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Vital Signs

Spring 2005

Mohs Precisely Removes Skin Cancer Using Microscope

When specialists excise one thin skin layer at a time, skin cancers on the neck and face —including eyelids, nose, ears or lip—can be completely removed with good cosmetic results using Mohs micrographic surgery, a technique that relies on examining each skin layer under a microscope. Used primarily to treat the two most common forms of skin cancer—basal cell and squamous cell carcinomas— the Mohs procedure allows the dermatologic surgeon to precisely map the location of the cancer and to take off minimal amounts of normal skin while removing the cancer down to its roots.

“Oftentimes, skin cancers have tumor extensions that we can’t see. We take one thin slice of skin and, while the patient waits, we stain the tissue with ink that allows us to detect cancer cells under the microscope. This technique enables us to map out the precise location of any remaining cancer cells,” explains Teresa Soriano, M.D., UCLA dermatologist. “If evidence of cancer remains, we repeat the Mohs procedure with another slice of skin until the cancer is completely gone.”

In Mohs micrographic surgery, the dermatologist usually serves as the surgeon, pathologist and reconstructive surgeon. At UCLA, the Mohs surgeon works closely with other specialists when more extensive reconstruction is needed. “We have an ocular plastic specialist for eyelid tumors, and head and neck or plastic surgeons for tumors on the nose and ears,” Dr. Soriano explains. “Through this collaboration, we are able to provide our patients with the best possible cosmetic outcome.”

Studies show that Mohs micrographic surgery has a five-year cure rate of 95 percent to 99 percent in treating basal cell and squamous cell carcinomas. Have your physician check yearly for cancers from scalp to soles of the feet, advises Lorraine Young, M.D., UCLA dermatologist. Also, seek shade, mainly from 10 a.m. to 3 p.m.; wear sunglasses and protective clothing; and use a 30 SPF or higher sunscreen before going in the sun, and reapply often.

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