Peripheral in-continuity tissue examination: a modification of Mohs' micrographic surgery

The use of peripheral in-continuity tissue examination, in which the surgeon or dermatologist and pathologist combine their talents to remove cutaneous tumors with rapid evaluation of all margins, is useful and practical for excision of basal cell and squamous cell carcinomas that are recurrent, large, or occur in historically difficult areas to treat. This procedure, like Mohs' micrographic surgery, can be used as a tissue-sparing measure while still providing the physician and patient with confidence of complete tumor removal. Because the technique allows for primary closure and immediate reconstruction of larger and more complex tumors, patients can be spared the added inconvenience, pain, and expense of multiple separate procedures that may be necessary with Mohs' micrographic surgery or traditional tumor excision with permanent section margin evaluation.