MOHS MICROGRAPHIC SURGERY FOR NONMELANOMA SKIN-CANCER

Mohs micrographic surgery is a technique by which skin cancers are exc ised with complete, three-dimensional microscopic control of all surgi cal margins, allowing the detection and excision of all subclinical tu mor extensions. Successive layers of tissue are removed, and the entir e undersurface and peripheral epidermal edge are examined histological ly, typically with frozen sections.(1-3)This approach is ideally appli ed to skin cancer excision, because most lesions grow in a contiguous fashion. Consequently, microscopic extensions, which often extend well beyond the clinically apparent margins,(4) can be detected and traced out after microscopic examination of the entire surgical margin. The precise nature of the technique also allows the preservation of uninvo lved tissues and obviates removal of predetermined margins of clinical ly normal skin.