Mohs Micrographic Surgery
Mohs micrographic surgery is a precise process used to accurately remove skin cancer. It is a process in which the surgeon removes one layer of cancerous tissue, surgically divides and maps the specimen, then immediately looks at each section under the microscope to understand where the remaining cancer cells are located. The surgeon returns to the surgical site to excise the remaining layers of diseased tissue and reexamines it under the microscope until there is no longer any evidence of cancerous cells remaining. This layer by layer process ensures that all skin cancer cells have been removed while preserving the healthy tissue surrounding it.
Advantages of Mohs Surgery Some skin cancers may be deceptively large – extending further under the skin than they appear from the surface. Mohs surgery is specifically designed to remove these cancers by tracking and removing the cancer cells that extend beyond the visible portion of the tumor.
Mohs surgery removes only the cancerous tissue, while the normal tissue is spared. It ensures that the healthy tissue is kept intact which minimizes scarring.
Mohs surgery has been recognized as the skin cancer treatment with the highest five year cure rate of primary (96%) and recurring (90%) tumors.
American College of Mohs Surgery
Skin Cancer Foundation
American Cancer Society
American Society of Dermatologic Surgery
Phototherapy is the controlled delivery of artificial ultraviolet light. Ultraviolet light (a portion of the light emitted by the sun) is subdivided into UVA, UVB and UVC.
- UVA and UVB light wavelengths are beneficial for the treatment of a variety of skin disorders including, but not limited to, psoriasis, vitiligo, mycosis fungoides (cutaneous T-cell lymphoma), chronic itching (pruritus and/or prurigo) and various types of dermatitis (eczema).
- When UV light is absorbed into the skin, it suppresses the immune function of the skin. This helps to rid the skin of immunologic problems that lead to skin damage and destruction. Fortunately, UV therapy does not suppress the overall immune function of the body (systemic immunity).
Narrowband UVB (NB-UVB) therapy is 311nm wavelength light that suppresses abnormal lymphocyte function in the skin. NB-UVB is thought to be superior to Broad Band UVB light exposure because narrowband light eliminates the most dangerous shortwave UVB rays. Those short rays are most highly associated with the induction of skin cancer.
Length of treatments will vary depending on your condition. Most patients initially require 3-5 treatments a week. Typically, treatments start with only a few seconds of light exposure and may increase gradually as determined by physician. It may take 15-25 treatments or more to improve your disease. Not all patients will clear completely. Many patients go into remission and may then stop treatments.Expected Benefits:
- Improvement of existing lesions
- Reduction of new lesions
- Remission- in many cases phototherapy has resulted in a near-total clearing of the disease process. Duration varies with each patient. Maintenance therapy may be required.
Risks and side-effects of phototherapy:
- Most common is UVB-induced sunburn. Certain drugs can also cause sunburn, so it is important that your doctor knows of any medications you may be taking.
- Possible with any form of UV light that an increased incidence of skin cancer may occur later in some patients.
- May cause dryness or itching.
- May age skin over time and may increase freckles and pigmentation of the skin.
- May damage the eyes and increase risk of cataracts. This is preventable with protective eye goggles. This will be given to you and are required for treatment.
- May cause flare up of fever blisters and mouth sores in susceptible people.
- Long-term UV exposure to the unprotected genital area in men can cause an increase in genital cancer.
- May cause exacerbation of other medical conditions such as lupus erythematosus which have sensitivity to UV wavelength.