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    1 OF 73

    Recurrence Rate of Melanoma in Situ when Treated with Serial Disk Staged Excision: A Case Series.
    J Clin Investig Dermatol 2017 Feb 27;5(1). Epub 2017 Feb 27.
    Department of Dermatology, Dermatologic and Mohs Micrographic Surgery Center, San Diego School of Medicine, University of California.
    Background: Cutaneous melanoma is one of the fastest rising cancer diagnoses in recent years. Melanoma in situ (MIS) constitutes a large proportion of all diagnosed melanomas. While surgical excision is considered the standard of therapy, the literature is not clear on which surgical technique minimizes local recurrence. Read More

    Clinical Characteristics of Non-Melanoma Skin Cancers Recurring within 5 years after Mohs Micrographic Surgery: Single Institution Retrospective Chart Review.
    J Clin Investig Dermatol 2017 Jan 10;5(1). Epub 2017 Jan 10.
    Department of Dermatology, Dermatologic and Mohs Micrographic Surgery Center, School of Medicine, University of California San Diego, CA, USA.
    Background: Mohs micrographic surgery (MMS) is used to treat certain high-risk non-melanoma skin cancers (NMSC) due to its high cure rate. However, clinical recurrences do occur in a small number of cases.

    Objective: We examined specific clinical characteristics associated with NMSC recurrences following MMS. Read More

    A matter of margins: Surgical and pathologic risk factors for recurrence in extramammary Paget's disease.
    Gynecol Oncol 2017 Sep 18. Epub 2017 Sep 18.
    Mayo Clinic, Division of Gynecologic Oncology, United States.
    Objectives: To determine surgical and pathologic variables associated with recurrence in extramammary Paget's disease (EMPD).

    Methods: Medical records of patients seeking care for EMPD from 1/1992-9/2015 were reviewed. Follow-up was restricted to 5years following primary surgery. Read More

    Sentinel lymph node biopsy in periocular merkel cell carcinoma: a case report.
    BMC Res Notes 2017 Sep 20;10(1):490. Epub 2017 Sep 20.
    University of Arizona COM Phoenix, University of Arizona Cancer Center at Dignity Health, 625 N 6th Street, Phoenix, AZ, 85004, USA.
    Background: The National Comprehensive Cancer Network guidelines for Merkel cell carcinoma recommend performance of the sentinel lymph node biopsy in all patients with clinically negative nodal disease for staging and treatment. Nevertheless, sentinel lymph node biopsy in the periocular region is debated as tumors are typically smaller and lymphatic variability can make performance procedurally problematic.

    Case Presentation: We present a case of a Caucasian patient in their seventies who presented with a 1. Read More

    Polydactylous Bowen's Disease in an Immunocompromised Patient: Resolution of All Lesions After Mohs Surgery on a Single Lesion.
    Dermatol Surg 2017 Sep 19. Epub 2017 Sep 19.
    Brody School of Medicine, East Carolina University, Greenville, North Carolina Department of Dermatology, University of North Carolina, School of Medicine, Chapel Hill, North Carolina Coastal Carolina Pathology, Wilmington, North Carolina Department of Dermatology, University of North Carolina School of Medicine, Chapel Hill, North Carolina.

    Use of Google Trends to Examine Interest in Mohs Micrographic Surgery: 2004 to 2016.
    Dermatol Surg 2017 Sep 19. Epub 2017 Sep 19.
    Department of Dermatology, Boston Medical Center, Boston, Massachusetts.
    Background: Mohs micrographic surgery (MMS) is the gold standard for treatment of high-risk skin cancers. There has been an upward trend in the use of this procedure as demonstrated by data from Medicare and the National Ambulatory Medical Care Survey.

    Objective: To assess interest in MMS among members of the general public as measured by number of online searches, and how that interest has changed over time. Read More

    Mohs micrographic surgery in the elderly. Comparison of tumours, surgery, and first-year follow-up in patients younger and older than 80 years-old in REGESMOHS.
    J Eur Acad Dermatol Venereol 2017 Sep 12. Epub 2017 Sep 12.
    Unidad de investigación. Fundación Piel Sana Academia Española de Dermatología, Madrid.
    Background: The elderly population is increasing and more patients in this group undergo Mohs micrographic surgery. The few publications investigating MMS in elderly people conclude that it is a safe procedure; however, these are single centre studies without a comparison group.

