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 ...

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...

Background/Aims Postoperative delirium (POD) is more frequent in elderly patients undergoing major cancer surgery. The interplay between individual clinical vulnerability and a series of perioperative factors seems to play a relevant role. Surgery is the first-line treatment option for cancer, and fast-track surgery (FTS) has been documented to decrease postoperative complications. The study so...

Techniques for minimally invasive mitral valve repair and replacement continue to evolve. This expert opinion, the second of a 3-part series, outlines current best practices for nonrobotic, minimally invasive mitral valve procedures, and for postoperative care after minimally invasive mitral valve surgery.

Ali Hendi, MD, has indicated no significant interest with commercial supporters. A n 80-year-old woman underwent surgery to treat primary basal cell carcinoma on the right nasal ala. The tumor measured 0.9 Â 0.4 cm and appeared to involve the nasal lining (Figure 1). Tumor-free margins were obtained after the first stage of Mohs micrographic surgery. A 1.3 Â 0.6-cm defect involving 2 mm of the ...

Gaining adequate visual exposure and mechanical access to tumors arising in the conchal bowl area can be difficult. Having a surgical assistant flatten the natural concavity of the bowl with pressure from behind may be of some help. Furthermore, the use of an angled beaver blade may improve the maneuverability of the scalpel in this tight space. However, even with these adjunctive measures, sur...

Precise removal of nonmelanoma cancers with minimum damage to the surrounding normal skin is guided by the histopathologic examination of each excision during Mohs micrographic surgery. The preparation of frozen histopathology sections typically requires 20-45 min per excision. Real-time confocal reflectance microscopy offers an imaging method potentially to avoid frozen histopathology and prep...