedure, detail the technique itself, discuss cutaneous tumors for which Mohs micrographic surgery is indicated, and present the economic benefit of Mohs surgery...
August 2017: Facial Plastic Surgery Clinics of North America
https://www.readbyqxmd.com/read/28661992/treatment-patterns-outcomes-and-patient-satisfaction-of-primary-epidermally-limited-nonmelanoma-skin-cancer
#13
Benjamin A Drew, Pritesh S Karia, Ariana N Mora, Christine A Liang, Chrysalyne D Schmults
BACKGROUND: Epidermally limited nonmelanoma skin cancer (ELNMSC) (superficial basal cell carcinoma [SBCC] and squamous cell carcinoma in situ [SCCIS]) is common. Data on outcomes and patient satisfaction are lacking. OBJECTIVE: To examine treatment efficacy and satisfaction in ELNMSC patients. PATIENTS AND METHODS: Retrospective cohort study of adults with primary SBCC or SCCIS. A 25% random subset completed a satisfaction questionnaire. RESULTS: Five hundred and fifty patients with 227 SBCC and 451 SCCIS were included; 329 tumors (49%) were treated with Mohs micrographic surgery (MMS) and 349 (51%) with non-MMS (imiquimod [n = 26], 5% 5-fluorouracil [n = 234], ingenol mebutate [n = 32], or cryotherapy [n = 57])...
June 28, 2017: Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et Al.]
https://www.readbyqxmd.com/read/28654580/mohs-mapping-fidelity-optimizing-orientation-accuracy-and-tissue-identification-in-mohs-surgery
#14
Janet Y Li, Sirunya Silapunt, Michael R Migden, Jamie L McGinness, Tri H Nguyen
BACKGROUND: Mohs micrographic surgery (MMS) is a highly effective process that requires consistent accuracy in resection, mapping, and histologic interpretation. Although the general sequence in MMS is similar, there are numerous variations among Mohs surgeons as to how this process is performed. OBJECTIVE: This article aims to review the process of MMS, with the intent to identify and mitigate the potential errors at each step. Existing variations will be discussed and protocols offered to minimize error and optimize accuracy...
June 23, 2017: Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et Al.]
https://www.readbyqxmd.com/read/28654579/detection-of-high-risk-histologic-features-and-tumor-upstaging-of-nonmelanoma-skin-cancers-on-debulk-analysis-a-quantitative-systematic-review
#15
Babu Singh, Adriana Dorelles, Nellie Konnikov, Bichchau M Nguyen
BACKGROUND: Histologic analysis of tumor debulks from Mohs micrographic surgery (MMS) or wide local excision may lead to the detection of adverse features missed on initial biopsy. OBJECTIVE: Determine the incidence of (1) high-risk features on debulk analysis compared with initial biopsy and (2) upstaging of tumors on debulk analysis according to the American Joint Committee of Cancer-7th Edition (AJCC-7) and the Brigham and Women's Alternative (BWH) staging criteria...
June 28, 2017: Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et Al.]
https://www.readbyqxmd.com/read/28654578/microcystic-adnexal-carcinoma-a-review-of-the-literature
#16
Shayna Gordon, Caroline Fischer, Ann Martin, Ilana S Rosman, M Laurin Council
BACKGROUND: Microcystic adnexal carcinoma (MAC) is a rare, locally aggressive cutaneous neoplasm that commonly occurs on the face. OBJECTIVE: The purpose of this article is to comprehensively review the current literature on MAC pertaining to epidemiology, pathogenesis, clinical presentation, histology, immunohistochemistry, prognosis, follow-up, and treatment. MATERIALS AND METHODS: An extensive literature review was conducted using OVID MEDLINE and PubMed to identify articles relating to MAC...
June 23, 2017: Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et Al.]
https://www.readbyqxmd.com/read/28628682/radiation-therapy-in-dermatology-non-melanoma-skin-cancer
#17
Nikoo Cheraghi, Armand Cognetta, David Goldberg
<p>Background: Dermatologists were historically well versed in the use of radiation therapy for the management of non-melanoma skin cancers and various inflammatory dermatologic conditions. With the advent of Mohs micrographic surgery and therapeutic discoveries for treating inflammatory dermatoses, radiotherapy assumed loss of a role in the clinical repertoire of the dermatologist. In recent years, its importance has again been realized for the management of non-melanoma skin cancers not amenable to surgical treatment or as adjuvant or palliative therapy...
May 1, 2017: Journal of Drugs in Dermatology: JDD
https://www.readbyqxmd.com/read/28619614/rapid-ex-vivo-examination-of-mohs-specimens-using-optical-coherence-tomography
#18
D Rashed, D Shah, A Freeman, R J Cook, C Hopper, C M Perrett
BACKGROUND: Mohs micrographic surgery (MMS) is an effective treatment for certain non-melanoma skin cancers. Optical coherence tomography (OCT) is a biomedical imaging modality that permits high-resolution imaging of the epidermis and dermis with the potential to detect both healthy tissue and tumour. OCT may also provide a means of detecting and differentiating between the various histological subtypes of basal cell carcinomas (BCC) in vivo. OBJECTIVE: The aim of this prospective ex vivo study was to evaluate the efficacy of OCT in recognising healthy and pathological margins of excised BCC lesions and detecting different BCC subtypes...
June 12, 2017: Photodiagnosis and Photodynamic Therapy
https://www.readbyqxmd.com/read/28607608/clinical-features-pathological-findings-and-treatment-of-recurrent-dermatofibrosarcoma-protuberans
#19
Yanan Li, Chuan Wang, Bo Xiang, Siyuan Chen, Li Li, Yi Ji
Dermatofibrosarcoma protuberans (DESP) is a relatively rare and low-grade tumor of the skin and soft tissue. We review the clinical features, pathological findings and management of recurrent DESP with the aim to improve our understanding of this rare tumor. Fifty-seven patients were diagnosed with recurrent DFSP. The mean age at the presentation of DFSP was 30.9 years. The mean age at diagnosis of DFSP was 40.2 years. Chest wall was the dominant location. The histopathological diagnosis was ordinary DFSP (O-DFSP) in 46 cases and fibrosarcomatous DFSP (FS-DFSP) in 11 cases...
2017: Journal of Cancer
https://www.readbyqxmd.com/read/28595252/recurrent-tumors-referred-for-mohs-micrographic-surgery-a-12-year-experience-at-a-single-academic-center
#20
H William Higgins, Sara Capobianco, Kachiu C Lee
BACKGROUND: Mohs micrographic surgery (MMS) is used for treatment of primary and recurrent tumors. Compared with primary tumors, recurrent tumors are often more aggressive. OBJECTIVE: To understand differing characteristics between primary versus recurrent tumors treated by MMS. MATERIALS AND METHODS: The authors conducted a retrospective review of a 12-year period at 1 academic center. Recurrent tumors were defined as recurrent if previously treated with cryotherapy, topical chemotherapeutics, electrodesiccation and curettage, or excision...
June 6, 2017: Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et Al.]
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