Second intention may be the best option available to the surgeon for the healing of particular surgical defects after Mohs micrographic surgery. It often provides satisfactory cosmetic and functional outcomes. However, healing takes longer than that for other repair options, and patients may need to endure a prolonged and cumbersome course of postoperative wound care. Some healing defects may d...

Malignant melanomas in situ can usually be treated in consultation with a specialist (C). Larger lesions may require referral. Based on best available evidence, surgical excision is the first-line treatment for most nonmelanoma skin cancers, with cure rates as high as 98% with proper margins. Consider Mohs surgery for larger lesions, sclerosing lesions with morpheaform histology, or for cosmeti...

Lesions in difficult locations within the auricular pavilion have been a major challenge for dermatologic surgeons, since access to their surgical approach tends to be complicated. In this article, the authors describe a case of basal cell carcinoma affecting the lower part of the left auricular concha that was resected by Mohs micrographic surgery, whose approach proved to be challenging. The ...

A lesion of nevus sebaceus with multifocal basal-cell carcinomas was excised by Mohs' fresh-tissue technique. Histologically, most of the foci of basal-cell carcinomatosis were of the superficial type, but the few more deeply situated foci had adamantinoid features. The malignancies extended well beyond the clinically discernible margins of the nevus sebaceus. Spontaneous healing of the wound o...

The use of the nasocheek sulcus flap with a cartilage strut provides an aesthetically pleasing result in total columella reconstruction. This provides thin hairless skin appropriate for the subunit. Mohs surgery aids in limiting the excision to the tumor involved area, providing a complete clearance and conserving precious units, which have an impact on the reconstructive options. The method of...