Mohs micrographic surgery for the treatment of malignant melanoma

Abstract 

Mohs micrographic surgery (MMS) is very successful in the treatment of nonmelanoma skin cancer. Examining 100% of the margin using MMS improves cure rates. This method has obvious appeal in treating melanoma. Evaluating the lateral margins of melanomas using frozen tissue sections is complicated. Some studies have shown that basic frozen sections can be accurate in margin evaluation, but others have shown that they are unreliable. The use of immunostains on frozen sections is one method that may make the analysis of frozen sections more accurate. Other modifications, including the use of rush paraffin sections in lieu of frozen sections, “slow Mohs,” have also been reported. Although the role of MMS in the treatment of melanoma has been controversial, multiple reports using all of the above-mentioned methods have shown great success. Mohs micrographic surgery has a role in the management of melanoma, especially for lesions with poorly defined margins or for those located in areas where tissue conservation is critical.