Mohs surgery is a technique used in the treatment of several skin cancers that allows for complete removal of the lesion while minimizing removal of otherwise normal adjacent skin. Any location in the body can be treated with Mohs surgery, but it is typically reserved for nonmelanoma skin cancers occurring on the following locations: Ears Eyelids Nose Lips Any sensitive location on the body that would have a higher risk of complications with regular surgical excision
Electrodesiccation is a fast and simple office-based procedure that uses electric current delivered via a needle-shaped electrode to superheat the skin in pinpoint precise areas.
Basal cell carcinoma (BCC), also known as basal cell epithelioma, is the most common form of skin cancer. Basal cell carcinoma usually occurs on sun-damaged skin, especially in light-skinned individuals with a long history of chronic sun exposure. Although it requires treatment to prevent it from becoming too invasive, basal cell carcinoma does not typically metastasize, or spread to lymph nodes or internal organs.There are several sub-types of basal cell carcinoma, including:Nodular BCC Infiltrating BCC Superficial BCC
Keratoacanthoma (KA) is a rapidly growing skin cancer usually appearing as a volcano-like bump on the sun-exposed skin of middle-aged and elderly individuals. Many scientists consider keratoacanthoma to be a less serious form of squamous cell carcinoma. Most keratoacanthoma cause only minimal skin destruction, but a few behave more aggressively and can spread to lymph nodes.
Squamous cell carcinoma (SCC) is the second most common form of skin cancer. Squamous cell carcinoma usually occurs on sun-damaged skin, especially in light-skinned individuals with a long history of chronic sun exposure.Squamous cell carcinoma requires treatment to prevent it from becoming too invasive. If it is caught early and treated appropriately, squamous cell carcinoma rarely spreads (metastasizes) to lymph nodes or to internal organs. However, if it is neglected, squamous cell carcinoma can cause tissue destruction or it may spread internally, causing serious health problems and even death.
Before I share my experience with Mohs surgery and what I learned, I want to make a very strong point. If you have anything on your skin that stays on for more than 1-3 months, get it checked out. It doesn’t matter what it looks like. We often see the pictures of what skin cancer is supposed to look like: my lesions didn’t look anything like the examples. Personally, I’d always thought skin cancer would appear much worse, but mine didn’t even look odd. I wasn’t even expecting it to be skin cancer. So please, if you have any abnormality, get it checked out.
As Mohs surgery becomes an ever more widely accepted and available treatment option for nonmelanoma skin cancer, it is very important to know how to choose the right surgeon. Technically, any surgeon who can cut the skin and process the tissue using the Mohs method is performing Mohs surgery – there is no specialized quality control requirement for surgeons who decide that they want to do Mohs. Consequently, as the interest in Mohs increases, it becomes especially important for a patient to select a qualified surgeon. What’s at stake? Nothing less than a patient’s chance for being cured and avoiding disfigurement.
In the first two posts of this Mohs Learning Series, I described the reasons why Mohs is gaining popularity and why the need for Mohs is greater than ever. But how did the unique procedure that is Mohs surgery begin? Who was the first person to conduct Mohs surgery? What is the future for Mohs surgeons and patients? I answer all these questions and more with a simple description of the Mohs history and the development of the American College of Mohs Surgery. I hope that you will find this history as fascinating and relevant in today’s Mohs environment as I do!
As a Mohs surgeon and member of the American College of Mohs Surgery, I love sharing information about what I feel is a very exciting advancement in skin cancer surgery. In my first post for this Mohs Learning Series, I introduced Mohs surgery by explaining how it differed from traditional skin cancer surgery and its advantages. With Mohs, most of my patients will leave my office fully repaired, with the highest cure rate, a minimal amount of removed tissue, and the least amount of disruption to their daily life.
My Mohs story actually began about 50 years ago when, as a youth, I developed chronic head-to-toe psoriasis. Psoriasis—characterized by thick, red, scaly patches on the skin that sometimes itch—is a life-long condition thought to be caused by a malfunction in the immune system. My psoriasis was extensive, and by adulthood, after getting married and entering the work force, I sought out more aggressive treatments to help manage the disease. At the time, treatment options were limited. Some of the therapies used back then would be considered inappropriate by today’s treatment standards. These treatments put me on a path to skin cell damage that would eventually lead me to my first Mohs surgery, which was 5 years ago.
Question: I’ve heard so much about the high cure rates for Mohs surgery in treating nonmelanoma skin cancers. Why isn’t Mohs surgery popular for malignant melanoma?
Cancer-curing surgeryMohs micrographic surgery is a developing type of skin cancer surgery that is generating impressive cure rates. About 99% of basal cell cancers and 95% of squamous cell cancers are cured with Mohs micrographic surgery. The American College of Mohs Surgery has awarded fellowship training to a number of leading physicians for this highly specialized “precision surgery,” increasingly recognized as a powerful tool to stop cancer in its tracks – literally, at a cellular level.
The tip of the iceberg… By the time you have made it to your Mohs surgery appointment, typically many prior steps have already happened. Perhaps you first noticed a bump or a spot that bled when you washed your face many months before. You thought it was a pimple or a blemish, but eventually, after several months, you realized this was not your average zit, and it was time to see a doctor.