Understanding Mohs Micrographic Surgery

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Presentation transcript:

Understanding Mohs Micrographic Surgery Stanislav N. Tolkachjov, MD, David G. Brodland, MD, Brett M. Coldiron, MD, Michael J. Fazio, MD, George J. Hruza, MD, Randall K. Roenigk, MD, Howard W. Rogers, MD, John A. Zitelli, MD, Daniel S. Winchester, MD, Christopher B. Harmon, MD Mayo Clinic Proceedings Volume 92, Issue 8, Pages 1261-1271 (August 2017) DOI: 10.1016/j.mayocp.2017.04.009 Copyright © 2017 Mayo Foundation for Medical Education and Research Terms and Conditions

Figure 1 A, Mohs micrographic surgery technique. B, Standard technique for wide local excision with breadloaf histology. Mayo Clinic Proceedings 2017 92, 1261-1271DOI: (10.1016/j.mayocp.2017.04.009) Copyright © 2017 Mayo Foundation for Medical Education and Research Terms and Conditions

Figure 2 A, Post–Mohs micrographic surgery (MMS) defect demonstrating preservation of cranial nerve 7 after perineural extension of squamous cell carcinoma. B, Reconstruction immediately after MMS with a bilobed transposition flap over a subcutaneous flap from the jowl covering the nerve. C, Three-year follow-up with no recurrence, and aesthetic outcome. Mayo Clinic Proceedings 2017 92, 1261-1271DOI: (10.1016/j.mayocp.2017.04.009) Copyright © 2017 Mayo Foundation for Medical Education and Research Terms and Conditions

Figure 3 Referral steps in the management of cutaneous malignancy for nonmelanoma skin cancer (NMSC). AFX = atypical fibroxanthoma; BCC = basal cell carcinoma; DFSP = dermatofibrosarcoma protuberans; EMPD = extramammary Paget disease; MAC = microcystic adnexal carcinoma; MCC = Merkel cell carcinoma; MIS = melanoma in situ; MMS = Mohs micrographic surgery; SC= sebaceous carcinoma; SCC = squamous cell carcinoma. Mayo Clinic Proceedings 2017 92, 1261-1271DOI: (10.1016/j.mayocp.2017.04.009) Copyright © 2017 Mayo Foundation for Medical Education and Research Terms and Conditions