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Mohs Micrographic Surgery

Hugh M Gloster
The following is a response to the Letter to the Editor by Konda, Francis, and Patel regarding the article "Mohs and Close" Technique (MCT) for selected cases to increase the efficiency of Mohs micrographic surgery.1,2 The letter raises questions about our utilization of MCT that require clarification.
March 1, 2018: Journal of Drugs in Dermatology: JDD
Junqian Zhang, Christopher J Miller, Victoria O'Malley, Jeremy R Etzkorn, Thuzar M Shin, Joseph F Sobanko
BACKGROUND: Changes in patient perceptions of quality of life (QOL) after Mohs micrographic surgery (MMS) may benefit from different counseling or treatment. OBJECTIVE: To measure QOL before and after MMS and to identify risk factors associated with impaired QOL. METHODS: Prospective observational study of 727 skin cancer patients who self-reported QOL via the Skin Cancer Index immediately before and at 1-2 weeks and 3 months after MMS. RESULTS: QOL fluctuated after MMS...
March 5, 2018: Journal of the American Academy of Dermatology
Ali A Damavandy, Vitaly Terushkin, John A Zitelli, David G Brodland, Christopher J Miller, Jeremy R Etzkorn, Thuzar M Shin, Mark A Cappel, Mario Mitkov, Ali Hendi
BACKGROUND: Extramammary Paget's disease (EMPD) is a rare intraepithelial malignancy with high recurrence rates following standard surgical treatments, ranging from 22% to 60% in large retrospective reviews. OBJECTIVE: To evaluate the local recurrence rate of Mohs micrographic surgery (MMS) supplemented with intraoperative immunohistochemistry for cytokeratin-7 (MMS + CK-7) for primary and recurrent EMPD. MATERIALS AND METHODS: Retrospective, multi-center, cross-sectional study of patients treated using MMS + CK-7...
March 2018: Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et Al.]
Felipe Bochnia Cerci
Mohs micrographic surgery (MMS) is the treatment of choice for high-risk basal cell carcinoma.1,2 The technique combines tissue conservation with complete microscopic margin control, leading to superior cure rates while minimizing deformity.3 MMS involves several steps that should be meticulously followed to achieve this high cure rate.4 This article is protected by copyright. All rights reserved.
March 6, 2018: Journal of the European Academy of Dermatology and Venereology: JEADV
Jeremy R Etzkorn, Scott D Tuttle, Ilya Lim, Elea M Feit, Joseph F Sobanko, Thuzar M Shin, Donald E Neal, Christopher J Miller
BACKGROUND: Surgical treatment options for facial melanomas include conventional excision with postoperative margin assessment (CE-POMA), Mohs micrographic surgery with immunostains (MMS-I) or slow Mohs. Patient preferences for these surgical options have not been studied. OBJECTIVES: To evaluate patient preferences for surgical treatment of facial melanoma and to determine how patients value the relative importance of different surgical attributes. METHODS: Participants completed a two-part study consisting of a stated preference survey and a choice-based conjoint analysis (CBCA) experiment...
March 2, 2018: Journal of the American Academy of Dermatology
Ryan B Thorpe, Rajiv I Nijhawan, Divya Srivastava
BACKGROUND AND OBJECTIVE: The V-to-Y advancement flap, also known as the island pedicle flap, is a single-stage repair option that can be used for defects on the distal nose. We report our experience using this flap for nasal defects following Mohs micrographic surgery, as well as describe optimal patient selection and flap design. MATERIALS AND METHODS: A retrospective review was conducted of all patient charts and operative photographs of nasal V-to-Y advancement flaps performed over 6 years at the Universtiy of Texas Southwestern Medical Center...
February 1, 2018: Journal of Cutaneous Medicine and Surgery
Janet Y Li, Jason T Rich, Eva A Hurst
No abstract text is available yet for this article.
February 6, 2018: Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et Al.]
Babu Singh, Muhammad M Qureshi, Minh Tam Truong, Debjani Sahni
BACKGROUND: The optimal surgical approach (wide local excision (WLE) vs. Mohs micrographic surgery (MOHS)) for treating Merkel cell carcinoma (MCC) is yet to be determined. OBJECTIVE: To compare survival outcomes in patients with early stage MCC treated with MOHS versus WLE. METHODS: A retrospective review of all cases in the National Cancer Data Base (NCDB) of MCC of clinical Stage I-II MCC treated with WLE or MOHS was performed. RESULTS: 1,795 cases of Stage I-II MCC were identified who underwent WLE (N=1,685) or MOHS (N=110)...
February 3, 2018: Journal of the American Academy of Dermatology
Michael R Migden, Anne Lynn S Chang, Luc Dirix, Alexander J Stratigos, John T Lear
Basal cell carcinoma (BCC) is the most commonly diagnosed skin cancer worldwide. In most patients, BCC can be effectively treated with standard surgical excision, Mohs micrographic surgery, curettage and electrodessication, radiotherapy, and/or superficial field therapies (including 5-fluorouracil, imiquimod, and photodynamic therapy); however, a minority of patients develop advanced BCC, for which treatment can be challenging and outcomes are poorer. Advanced BCC encompasses a heterogeneous assortment of cases, including metastatic BCC as well as locally advanced BCC (for which no formal definition exists but which generally includes large, deep, aggressive, or recurrent tumors)...
