Publications by authors named "David Ciocon"

Importance: Functional and cosmetic outcomes following Mohs micrographic surgery (MMS) are poorly studied in individuals with skin of color (SOC). Postinflammatory hyperpigmentation (PIH) may be long-lasting and highly distressing. SOC individuals are particularly susceptible to PIH following procedures.

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Background: The population of the United States is becoming increasingly diverse, yet dermatology, especially Mohs micrographic surgery (MMS), lags behind.

Objective: This survey study investigates perceived barriers of underrepresented groups in medicine (URM) who are pursuing fellowship in Mohs micrographic surgery and dermatologic oncology (MSDO).

Methods And Materials: An IRB-approved survey was distributed electronically to accredited dermatology residencies between December 2020 and April 2021.

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The United States population is becoming increasingly diverse. Data show increased utilization of Mohs micrographic surgery (MMS) in people of color. Though the incidence of skin cancer in skin of color is low, morbidity and mortality are disproportionately high.

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Trichilemmal cysts (TCs) are the most common cystic lesions arising on the scalp and up to 2% give rise to a proliferating trichilemmal tumor (PTT). A rare subset of PTTs are termed malignant due to their histologic characteristics, aggressive behavior and potential for metastasis. The histological hallmark of TCs and PTTs is the absence of a granular layer resulting in abrupt trichilemmal keritanization.

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Based on surveys by Robinson1 in 2001 and Trimble and Cherpeli2 in 2013, Immunohistochemistry (IHC) utilization in Mohs micrographic surgery (MMS) has been rising. Although these surveys provided important subjective data regarding IHC use in MMS, there is a paucity of objective data describing its current utilization patterns. The objective of this study is to characterize IHC utilization during MMS by Mohs surgeons in the treatment of Medicare beneficiaries from 2012-2017.

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As the incidence of non-melanoma skin cancer (NMSC) increases in the United States, one area of particular concern is NMSC arising on the genitalia. In the past, most genital skin tumors have been treated by conventional radical surgical approaches such as penectomy, vulvectomy, or wide local excision. In recent years, tissue sparing Mohs micrographic surgery (MMS) has been established as a safe and effective method of achieving cutaneous genital tumor clearance.

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Background: Insurance companies have implemented new policies including excessive prior authorization (PA) requirements, high-deductible plans, and complicated billing structures in an effort to curb rising health care costs. Studies investigating the real-time impact on providers and patients are emerging, but few within the field of dermatology have been published.

Objective: To assess the impact of cost-cutting policies on patients and physicians.

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Background: Wide local excision (WLE) with 2 to 5 cm margins has been conventionally used for the treatment of superficial leiomyosarcoma (LMS). Because margin control is the strongest predictor of clinical recurrence, many dermatologic surgeons have recently recommended Mohs micrographic surgery (MMS) over wide local excision (WLE) as the primary treatment modality.

Objective: To determine the aggregate rate of local recurrence after treatment of superficial LMS with MMS among the few reports in the literature.

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