One of my three board certifications is in Micrographic Dermatologic Surgery, also known as Mohs.
Mohs is ideal for treating cancer in cosmetically and functionally prominent areas such as the ears, nose, eyelids, lips, hairline, hands and feet. With Mohs Micrographic Surgery, the tumor is removed and then thin tissue samples are removed and examined under a microscope until no more cancerous cells are found. This way healthy skin is preserved.
Designed by Frederic E. Mohs, M.D., the surgery excises not only the visible tumor but also any “roots” that may have extended beneath the surface of the skin.
This procedure is most commonly used for the treatment of basal and squamous cell carcinomas, the two most common types of skin cancer, although it can also be used to treat melanoma and other types of cancer. Mohs surgery is often recommended for recurring cancer because its results are so thorough.
Compared to other skin cancer treatments, Mohs Surgery has a very high success rate with skin cancers that have not been treated before. Basal cell carcinomas have up to a 99% cure rate, while primary squamous cell cancers are cured up to 96% of the time. This is because 100% of the margins are examined in Mohs, versus only about 5% in traditional sectioning.
Basal Cell Cancer on Ear
After cancer was removed and before the skin graft.
My patient 3 1/2 months after Mohs and her skin graft.
I performed Mohs surgery on the patient above and then did a skin graft. She had a basal cell cancer on her ear. The second photo was taken 3 1/2 months after her surgeries. Her face mask is pulling her ear forward in the “after” photo.
Basal Cell Carcinoma on Nose
My patient pictured above had a basal cell carcinoma on his nose.
First, we did a biopsy to confirm my diagnosis, which involved cutting out a small piece of the lesion and sending it to a laboratory for analysis.
Once we received the confirmation of my basal cell diagnosis, we scheduled his Mohs surgery. In my office, his surgery and the microscopic analysis took 3 hours (2 stages and closure).
To reduce discomfort, I administered local anesthesia prior to the surgery. I removed thin layers of tissue from each lesion for analysis in our in-office laboratory. While this is done, my patient’s wounds were lightly dressed to protect them while he waited.
In the second and third photos (top right, bottom left) you can see the stages of the surgery as I took thin layers of tissue for analysis until no more cancer was detected by micrographic analysis.
The photo on the bottom right is only two weeks after my patient’s Mohs surgery. He is healing very nicely!
Board Certification for Mohs Began Just Recently
I am now triple board certified in Dermatology, Dermatopathology and Mohs.
The exam and board certification demonstrates that I have the knowledge, experience and skills to be a specialist in Mohs.
Does a doctor have to be board certified to practice medicine? No.
But as a patient you want a physician who stays up-to-date with the latest developments, medicines and treatments in her specialty. Board certification means your doctor has gone above and beyond the many years of education required for a medical license by passing the exams given by her specialty’s governing body.
