Mohs micrographic surgery is a highly specialised method of removing common skin cancers, usually BCCs and SCCs. It is named after the founder of the technique, Dr Fred Mohs. The dermatologist performs both the surgery on the patient, and the pathology on the removed tissue.

The apparent tumour, with a small surrounding safety margin of skin, is removed under local anaesthetic, and a dressing applied to the wound. The tissue is sectioned and marked by the dermatologist, then processed by a technician to make pathology slides. The slides are examined by the dermatologist to see if there is any residual cancer, if so, a map of the affected area is created. The patient is returned to the operating theatre, and a further layer is taken encompassing the positive areas. The process is repeated until the tumour appears completely removed (>99% cure rate for a BCC that has not been previously treated). ¬†Once the patient’s site is clear of cancer, plans for closure can be made, either by the dermatologist or another practitioner, depending on prior arrangements.

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