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Published on: January 9, 2019
Rapid immunostaining in Mohs: current applications and attitudes
James S Trimble1, Basil S Cherpelis
1Department of Dermatology and Cutaneous Surgery, The University of South Florida, Tampa, Florida, USA. jtrimble@health.usf.edu
Background:
Rapid immunostaining in Mohs micrographic surgery (MMS) has been extensively reviewed in the recent literature. Despite the recent attention, there is relatively little information on how frequently these techniques are actually utilized and the current attitudes of the Mohs community towards immunohistochemical (IHC) stains.
Objective:
We attempted to obtain information on the utilization and attitudes towards the use of rapid immunostaining in Mohs through a survey of fellowship-trained Mohs surgeons.
Materials And Methods:
A twenty-five question survey was sent to members of the American College of Mohs Surgery (ACMS) through various methods including SurveyMonkey(®) , email, fax, and Metrofax(®) .
Results:
A total of 378 surveys were completed. These responses represent a cross-section of fellowship-trained members of the ACMS.
Conclusions:
The vast majority of respondents felt as though IHC stains could be used reliably in Mohs. A subset of responses indicated that the most common reasons for not using IHC stains are time consumption, lack of education, and startup and/or maintenance costs. An increase in immunostain usage over 10 years ago appears to correlate with the activity in the literature. There may be an underutilization of IHC staining in fellowship programs, as indicated by respondents' opinions.
Insights
Most Mohs surgeons find immunohistochemical (IHC) stains reliable for Mohs micrographic surgery (MMS). However, barriers like time, cost, and education limit their widespread adoption, suggesting potential underutilization in training programs.
Area of Science:
- Dermatology
- Surgical Pathology
- Mohs Micrographic Surgery
Background:
- Recent literature extensively reviews rapid immunostaining in Mohs micrographic surgery (MMS).
- Limited data exists on current utilization and attitudes towards immunohistochemical (IHC) stains in Mohs surgery.
- Understanding the practical application and surgeon perception of IHC stains is crucial.
Purpose of the Study:
- To assess the utilization rates of rapid immunostaining in Mohs surgery.
- To gauge the attitudes of fellowship-trained Mohs surgeons towards immunohistochemical (IHC) stains.
- To identify barriers hindering the adoption of IHC stains in MMS.
Main Methods:
- A 25-question survey was distributed to members of the American College of Mohs Surgery (ACMS).
- Surveys were administered via multiple channels including SurveyMonkey, email, fax, and Metrofax.
- Data was collected from a diverse group of fellowship-trained Mohs surgeons.
Main Results:
- A total of 378 surveys were completed, representing a broad cross-section of ACMS members.
- The majority of respondents believe IHC stains are reliable for use in Mohs surgery.
- Common barriers to IHC stain use include time constraints, lack of education, and costs.
Conclusions:
- Immunohistochemical (IHC) stains are perceived as reliable by most Mohs surgeons.
- Increased literature activity correlates with a rise in immunostain usage over the past decade.
- Potential underutilization of IHC staining in fellowship programs warrants further investigation.
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