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Squamous Cell Carcinoma In Situ on High-Risk Sites and With Larger Sizes Require More Stages for Clearance With Mohs
Background:
Few studies have evaluated Mohs micrographic surgery (MMS) for the treatment of squamous cell carcinoma in situ or evaluated the results by Mohs Appropriate Use Criteria.
Objective:
Evaluate the clinical and surgical characteristics of squamous cell carcinoma in situ treated with MMS and categorize the results by Mohs Appropriate Use Criteria.
Methods And Materials:
A single Mohs surgeon, prospective, longitudinal cohort study of all squamous cell carcinoma in situ tumors treated with MMS between April 2018 and May 2021.
Results:
A total of 485 tumors were treated and 96.9% were primary tumors. Mean age of patients was 73.8 years; 80.6% were male. Mean tumor length, wound length, and subclinical extension were 0.98 cm, 1.58 cm, and 0.7 cm, respectively. These dimensions were lowest in Area H and highest in Area L. Mean stages to clear margins was 1.14. Area H tumors required significantly more stages than those in Areas M and L (P=0.031).
Conclusions:
Mean tumor and wound sizes, stages to clearance, and subclinical extension were lower than previously reported. Area H tumors required more stages to clearance than those in Areas M and L. Stages to clearance increased with increased tumor size. Curettage before surgery did not decrease the number of required stages to achieve clear tumor margins.
Citation:
Steinman HK, Dixon AJ. Squamous cell carcinoma in situ on high-risk sites and with larger sizes require more stages for clearance with Mohs surgery. J Drugs Dermatol. 2025;24(5):494-497. doi:10.36849/JDD.8609.