    Objective: To compare the characteristics of patients, tumours, MMS, and one-year follow-up in patients younger than 80 years, with patients older than 80 years at the time of surgery. Read More

    Association of Mohs Reconstructive Surgery Timing With Postoperative Complications.
    JAMA Facial Plast Surg 2017 Sep 7. Epub 2017 Sep 7.
    University of Virginia School of Medicine, Charlottesville.
    Importance: Same-day Mohs reconstructive surgery is not always possible; moreover, a delay can offer benefits such as improved surgical planning and increased blood supply to the cauterized wound bed. However, recent work found that delaying reconstruction by more than 2 days increases the postoperative complication rate.

    Objective: To review the outcomes of Mohs micrographic surgery (MMS) reconstruction with respect to patient- and surgery-specific variables, especially timing of repair. Read More

    A Novel, Disease-Specific Self-Report Instrument to Measure Body Image Concerns in Patients With Head and Neck Skin Cancer.
    Dermatol Surg 2017 Sep 1. Epub 2017 Sep 1.
    *Department of Dermatology, Cleveland Clinic, Cleveland, Ohio; †St. Louis University School of Medicine, St. Louis University, St. Louis, Missouri; ‡Department of Psychiatry and Psychology, Cleveland Clinic, Cleveland, Ohio; §Center for Outcomes Research, St. Louis University, St. Louis, Missouri; ‖St. Louis University, St. Louis, Missouri; ¶Department of Dermatology, St. Louis University School of Medicine, St. Louis, Missouri.
    Background: Skin cancer commonly occurs on areas that are salient to body image perception (i.e., head and neck). Read More

    Utilization of Topographical Mohs Micrographic Surgery Maps for Rapid Review of Clinicopathologic Characteristics of Nonmelanoma Skin Cancers of the Ear.
    Dermatol Surg 2017 Aug 29. Epub 2017 Aug 29.
    Surgical Dermatology Group, Birmingham, Alabama.
    Background: Nonmelanoma skin cancers (NMSCs) of the ear are considered high risk. Precise location of tumor sites is important when identifying surgical treatment sites.

    Objective: Review precise locations and histopathologic subtypes of auricular NMSC treated with Mohs micrographic surgery (MMS) using a standardized topographical numbering system for rapid data extraction. Read More

    Videodermoscopy and Curettage: The Value of Simple Procedures During Mohs Surgery.
    Dermatol Surg 2017 Aug 30. Epub 2017 Aug 30.
    Departments of *Dermatology, and †Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy; ‡Department of Dermatology, University of California, San Francisco, San Francisco, California.
    Background: Mohs surgery (MS) is regarded as one of the most efficient surgical procedures for the treatment of skin tumors.

    Objectives: Delineating tumor margins accurately is important in limiting broad excisions during conventional surgery and in reducing the number of stages during Mohs procedure.

    Methods: This study aimed to evaluate the role of 2 simple procedures, curettage and videodermoscopy (VDS), in determining margins during MS for the treatment of basal cell carcinoma (BCC) of the head and neck. Read More

    A Novel Mohs Precision Tool.
    Dermatol Surg 2017 Aug 30. Epub 2017 Aug 30.
    *Division of Plastic and Reconstructive Surgery, McGill University Health Centre, Montreal, Quebec; †Division of Mohs Surgery, Jewish General Hospital, Montreal, Quebec; ‡Faculty of Medicine, McGill University, Montreal, Quebec.
    Background: Effective treatment by Mohs micrographic surgery requires preparation of high-quality slides.

    Objective: To examine a novel tissue alignment device designed to address variability in tissue processing because of excessive sample trimming.

