ABD Mohs Surgery case studies
ABD Mohs Surgery · Put your knowledge to work in context.
Mohs micrographic surgery is the subspecialty credential in dermatologic surgery built around a single technical idea: excising a cutaneous tumor, mapping the specimen, and examining essentially 100% of the surgical margin on frozen sections before deciding whether to close. Certification in this area is intended for dermatologists who have completed Mohs fellowship training and who run or intend to run a Mohs laboratory, because the exam tests the whole pipeline rather than just the excision - tumor biology, margin mapping and tissue orientation, frozen-section histology, reconstruction, anesthesia and complication management, head and neck anatomy, and the regulatory and ethical side of running a laboratory. The ABD Mohs Surgery case studies are 5 cases and about 2,209 words.
1Recurrent Basal Cell Carcinoma at a Prior Graft Margin
A 68-year-old man presents with a 1.4 cm pearly, telangiectatic nodule on the left nasal ala, present for 14 months. Seven years earlier he had a basal cell carcinoma at the same site treated by excision and full-thickness skin grafting; the graft is still visible.
514 words, about 3 min2Frozen Section Shows Inflammation at the Margin
You are performing Mohs surgery on a 74-year-old woman with a 2.0 cm morpheaform basal cell carcinoma of the left medial canthus. After the first stage, the cryostat sections show dense lymphocytic infiltrate and fibrosis at the deep margin, but no unequivocal tumor islands.
455 words, about 2 min3Anticoagulation and a Bleeding Nasal Defect After Mohs
A 79-year-old woman on apixaban (for atrial fibrillation) and aspirin 81 mg undergoes Mohs surgery for a 1.5 cm squamous cell carcinoma of the nasal dorsum. Clearance is achieved in two stages; the defect is 2.2 x 1.8 cm and is repaired with a full-thickness skin graft and a bolster.
425 words, about 2 min4Informed Consent and a Resident Performing the Case
A 62-year-old man with a 1.1 cm basal cell carcinoma of the right cheek is scheduled for Mohs surgery at an academic center. On the day of surgery, the attending introduces a dermatology resident who will perform the excision and repair under supervision.
370 words, about 2 min5A Deep Defect Over the Temporal Branch and a Question of Flap Choice
A 70-year-old woman undergoes Mohs surgery for a 2.5 cm recurrent basal cell carcinoma of the left temple. Clearance requires three stages; the final defect is 3.5 x 3.0 cm, extends to the deep temporal fascia, and lies over the course of the temporal branch of the facial nerve.
445 words, about 2 min