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Semin Plast Surg 2024; 38(04): 264-267
DOI: 10.1055/s-0044-1791563
Review Article

Mohs Micrographic Surgery: A Brief Overview

A. Caresse Gamret
1   Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, Texas
,
Jared E. Roberts
1   Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, Texas
,
Divya Srivastava
1   Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, Texas
,
Rajiv I. Nijhawan
1   Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, Texas
› Author Affiliations Funding None.
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Abstract

Mohs micrographic surgery (MMS) is a tissue-sparing skin cancer resection technique that involves 100% margin analysis. This procedure is performed in the outpatient setting under local anesthesia by dermatologic surgeons who act as both the surgeon and the pathologist. The technique allows for prompt reconstruction immediately after cancer clearance and offers the highest cure rate for many skin malignancies, including basal and squamous cell carcinoma, as well as more rare tumors. Mohs surgery effectively ensures cancer clearance while minimizing defect size and optimizing cosmetic and functional outcomes for patients. Herein we will discuss the evolution, procedure, and indications of MMS.

Keywords

Mohs micrographic surgery - Mohs surgery - cutaneous malignancy - skin cancer


Publication History

Article published online:
04 November 2024

© 2024. Thieme. All rights reserved.

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  • References

  • 1 Mohs FE. Mohs micrographic surgery. A historical perspective. Dermatol Clin 1989; 7 (04) 609-611
    CrossrefPubMedSearch in Google Scholar
  • 2 Brodland DG, Amonette R, Hanke CW, Robins P. The history and evolution of Mohs micrographic surgery. Dermatol Surg 2000; 26 (04) 303-307
    CrossrefPubMedSearch in Google Scholar
  • 3 Mohs FE. Chemosurgery: a microscopically controlled method of cancer excision. Arch Surg 1941; 42 (02) 279-295
    CrossrefPubMedSearch in Google Scholar
  • 4 Tromovitch TA, Stegeman SJ. Microscopically controlled excision of skin tumors. Arch Dermatol 1974; 110 (02) 231-232
    CrossrefPubMedSearch in Google Scholar
  • 5 Lee E, Wolverton JE, Somani AK. A simple, effective analogy to elucidate the Mohs micrographic surgery procedure: the peanut butter cup. JAMA Dermatol 2017; 153 (08) 743-744
    CrossrefPubMedSearch in Google Scholar
  • 6 Pennington B, Moody BR. Nonmelanoma of the skin and Mohs surgery. Plast Reconstr Surg 2004; 113 (07) 2233 , author reply 2233–2234
    CrossrefPubMedSearch in Google Scholar
  • 7 Connolly SM, Baker DR, Coldiron BM. et al; Ad Hoc Task Force, Ratings Panel. AAD/ACMS/ASDSA/ASMS 2012 appropriate use criteria for Mohs micrographic surgery: a report of the American Academy of Dermatology, American College of Mohs Surgery, American Society for Dermatologic Surgery Association, and the American Society for Mohs Surgery. J Am Acad Dermatol 2012; 67 (04) 531-550
    CrossrefPubMedSearch in Google Scholar
  • 8 Zalla MJ, Lim KK, Dicaudo DJ, Gagnot MM. Mohs micrographic excision of melanoma using immunostains. Dermatol Surg 2000; 26 (08) 771-784
    CrossrefPubMedSearch in Google Scholar
  • 9 Cook J, Zitelli JA. Mohs micrographic surgery: a cost analysis. J Am Acad Dermatol 1998; 39 (5, Pt 1): 698-703
    CrossrefPubMedSearch in Google Scholar
  • 10 Rowe DE, Carroll RJ, Day Jr CL. Long-term recurrence rates in previously untreated (primary) basal cell carcinoma: implications for patient follow-up. J Dermatol Surg Oncol 1989; 15 (03) 315-328
    CrossrefPubMedSearch in Google Scholar
  • 11 Rowe DE, Carroll RJ, Day Jr CL. Mohs surgery is the treatment of choice for recurrent (previously treated) basal cell carcinoma. J Dermatol Surg Oncol 1989; 15 (04) 424-431
    CrossrefPubMedSearch in Google Scholar
  • 12 Rowe DE, Carroll RJ, Day Jr CL. Prognostic factors for local recurrence, metastasis, and survival rates in squamous cell carcinoma of the skin, ear, and lip. Implications for treatment modality selection. J Am Acad Dermatol 1992; 26 (06) 976-990
    CrossrefPubMedSearch in Google Scholar
  • 13 Bene NI, Healy C, Coldiron BM. Mohs micrographic surgery is accurate 95.1% of the time for melanoma in situ: a prospective study of 167 cases. Dermatol Surg 2008; 34 (05) 660-664
    PubMedSearch in Google Scholar
  • 14 Meyer SN, Ren Y, Taylor S, Kiuru M, Eisen DB. Mohs micrographic surgery versus wide local excision for the treatment of atypical fibroxanthoma: a retrospective cohort analysis. JAAD Int 2023; 12: 174-176
    CrossrefPubMedSearch in Google Scholar
  • 15 Malan M, Xuejingzi W, Quan SJ. The efficacy of Mohs micrographic surgery over the traditional wide local excision surgery in the cure of dermatofibrosarcoma protuberans. Pan Afr Med J 2019; 33: 297
    CrossrefPubMedSearch in Google Scholar
  • 16 Spencer JM, Nossa R, Tse DT, Sequeira M. Sebaceous carcinoma of the eyelid treated with Mohs micrographic surgery. J Am Acad Dermatol 2001; 44 (06) 1004-1009
    CrossrefPubMedSearch in Google Scholar
  • 17 O'Connor WJ, Lim KK, Zalla MJ. et al. Comparison of mohs micrographic surgery and wide excision for extramammary Paget's disease. Dermatol Surg 2003; 29 (07) 723-727
    CrossrefPubMedSearch in Google Scholar
  • 18 Damavandy AA, Terushkin V, Zitelli JA. et al. Intraoperative immunostaining for cytokeratin-7 during Mohs micrographic surgery demonstrates low local recurrence rates in extramammary Paget's disease. Dermatol Surg 2018; 44 (03) 354-364
    CrossrefPubMedSearch in Google Scholar