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Who should have Mohs micrographic surgery?

William Perkins¹

¹Nottingham University Hospitals NHS Trust, Queen's Medical Centre, Nottingham, UK. william.perkins@nuh.nhs.uk

Current Opinion in Otolaryngology & Head and Neck Surgery

|July 9, 2010

Summary

Mohs micrographic surgery is increasingly indicated for skin cancers, including basal cell carcinoma and squamous cell carcinoma, especially on the head and neck. Future developments may expand its use for melanoma.

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Skin Cancer

Skin Cancer

Skin cancer is a type of cancer that occurs when there is an abnormal growth of skin cells, usually triggered by damage to the DNA within the skin cells. It is primarily caused by exposure to ultraviolet (UV) radiation from the sun or artificial sources like tanning beds. Skin cancer is the most common type of cancer worldwide, and its incidence continues to rise.
Basal Cell Carcinoma (BCC): BCC is the most common type of skin cancer, accounting for about 80% of cases. It typically develops in...

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Area of Science:

Dermatology
Surgical Oncology
Cutaneous Oncology

Background:

Mohs micrographic surgery is a specialized technique for skin cancer removal.
Its application is particularly relevant for complex cases, including those on the head and neck.

Purpose of the Study:

To review current indications for Mohs micrographic surgery in skin cancer.
To explore its specific relevance to head and neck tumors.
To identify recent advancements influencing future indications.

Main Methods:

Review of current literature and evidence.
Analysis of recent technological and diagnostic developments.

Main Results:

Growing evidence supports Mohs surgery for basal cell carcinoma and squamous cell carcinoma, especially with perineural invasion.

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Establishment of a Clinic-based Biorepository

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It is highly effective for dermatofibrosarcoma protuberans, particularly in challenging head and neck locations.

Emerging technologies like confocal fluorescence microscopy, Raman spectroscopy, and rapid immunohistochemistry may enhance future applications, potentially including lentigo maligna and melanoma in situ.

Conclusions:

The evidence supporting Mohs micrographic surgery for diverse cutaneous tumors is expanding.
Ongoing technological advancements are refining the technique.
Multidisciplinary collaboration is crucial for optimal patient care with complex skin cancers.