March 2018: Cancer Treatment Reviews
Spencer D Hawkins, Sarah B Koch, Phillip M Williford, Steven R Feldman, Daniel J Pearce
BACKGROUND: Consent and wound care (WC) videos are used for education in Mohs micrographic surgery (MMS). Postoperative text messaging is poorly studied. OBJECTIVE: Develop and evaluate perioperative resources for MMS patients-video modules ( and postoperative text messaging ( MATERIALS AND METHODS: A study was conducted on 90 MMS patients. Patients were randomized 1:1:1:1 to videos with text messages, videos-only, text messages-only, or control...
February 5, 2018: Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et Al.]
Nicole Warner, Mary Petrick
No abstract text is available yet for this article.
February 5, 2018: Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et Al.]
K Sinha, F Ali, G Orchard, W Rickaby, M Shams, R Mallipeddi, R Patalay
For squamous cell carcinoma (SCC) treated using Mohs micrographic surgery (MMS), interpretation of haematoxylin and eosin-stained frozen sections can be challenging. In these situations, ancillary use of immunostaining is a useful tool for the Mohs surgeon. However, use of immunostaining in MMS laboratories is limited, mainly because current manual immunostaining platforms are subject to operator error, and automated immunostaining, albeit accurate, is too slow for inclusion in MMS. In this report, we describe a novel 1-hour protocol for rapid frozen section immunocytochemistry, using the pancytokeratin markers AE1/AE3...
February 3, 2018: Clinical and Experimental Dermatology
Adam Tinklepaugh, Zain Husain, Tiffany J Libby, David Ciocon
No abstract text is available yet for this article.
January 29, 2018: Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et Al.]
Edmund Wee, Michelle S Goh, Vanessa Estall, Albert Tiong, Angela Webb, Catherine Mitchell, William Murray, Phillip Tran, Christopher J McCormack, Michael Henderson, Emma L Hiscutt
BACKGROUND/OBJECTIVES: To describe the characteristics, subsequent management and outcomes of patients referred for further management following Mohs micrographic surgery (MMS) for basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). METHODS: Retrospective analysis of patients referred to a quaternary cancer centre from 2000 to 2015. RESULTS: In total, 83 lesions in 82 patients were referred for further management; 52 (62%) were SCC and 80 (96%) were located in the head and neck...
January 18, 2018: Australasian Journal of Dermatology
Sandeep Singh, Rupak Desai, Mitul Modi, Showket Hussain
Mohs micrographic surgery is the technique of surgically removing skin tumors by gradually excising thin layers and visualizing under a microscope till a tumor-free zone is obtained. During the surgical procedure, visible tumors are surgically removed. During the second stage, if tumor margins are clear with the positive specimen at depth, only depth cavitations need to be done without altering the tumor diameter. Defining the depth during this procedure is a major challenge due to the nonexistence of proper guidelines...
November 13, 2017: Curēus
Lymaries Velez, Jennifer Harb, Stephanie Anuszewski, Stanton Wesson
Tattoo popularity continues to rise, with 3 in 10 Americans bearing at least one. Among tattoo complications, non-tuberculous mycobacteria (NTM) has emerged as a global public health concern. NTM infections associated with tattooing of immunocompetent individuals have occurred as sporadic cases and community outbreaks. Water sources are considered the major pathogenic reservoirs. Tattoo-related inoculation has been linked to contamination of ink, either during the manufacturing process or during dilution of black ink using non-sterile water...
January 12, 2018: BMJ Case Reports
Marwa Munem, Oscar Zaar, Kelly Dimovska Nilsson, Noora Neittaanmäki, John Paoli, John S Fletcher
A set of basal cell carcinoma samples, removed by Mohs micrographic surgery and pathologically identified as having an aggressive subtype, have been analyzed using time-of-flight secondary ion mass spectrometry (SIMS). The SIMS analysis employed a gas cluster ion beam (GCIB) to increase the sensitivity of the technique for the detection of intact lipid species. The GCIB also allowed these intact molecular signals to be maintained while surface contamination and delocalized chemicals were removed from the upper tissue surface...
January 12, 2018: Biointerphases
Michael J Davis, Lauren P Rimoin, Travis W Blalock
No abstract text is available yet for this article.
January 8, 2018: Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et Al.]
Christopher Mancuso, Jeffrey B Morris, Nilda Hernandez, M Isabel Fernandez
Context: As future physicians, osteopathic medical students will play a critical role in helping patients make informed decisions regarding treatment options. Objective: To examine the influence that the time, cost, and cosmetic effects associated with treatment options for basal cell carcinoma (BCC), along with students' demographic characteristics, have on treatment decision-making. The influence that different sources of information have on students was also studied...
January 1, 2018: Journal of the American Osteopathic Association
Radu Boitor, Kenny Kong, Dustin Shipp, Sandeep Varma, Alexey Koloydenko, Kusum Kulkarni, Somaia Elsheikh, Tom Bakker Schut, Peter Caspers, Gerwin Puppels, Martin van der Wolf, Elena Sokolova, T E C Nijsten, Brogan Salence, Hywel Williams, Ioan Notingher
Multimodal spectral histopathology (MSH), an optical technique combining tissue auto-fluorescence (AF) imaging and Raman micro-spectroscopy (RMS), was previously proposed for detection of residual basal cell carcinoma (BCC) at the surface of surgically-resected skin tissue. Here we report the development of a fully-automated prototype instrument based on MSH designed to be used in the clinic and operated by a non-specialist spectroscopy user. The algorithms for the AF image processing and Raman spectroscopy classification had been first optimised on a manually-operated laboratory instrument and then validated on the automated prototype using skin samples from independent patients...
December 1, 2017: Biomedical Optics Express
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