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Mohs Micrographic Surgery

   
 
Table 6-11 Mohs Surgery Indications
 IndicationDescription
 
Location (tissue sparing)
 
Eyelids, lips, ears, nose, digits, genitalia, nails, periorbital
 
Tumors at high risk for recurrence or metastasis
Merkel cell carcinoma
Morpheaform or infiltrative BCC
Dermatofibrosarcoma protuberans
Malignant fibrous histiocytoma
Microcystic adnexal carcinoma
Melanoma
Sebaceous carcinoma
Perineural BCC or SCC
Atypical fibroxanthoma
Angiosarcoma
 
Histopathologic findings
Aggressive histologic type (i.e., perineural invasion)
Positive margin after simple excision
 
Clinical findings
Recurrent tumor, large diameter tumors (>2 cm trunk, >1 cm on face), poorly defined clinical margins
 
PMHx indication
 
Skin previously treated with ionizing radiation
    
 
   


   
 Scalpel oriented at 45° angle to skin in Mohs surgery 
   
Mohs Micrographic Surgery
  • Examines peripheral margins of fresh tissue via sectioning in horizontal planes; lesion must grow in contiguous fashion to be considered for Mohs surgery
 

 

 

 

 

 

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