Barriers to Mohs Micrographic Surgery in Japanese Patients With Basal Cell Carcinoma

Mohs micrographic surgery (MMS) is a well-recognized treatment for nonmelanoma skin cancer worldwide, but Japan has lagged behind many other countries in adopting MMS. We present a series of 5 cases of MMS utilized in Japanese patients. All cases had a favorable outcome, each benefiting from MMS with a smaller final defect or a higher likelihood of cure than standard excision. Slow adaptation of MMS in Japan likely is due to a lack of familiarity with the technique, lack of a training pipeline for physicians, barriers to payment for the procedure, and misconceptions among Japanese physicians. Our case series demonstrates the utility of MMS in treating skin cancer among Japanese patients.