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August 28, 2019

Mohs Micrographic Surgery for Melanoma: As Use Increases, So Does the Need for Best Practices

Author Affiliations
  • 1Penn Dermatology Oncology Center, Hospital of the University of Pennsylvania, Philadelphia
  • 2Department of Dermatology, Mount Sinai Icahn School of Medicine, New York, New York
  • 3Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
JAMA Dermatol. Published online August 28, 2019. doi:10.1001/jamadermatol.2019.2589

Mohs micrographic surgery (MMS) is expanding surgical treatment options for melanoma. For more than 2 decades, National Comprehensive Cancer Network (NCCN) guidelines have recommended conventional wide local excision (WLE) with prescribed surgical margins for all cutaneous melanomas, regardless of anatomical location or histological subtype.1 Despite those recommendations, use of MMS for melanoma in the United States increased 304% from 2001 (2.6% of melanomas) to 2016 (7.9% of melanomas).2 Use of MMS for melanoma varies geographically in the United States, as does use of melanocytic immunohistochemical stains during MMS.2 Why is the use of MMS for melanoma growing? How do we develop best practices to reduce variations for this specialized technique?

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