Use of ex vivo confocal scanning laser microscopy during Mohs surgery for nonmelanoma skin cancers.

Background: Ex vivo confocal scanning laser microscopy offers rapid optical reflectance imaging of excised tissue without conventional frozen histopathology that can potentially expedite Mohs surgery.

Objective: The objective was to determine the feasibility of using ex vivo confocal scanning laser microscopy during Mohs surgery for detecting residual basal cell carcinoma and squamous cell carcinoma.

Methods: One-hundred fifteen Stage I Mohs surgery excisions (92 basal cell carcinoma, 23 squamous cell carcinoma) were imaged with acetowhitening and confocal scanning laser microscopy and compared to conventional Mohs frozen histologic sections for normal and tumor features.

Wound dressings for office-based surgery.

Since the turn of the 20th century, our understanding of wound healing has changed completely. Because of this, we now realize that wounds heal better under occlusive or semi-occlusive conditions. This revelation has led to the creation of a vast array of wound-dressing techniques and products that any office-based surgeon must use on a daily basis.

Nonablative laser resurfacing using the long-pulse (1064-nm) Nd:YAG laser.

Background: Lasers with infrared wavelength ranges have been used in nonablative rejuvenation of skin. In this process, cooling of the epidermis allows for laser energy heat-induced injury to the dermis without ablation of the epidermal layer. This dermal injury is theorized to produce improvements in skin quality.

Confocal examination of nonmelanoma cancers in thick skin excisions to potentially guide mohs micrographic surgery without frozen histopathology.

Precise removal of nonmelanoma cancers with minimum damage to the surrounding normal skin is guided by the histopathologic examination of each excision during Mohs micrographic surgery. The preparation of frozen histopathology sections typically requires 20-45 min per excision. Real-time confocal reflectance microscopy offers an imaging method potentially to avoid frozen histopathology and prepare noninvasive (optical) sections within 5 min.