    Materials And Methods: A device was designed to account for angular errors and unparalleled tissue embedding. Read More

    Correlation Between Original Biopsy Pathology and Mohs Intraoperative Pathology.
    Dermatol Surg 2017 Aug 28. Epub 2017 Aug 28.
    *Department of Dermatology, Cleveland Clinic, Cleveland, Ohio; †Department of Dermatology, Penn State College of Medicine, The Milton S. Hershey Medical Center, Hershey, Pennsylvania; ‡Department of Dermatology, Indiana University School of Medicine, Indianapolis, Indiana.
    Background: The pathology observed on initial biopsy specimens for nonmelanoma skin cancer (NMSC), specifically the tumor subtype, weighs heavily into the selection of the treatment modality. Recognizing aggressive features on intraoperative Mohs micrographic surgery (MMS) frozen sections that were not indicated on initial biopsy reports is not uncommon. To date, there is limited data describing this discrepancy. Read More

    Dermoscopy prior to Mohs Micrographic surgery does not improve tumour margin assessment and lead to fewer Mohs stages.
    Br J Dermatol 2017 Aug 29. Epub 2017 Aug 29.
    Royal Victoria Infirmary, Department of Dermatology, Newcastle upon Tyne, UK.
    Mohs micrographic surgery (MMS) is a time consuming and expensive gold standard treatment for difficult to treat basal cell carcinoma (BCC). One factor that contributes significantly to the expense and duration is the number of stages required to obtain clear excision margins. Dermoscopy is a non-invasive and inexpensive procedure. Read More

    Aggressive digital papillary adenocarcinoma: treatment with Mohs micrographic surgery and an update of the literature.
    Int J Dermatol 2017 Oct 21;56(10):1061-1064. Epub 2017 Aug 21.
    Department of Dermatology, Cleveland Clinic Foundation, Cleveland, OH, USA.
    Background: Aggressive digital papillary adenocarcinoma (ADPA) is a rare adenocarcinoma of the sweat glands.

    Aims: We wish to report the treatment of two cases of ADPA with Mohs micrographic surgery and review the presentation, management, and prognosis of this rare malignancy.

    Materials & Methods: Cases of ADPA were identified from recent surgery logs. Read More

    Eosinophilic variant of eccrine porocarcinoma of the scalp: Case report and review of the literature.
    Int J Womens Dermatol 2017 Sep 14;3(3):157-160. Epub 2017 Jul 14.
    Department of Dermatology, University of Connecticut School of Medicine, Farmington, CT.
    Porocarcinoma is a rare malignant neoplasm of the acrosyringium with metastatic potential that most commonly presents on the acral skin in older adults (mean age = 72 years). We present the case of a 43-year-old woman who developed a rapidly growing de novo porocarcinoma on the scalp with an unusual oncocytic appearance. The tumor consisted of benign eccrine poroma that arose from the epidermis and broad pushing borders with minimal cytological atypia but ample eosinophilic cytoplasm with numerous mitotic figures. Read More

    Atypical fibroxanthoma management: Recurrence, metastasis and disease-specific death.
    Australas J Dermatol 2017 Aug 17. Epub 2017 Aug 17.
    Skin and Cancer Foundation, Sydney, New South Wales, Australia.
    Atypical fibroxanthoma (AFX) is a rare spindle cell neoplasm predominantly found on the head and neck of elderly individuals with sun-damaged skin, with no evidence-based guidelines for their management. A systematic retrospective review of the literature focusing on treatment modality found a recurrence and metastasis rate of 8.0% (5. Read More

    Characterization of Surgical Procedures in the Spanish Mohs Surgery Registry (REGESMOHS) for 2013-2015.
    Actas Dermosifiliogr 2017 Aug 9. Epub 2017 Aug 9.
    Unidad de Investigación, Fundación Piel Sana, Academia Española de Dermatología, Madrid, España.
    Introduction: The Spanish Mohs Surgery Registry is used to collect data on the use and outcomes of Mohs micrographic surgery (MMS) in Spain. The aim of this study was to describe perioperative and intraoperative data recorded for MMS procedures performed between July 2013 (when the registry started) and January 2016.

