Shared decision making for perioperative antibiotic use during Mohs micrographic surgery on the lower extremities.

Background: While there is a higher risk of surgical site infection (SSI) on the lower extremities following Mohs micrographic surgery (MMS), antibiotic prophylaxis (AP) is debated.

Objective: To determine the role of shared decision making (SDM) in guiding AP usage during MMS on the lower extremities.

Materials And Methods: A prospective observational study was conducted whereby patients received a standardized SDM discussion or routine counseling.

Endocrine Mucin-Producing Sweat Gland Carcinoma and Primary Cutaneous Mucinous Carcinoma: A Case Series.

Endocrine mucin-producing sweat gland carcinoma (EMPSGC) and primary cutaneous mucinous carcinoma (PCMC) are rare low-grade neoplasms thought to arise from apocrine glands that share many histological features and are proposed to be on a single histopathologic continuum, with EMPSGC as the in situ form that may progress to the invasive PCMC. Management involves a metastatic workup and either wide local excision (WLE) with greater than 5 mm margins or Mohs micrographic surgery (MMS) in anatomically sensitive areas. We present 2 cases of EMPSGC and 3 cases of PCMC and review their clinical and histopathologic features, differential diagnoses, and treatment.

Liposomal and Nonliposomal Bupivacaine for Mohs Surgery: A Systematic Review.

Background: Lidocaine is the most commonly used local anesthetic for Mohs micrographic surgery (MMS), but given its limited half-life, postoperative pain remains a significant concern for patients. Bupivacaine is used in various surgical subspecialty procedures and has demonstrated improved pain control compared with lidocaine. However, its role in MMS is insufficiently explored.

Neurotropic melanoma arising from a neurocristic hamartoma.

Neurotropic melanoma is a rare type of malignant melanoma with nerve invasion or neural differentiation. Neurocristic cutaneous hamartoma is a rare, benign tumor of the skin and superficial soft tissue that arises from aberrant migration of neural crest cells. We report a rare case of a 74-year-old man with a clinically diagnosed giant congenital nevus of the right mid-back, histopathologically confirmed to be a neurocristic cutaneous hamartoma, who developed neurotropic spindle cell melanoma within the lesion.

Extraocular Sebaceous Carcinoma Treated With Mohs Micrographic Surgery-A 24-Year Retrospective Review of Tumor Characteristics and Treatment Outcomes.

Background: Extraocular sebaceous carcinoma (SC) is rare, with distinct features from its ocular counterpart. These neoplasms have been associated with Muir-Torre syndrome (MTS). Associated internal malignancies include gastrointestinal and genitourinary.

Successful Treatment of Chronic Venous Ulcers With a 1,320-nm Endovenous Laser Combined With Other Minimally Invasive Venous Procedures.

Background: Venous ulcers are very common with few curative treatment options.

Objective: To report the closure rate and clinical characteristics of active venous ulcers in a vein clinic using endovenous laser ablation (EVLA) with a 1,320-nm laser.

Methods And Materials: A prospective database was kept consisting of patients with an active venous ulcer at the time of consultation in a single-practitioner academic vein clinic from March 2007 to May 2014.

Rare case of acral calcified angioleiomyoma with macroscopic calcium extrusion.

Acral calcified angioleiomyoma is an uncommon tumor that presents as a non-descript papule or subcutaneous nodule, classically on the foot. Biopsy or excision is typically the diagnostic method of choice as well as the treatment for these sometimes painful tumors. We report an uncommon clinical presentation of acral calcified angioleiomyoma with considerable extrusion of calcium perforating through the skin.

Infection rates of wound repairs during Mohs micrographic surgery using sterile versus nonsterile gloves: a prospective randomized pilot study.

Background: Mohs micrographic surgery (MMS) is a multistep outpatient procedure that has become the treatment of choice for the removal of many cutaneous malignancies. The surgeon initially removes the tumor with nonsterile gloves in MMS. Sterile or nonsterile gloves are then used during the final repairs.

Modified Mohs micrographic surgery for periocular melanoma and melanoma in situ: long-term experience at Scripps Clinic.

Background: Excision of invasive melanoma and melanoma in situ (MIS) using variations of the Mohs micrographic surgery (MMS) technique is becoming increasingly common in difficult areas, such as the periocular area, where standard surgical margins may not be feasible, and clinical margins are poorly defined. However, little long-term data evaluating the treatment of periocular melanoma are available in the literature.

Objective: To present our long-term experience in the treatment of periocular melanoma using a staged, modified Mohs excision technique with rush permanent, paraffin-embedded tissue sections.

Calcium hydroxylapatite tissue filler discovered 6 years after implantation into the nasolabial fold: case report and review.

Background: Injectable calcium hydroxylapatite is becoming increasingly popular as a facial soft tissue filler, due in part to its purported longevity of esthetic correction compared with other materials, but little is known about its long-term histologic appearance and persistence in facial skin. We recently encountered calcium hydroxylapatite microspheres incidentally during Mohs surgery of the nasolabial fold 6 years after implantation.

Objective: To describe the long-term histologic appearance of calcium hydroxylapatite microspheres in human facial skin and review the relevant literature with a consideration of clinical implications.

Treatment of dermatofibroma sarcoma protuberans using modified Mohs micrographic surgery: no recurrences and smaller defects.

Objectives: The purpose of this study was to evaluate the use of modified Mohs micrographic surgery (MMS) for dermatofibroma sarcoma protuberans (DFSP) in a single institution by a single surgeon.

Methods: The authors conducted a retrospective analysis of 25 patients with DFSP who were treated with modified MMS over the past 19 years at Scripps Clinic.

Results: Of the 25 patients treated with modified MMS for DFSP, there were no identifiable recurrences.