In Reply We would like to thank Dr Thomas1 for illustrating the excellent results that can be obtained with conservative treatment of scalp defects secondary to Mohs dermatographic surgery. We agree, that in the appropriately selected and counseled patient, that granulation can produce an excellent result in patients with hair loss. As pointed out, granulation is most suitable for superficial defects in which subcutaneous fat or pericranium is present and the patient wishes to avoid surgical intervention. The main downside of granulation is the daily wound care required and the potential for an unpredictable, hyperemic scar that may infrequently occur in certain patients.
Moyer JS. Healing by Secondary Intention—Reply. JAMA Facial Plast Surg. 2016;18(3):233. doi:10.1001/jamafacial.2016.0061