    Material And Methods: Prospective cohort study of data from 18 hospitals. Read More

    Dermatofibrosarcoma Protuberans.
    Curr Treat Options Oncol 2017 Aug 10;18(9):56. Epub 2017 Aug 10.
    Dermatology Oncology Universidad Militar Nueva Granada, Instituto Nacional de Cancerología, Calle 1a No. 9-85, Bogotá, Colombia.
    Opinion Statement: Dermatofibrosarcoma protuberans (DFSP) is a slow growing tumor with a very low metastatic potential but with significant subclinical extension and great capacity for local destruction. Thus, the first surgeon approached with such challenging tumor must attempt to cure the patient with a method that spares healthy tissue and ensures an optimal oncological, functional, and esthetic result. The treatment of DFSP often requires a multidisciplinary approach. Read More

    New embedding and staining systems PrestoCHILL and Presto stainer for application in the advancement of Mohs micrographic surgery.
    Br J Biomed Sci 2017 Aug 8:1-6. Epub 2017 Aug 8.
    c Dermatological Surgery and Laser Unit (DSLU) , St. John's Institute of Dermatology, Guy's Cancer Centre, Guy's Hospital , London , UK.
    Background: Mohs micrographic surgery (MMS) involves evaluation of frozen tissue sections to determine complete circumferential and deep tissue margin clearance of skin tumours. PrestoCHILL and Presto stainer devices are two new innovative tools which bring benefits of automation, speed and efficiency to the preparation of frozen section analysis in MMS. The devices were assessed at Viapath's Tissue Science Mohs laboratory at Guy's Cancer Centre. Read More

    Multiple Primary Recurrent Basaliomas (mPR-BCCs) of the Scalp with Cranial Bone Invasion.
    Open Access Maced J Med Sci 2017 Jul 25;5(4):564-565. Epub 2017 Jul 25.
    Department of Dermatology and Allergology, Academic Friedrichstrasse 41, 01067, Dresden, Germany.
    We present a 68-year-old patient with multiple primary infiltrative BCCs in the scalp area, initially treated 14 years ago with superficial contact X-ray therapy, end dose 60 greys, followed by electrocautery (x2) several years later. He presented in the dermatologic policlinic for diagnosis and therapy of two additional, newly-formed pigmented lesions, and because of an uncomfortable, itchy, burning sensation in the area where lesions had been treated years before. Screening cranial computer-tomography (CT) examination revealed two deformities in the form of tumor-mediated osteolysis, affecting the diploe of the tabula externa on the left parietal and parasagittal areas. Read More

    Mushroom-Like Skin Tumours: Report of Three Cases.
    Open Access Maced J Med Sci 2017 Jul 21;5(4):515-517. Epub 2017 Jul 21.
    Department of Dermatology, Venereology and Dermatologic Surgery, Medical Institute of Ministry of Interior, and Onkoderma Policlinic for Dermatology and Dermatologic Surgery, Sofia, Bulgaria.
    Mushroom like the growth of skin tumour is a rare phenomenon although described already in 1806 by Alibert, who focused on mycosis fungicides. We identified only four case reports in PUBMED database using the terms "mushroom-like growth" and "skin tumour". We analysed our files and identified three elderly female patients (69 to 94 years old). Read More

    Very Rare Amelanotic Lentigo Maligna Melanoma with Skull Roof Invasion.
    Open Access Maced J Med Sci 2017 Jul 19;5(4):458-461. Epub 2017 Jul 19.
    Department of Anesthesiology & Intensive Care Medicine, Emergency Medicine & Pain Management, Hospital Dresden-Friedrichstadt, Academic Teaching Hospital of the Technical University of Dresden, Friedrichstrasse 41, 01067, Dresden, Germany.
    Background: Lentigo malignant melanoma is a melanoma subtype of chronic sun-damaged skin in elderly Caucasians. Amelanotic variants of lentigo malignant are extremely rare.

    Case Presentation: This is a case report of an 80-year-old male patient who presented with a non-pigmented exophytic tumour of his bald head. Read More

    Interdigital Melanoma of the Foot Affecting Two Neighbouring Interdigital Spaces - Second Case Report.
    Open Access Maced J Med Sci 2017 Jul 19;5(4):448-450. Epub 2017 Jul 19.
    Department of Dermatology, Venereology and Dermatologic Surgery, Medical Institute of Ministry of Interior, and Onkoderma Policlinic for Dermatology and Dermatologic Surgery, Sofia, Bulgaria.
    Melanoma affecting two interdigital spaces has been recently described by our group for the first time in medical literature. Here we present a second patient with acrolentiginous melanoma of the sole affecting the 1st and 2nd interdigital space. The tumour was removed by delayed Mohs surgery. Read More

    Understanding Mohs Micrographic Surgery: A Review and Practical Guide for the Nondermatologist.
    Mayo Clin Proc 2017 Aug;92(8):1261-1271
    Surgical Dermatology Group, Birmingham, AL.
    The incidence and diagnosis of cutaneous malignancies are steadily rising. In addition, with the aging population and increasing use of organ transplant and immunosuppressive medications, subsets of patients are now more susceptible to skin cancer. Mohs micrographic surgery (MMS) has become the standard of care for the treatment of high-risk nonmelanoma skin cancers and is increasingly used to treat melanoma. Read More

    Conception and Management of a Poorly Understood Spectrum of Dermatologic Neoplasms: Atypical Fibroxanthoma, Pleomorphic Dermal Sarcoma, and Undifferentiated Pleomorphic Sarcoma.
    Curr Treat Options Oncol 2017 Aug;18(8):50
    Department of Dermatology, Stanford University School of Medicine, 450 Broadway Street Pavilion C, 2nd Floor, Redwood City, CA, 94063, USA.
    Opinion Statement: Atypical fibroxanthoma (AFX) and pleomorphic dermal sarcoma (PDS) tumors share many clinical, etiologic, and histologic features and likely represent components of a tumor spectrum. In dermatologic oncology, differentiating between AFX and PDS is pivotal as tumors with histological features consistent with PDS are more likely to behave in a clinically aggressive manner. Importantly, the term "pleomorphic dermal sarcoma" (PDS) is a more appropriate designation than "undifferentiated pleomorphic sarcoma" (UPS) for describing deeper, more aggressive, histologically high-grade cutaneous tumors that otherwise resemble AFX. Read More

    [Dermatofibrosarcoma protuberans: Surgical margins using Slow-Mohs micrographic surgery. A clinical retrospective study about 20 cases].
    Ann Chir Plast Esthet 2017 Jul 26. Epub 2017 Jul 26.
    Service de chirurgie maxillo-faciale, stomatologie et chirurgie orale, centre François-Xavier-Michelet, groupe hospitalier Pellegrin, CHU de Bordeaux, place Amélie-Raba-Léon, 33000 Bordeaux, France.
    Objectives: The main objective of this study is to determine the necessary surgical margins to obtain a complete R0 resection for head and neck dermatofibrosarcoma protuberans (DFSP) using Slow-Mohs micrographic surgery. The secondary objective is to study the recurrence rate of these tumors.

    Patients And Methods: Slow-Mohs micrographic surgery was used for patients included between 2005 and 2015 at Bordeaux universitary hospital. Read More

    Case Report: Diagnosis of a Rare Plaque-Like Dermal Fibroma Successfully Treated With Mohs Surgery.
    J Cutan Med Surg 2017 Jul 1:1203475417722733. Epub 2017 Jul 1.
    1 Department of Pathology and Laboratory Medicine, University of Calgary and Calgary Lab Services, Calgary, AB, Canada.
    Background: CD34-positive plaque-like dermal fibroma (PDF) is a poorly characterised benign dermal neoplasm that has a wide differential diagnosis. It can be mistaken for other entities on superficial biopsy and be overtreated, leading to unnecessary worry and extensive surgery.

    Objective: To report on an uncommon presentation of this entity, the histopathologic differential diagnosis of PDF, and a novel treatment method. Read More

    Cutaneous squamous cell carcinoma of the scalp extending to the skull: A case report and review of the literature.
    J Cosmet Dermatol 2017 Jul 23. Epub 2017 Jul 23.
    Skin Laser & Surgery Specialists of NY and NJ, Hackensack, NJ, USA.
    Squamous cell carcinoma (SCC) of the scalp has increased prevalence in older patients and often presents later in life. Mohs micrographic surgery remains the most effective treatment in most cases. Delayed presentation may result in localized bony invasion or distant metastases. Read More

    Surgical Management of Periocular Cancers: High- and Low-Risk Features Drive Treatment.
    Curr Oncol Rep 2017 Sep;19(9):57
    Section of Ophthalmology, Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, 1400 Pressler Street, Unit 1445, Houston, TX, 77030, USA.
    Purpose Of Review: Recent advances in the treatment of eyelid tumors have centered on the excision, evaluation of margins, role of sentinel lymph node biopsy, and adjunctive/adjuvant systemic and radiation therapy. The purpose of this review is to elaborate on these advances.

