American Mohs: A Critical Review

Over 80 years ago, Fred Mohs, then 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? Full Article Pdf: Full Article Word: Mohs 5.26

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Cry the Beloved Specialty

by David J. Elpern, M.D. presented in shorter form at the Lown Institute Conference, Washington, D.C. April 9. 2018 Every peddler praises his needles. Portuguese proverb In November 2017, the NY Times published an expose about the current state of dermatology.1 It documented bizarre instances of over-diagnosis and over-treatment that are driven by ignorance and greed. Over the past 40 years, I have witnessed these changes in my specialty and am dismayed by the reluctance of my colleagues to address them. This trend began in the early 1980s when the Academy of Dermatology (AAD) assessed its members over 2 million dollars to hire a prominent New York advertising agency to … Continue reading

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Micrographic Surgery: A Patient’s Experience

My Mohs Experience Abstract: This is the personal account of a 70 year old man who underwent micrographic surgery for an ill-defined basal cell skin cancer on his temple.  It is intended to inform patients and physicians about the personal experiences and perceptions of Mohs patients.  A micrographic surgeon has added a coda. Keywords:  micrographic surgery, Mohs surgery, Mohs micrographic surgery, MMS, nonmelanoma skincancer, basal cell carcinoma, squamous cell carcinoma, illness narrative Who knows/ whose nose/ needs Mohs?  E. Dorinda Shelley Introduction:  Dermatologists see patients with nonmelanoma skin cancer on a daily basis.  Certain tumors, especially those around the nose, ears, and eyes are best handled with micrographic surgery (aka, … Continue reading

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