Mohs Micrographic Surgery This technique was first described in 1936 by Dr. Frederick Mohs. It involves removing successive horizontal layers of the skin cancer and any surrounding tissue that may be involved. Each layer is microscopically examined and the section that involves tumor is marked. Subsequent horizontal layers remove the areas of tumor involvement, sparing the normal skin tissue.
Mohs surgery has the highest cure rate of all treatment methods. It is, therefore, recommended for poorly differentiated SCC, morpheaform BCC, invasive tumors, recurrent lesions, lesions with indistinct borders, large primary tumors of long duration, lesions at sites of decreased cure rate and in patients with nevoid basal cell syndrome.
The disadvantages of Mohs surgery are that a great deal of expertise is required by the physician, the procedure is time-consuming and it requires more equipment than the other methods. The resulting wound may be closed with stitches, often followed by plastic reconstruction.
Investigational
Although the treatments now most widely used have greater than a 90 percent cure rate, other therapies are being investigated that may be more practical, effective and cosmetically elegant. Examples of the newer methods of treatment include:
