What histologic stains are used in Mohs surgery?

The majority of Mohs surgeons stain their fresh frozen tissue with hematoxylin and eosin (H&E), the most common stain used in paraffin fixed sections. Some Mohs surgeons use toluidine blue, a stain that is particularly useful for highlighting basal cell carcinoma, but this has become less common. The most common immunohistochemical stain used by Mohs surgeons is a Melan-A (MART-1) stain used to highlight melanocytic cells in lentigo maligna and other melanocytic tumors. Other immunohistochemical stains that can be used for more rare tumors include CD-34 for dermatofibrosarcoma protuberans and cytokeratin-7 for squamous cell carcinoma. However, the majority of Mohs surgeons use only H&E staining in their day to day practice.

Stranahan D, Cherpelis B, Glass L, et al: Immunohistochemical stains in Mohs surgery: a review, Dermatol Surg 35:1023–1034, 2009.