Dermatoscopy as an Aid for Detecting Tumor Borders During Mohs Surgery

Mohs micrographic surgery (MMS) is a widely used technique for removing cutaneous tumors. Currently, there is no accepted protocol to evaluate and determine lesion borders prior to surgery. Our aim was to evaluate the use of dermatoscopy as an aid for identifying lesion borders prior to MMS. Clinical and dermatoscopic images of skin lesions were evaluated by plastic surgery specialists and students to assess whether they were completely excised, the number of stages required, and characteristics of the lesions. A total of 133 patients and 2128 photographs were included in the study. Overall, specialists were better than students in evaluating lesion borders dermatoscopically (P < 0.001) and clinically (P = 0.015). The use of a dermatoscope increased accurate analysis of both groups for patients who required multiple stages. Dermatoscopy is a powerful tool, complementary to clinical examination and can be used to help delineate lesion borders prior to MMS, especially when evaluating complex skin lesions.