American Mohs: A Critical Review

Authors: Brett M. Will1, David J. Elpern2 MD; Roy Grekin3, MD; Douglas W. Johnson4, MD

Affiliations: 1 Medical Student, Georgetown University School of Medicine, Washington, DC; 2Practicing Clinical Dermatologist, Williamstown, Massachusetts; 3Department of Dermatology, Clinical Professor, University of California San Francisco School of Medicine, San Francisco, California; 4Department of Dermatology, The Queen’s Medical Center, Honolulu, HI

Keywords: Mohs Surgery, Health Care Costs, History of Medicine, Practice Guidelines as a Topic, Skin Neoplasms

Abstract
Over 80 years ago, a medical student conceived of a novel approach to remove difficult-to-treat nonmelanoma skin cancers. The procedure, called Mohs Micrographic Surgery (MMS), has been refined over the ensuing years and now large numbers of practitioners provide the service. As the indications have continued to evolve and enlarge, the appropriate use of MMS needs to be addressed. We look at the history of MMS since its inception and present questions that clinical dermatologists are asking. Most importantly, is MMS overused and should precautions be taken to temper its overuse?

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