    Recent Findings: Mohs excision of basal cell carcinoma and squamous cell carcinoma continues to provide the greatest success in complete excision of the cancer, especially in those cases of high-risk disease including medial canthal location and recurrent disease. Read More

    Reconstruction of Large Facial Defects via Excision of Skin Cancer Using Two or More Regional Flaps.
    Arch Plast Surg 2017 Jul 15;44(4):319-323. Epub 2017 Jul 15.
    Department of Plastic and Reconstructive Surgery, Pusan National University School of Medicine, Busan, Korea.
    Background: Free-flap surgery and skin grafting can be used to reconstruct large facial defects that may result after skin cancer removal by Mohs micrographic surgery (MMS). However, these two methods may produce low postsurgical patient satisfaction with aesthetics, and free-flap surgery may produce an undue burden for the majority of skin cancer patients, who are of advanced age. Hence, the authors examined outcomes of large facial defect reconstruction using multiple flaps. Read More

    Perineural invasion present exclusively in central tissue blocks of Mohs surgical excisions of basal cell carcinoma.
    Australas J Dermatol 2017 Jul 14. Epub 2017 Jul 14.
    Dermatology Specialist Centre, Brisbane, Queensland, Australia.
    Perineural invasion (PNI) may be present in basal cell carcinomas (BCC) treated with Mohs micrographic surgery. This single-centre, non-randomised, prospective study demonstrates the potential for PNI to exist exclusively within the central tissue blocks of Mohs specimens. Read More

    The use of lasers in the treatment of skin cancer: A review.
    J Cosmet Laser Ther 2017 Jul 10:1-8. Epub 2017 Jul 10.
    c Skin and Laser Surgery Center of New England , Nashua , NH , USA.
    Background: In considering skin cancer, a number of factors-including effectiveness, simplicity of treatment, cost, and esthetic outcomes-are important to ensure patient's satisfaction. There are several existing interventions, such as electrodessication and curettage, excision, Mohs surgery, radiation therapy, cryotherapy, and topical/oral treatments. Laser therapy has emerged as a new promising alternative that should be explored. Read More

    Amelanotic Lentigo Maligna Melanoma: Mohs Surgery as the Definitive Treatment of an Invisible Tumour.
    J Cutan Med Surg 2017 Jul 1:1203475417719046. Epub 2017 Jul 1.
    1 Department of Dermatology and Skin Science, University of British Columbia, Vancouver, British Columbia, Canada.
    Amelanotic lentigo maligna melanoma represents <2% of melanomas. Diagnosis is delayed owing to the lack of lesion pigmentation and advanced disease at presentation. Excision with appropriate margins is the treatment standard, but the starting point for such margins is often unclear. Read More

    Sebaceous Carcinoma: A Review of the Scientific Literature.
    Curr Treat Options Oncol 2017 Aug;18(8):47
    Department of Dermatology, Columbia University Medical Center, New York, NY, 10032, USA.
    Opinion Statement: Sebaceous carcinoma is a rare and potentially aggressive cutaneous malignancy. Commonly reported in the periocular area and the head and neck region, sebaceous carcinoma can arise from any sebaceous gland in the skin. The clinical presentation may be nonspecific, and a biopsy is important to establish a diagnosis and to differentiate from mimickers including benign sebaceous neoplasms, other adnexal tumors, and basal cell carcinoma. Read More

    Microcystic Adnexal Carcinoma and a Summary of Other Rare Malignant Adnexal Tumours.
    Curr Treat Options Oncol 2017 Aug;18(8):49
    St Helens and Knowsley Teaching Hospitals NHS Trust, Marshalls Cross Road, St Helens, WA9 3DA, UK.
    Opinion Statement: Microcystic adnexal carcinoma (MAC) is a rare, slow-growing, infiltrative malignant tumour most commonly found on the head and neck. It often presents as a solitary skin-coloured or yellow papule, plaque or nodule. Ultraviolet radiation, immunosuppression and ionising radiation are possible risk factors. Read More

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