Mohs Surgery and Histopathology: Beyond the Fundamentals

Mohs surgery is a highly effective treatment for certain cutaneous and oral pharyngeal cancers. The procedure allows for the precise and complete removal of cancers while preserving significant amounts of normal tissue. Through the presentation and orientation of the specimens’ complete surgical margin on pathology slides, the location of tumor foci and other relevant findings can be correlated with their locations on the surgical wound. The ability to create perfect slides for histological examination lies at the core of effective Mohs surgery. These procedures have a 99 percent cure rate for certain cancers when implemented correctly. This book describes the methods the dermatologist, pathologist, or technician can use to optimize the Mohs technique and produce the highest-quality slides and highest cure rates possible.

This book describes the methods a dermatologist, pathologist, or technician can use to optimize the Mohs technique in skin cancer treatment.

Doody Review Services

Reviewer:Tara D Miller, MD(Peninsula Dermatologic Surgery)
Description:This book describes the Mohs surgical process in great detail, including techniques and methods used by Mohs surgeons and technicians from the bedside to the laboratory.
Purpose:The purpose is to describe the methods Mohs surgeons-pathologists and Mohs technicians use to optimize the Mohs technique and produce the highest quality slides and the highest possible cure rates for skin cancers.
Audience:This book is written for a several audiences. Its main audience is practitioners, particularly Mohs surgeons. However, it would be very helpful for dermatology residents during their surgery rotations or for Mohs fellows, and it is also a valuable tool for Mohs technicians.
Features:The book begins with microscopy and tissue preparation including tips on optimizing the microscope and how to section and embed the tissue specimens. The next section delves into laboratory techniques, including how to stain the tissue, and multiple clinical pearls and trouble-shooting suggestions. The book then moves into Mohs mapping and a brief section on pathologic interpretation of the slides. Finally, it discusses special staining techniques and the various clinical templates used in Mohs surgery. This highly specialized book has few if any equivalents. The detailed discussion and photographs on tissue preparation, embedding, staining, and coverslipping are clear and helpful. The pearls and trouble-shooting sections throughout are also very useful. I appreciated the examples of consent forms and Mohs templates, which would be very helpful for someone starting up a practice. The pathology portion of the book is small and cursory, but teaching pathologic interpretation is not the stated mission of the book nor should it be. A few photos are of poor quality.
Assessment:This is a high-quality, concise book with a limited audience, namely Mohs surgeons, Mohs technicians, and dermatology residents and fellows. Dermatology and dermatologic surgery textbooks include brief chapters in on Mohs surgery but none that describe the process and laboratory techniques in this detail.

Ken Gross, MD, is Clinical Professor in the Division of Dermatology at the University of California, San Diego School of Medicine, and is also in private practice in dermatology in San Diego, California.

Howard K. Steinman, MD, is Assistant Clinical Professor of Dermatology at the University of California, San Diego School of Medicine, and is in private practice in dermatology and cosmetic surgery in Chula Vista, California.