Mohs Micrographic Surgery: A Brief Overview

Abstract

Mohs micrographic surgery (MMS) is a tissue-sparing skin cancer resection technique that involves 100% margin analysis. This procedure is performed in the outpatient setting under local anesthesia by dermatologic surgeons who act as both the surgeon and the pathologist. The technique allows for prompt reconstruction immediately after cancer clearance and offers the highest cure rate for many skin malignancies, including basal and squamous cell carcinoma, as well as more rare tumors. Mohs surgery effectively ensures cancer clearance while minimizing defect size and optimizing cosmetic and functional outcomes for patients. Herein we will discuss the evolution, procedure, and indications of MMS.

Keywords: Mohs micrographic surgery; Mohs surgery; cutaneous malignancy; skin cancer.

Fig. 1

( A ) Mohs specimen after removal with double hash at the 12 o'clock position and single hash mark at the 3, 6, and 9 o'clock positions. ( B ) The same specimen after being inked red at the 12 o'clock position, green at the 3 o'clock position, blue at the 6 o'clock position, and black at the 9 o'clock position to enable histologic localization of residual tumor.

Fig. 2

Mohs map with symbols that correlate to the red ink at the 12 o'clock position, green ink at the 3 o'clock position, blue ink at the 6 o'clock position, and black ink at the 9 o'clock position.