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November 1992

Redefinition of Mohs Surgery

Author Affiliations

Department of Surgery University Station Clinics 2880 University Ave PO Box 5902 Madison, WI 53705

Arch Dermatol. 1992;128(11):1546-1547. doi:10.1001/archderm.1992.01680210126023

To the Editor.—  Dr Rapini's editorial on Mohs Surgery1 was both disturbing and provocative. I am concerned that a dermatopathologist who is obviously very critical of Mohs surgery should be given an opportunity to redefine Mohs surgery. Several of Dr Rapini's statements deserve comment.I am surprised to hear that complete marginal examination was an "ancient rite" practiced for "decades" by other specialties. Dr Mohs began complete marginal examination in 1936 and was maligned and criticized for years for his technique. Through dogged determination and meticulous record keeping, Dr Mohs was able to show the merit of Mohs surgery.Dr Rapini suggests in his editorial that Mohs surgeons excise too much tissue. Tissue preservation using Mohs surgery for treatment of skin cancers has been well demonstrated by Bumsted and Ceilley.2 They evaluated the size of the proposed excision using conventional surgery vs the actual defect using Mohs surgery

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