Nonmelanoma Skin Cancer in Patients Older Than Age 85 Years Presenting for Mohs Surgery: A Prospective, Multicenter Cohort Study.

Importance: It has been suggested that Mohs surgery for skin cancer among individuals with limited life expectancy may be associated with needless risk and discomfort, along with increased health care costs.

Objective: To investigate patient- and tumor-specific indications considered by clinicians for treatment of nonmelanoma skin cancer in older individuals.

Design, Setting, And Participants: This multicenter, prospective cohort study was conducted using data from US private practice and academic centers.

Development of a core outcome set for basal cell carcinoma.

Background: There is variation in the outcomes reported in clinical studies of basal cell carcinoma. This can prevent effective meta-analyses from answering important clinical questions.

Objective: To identify a recommended minimum set of core outcomes for basal cell carcinoma clinical trials.

Managing sharps injuries and other occupational exposures to HIV, HBV, and HCV in the dermatology office.

Dermatologists and their staff are at risk for needlestick injuries and exposures to body fluids. Despite the availability of treatment to reduce the risk of blood-borne infection, many exposures go unreported. This paper identifies current recommendations and the specific details for response to occupational exposures to HIV, hepatitis B virus, and hepatitis C virus in the dermatology office.

Assessment of the Focused Practice Improvement Module Pilot Program of the American Board of Dermatology for Meeting Requirements of Maintenance of Certification.

This study assesses an online activity for practice assessment and its ability to help dermatologists and dermatopathologists meet maintenance of certification requirements.

Skin biopsy: Identifying and overcoming errors in the skin biopsy pathway.

The skin biopsy pathway involves numerous communication requirements, technical events, human handoffs, and cognitive decisions. Every step in the process has an error rate >0. To deliver the highest quality care, dermatologists obtaining skin biopsy specimens should implement systems in their office to minimize errors.

Skin biopsy: Biopsy issues in specific diseases.

Misdiagnosis may result from biopsy site selection, technique, or choice of transport media. Important potential sources of error include false-negative direct immunofluorescence results based on poor site selection, uninformative biopsy specimens based on both site selection and technique, and spurious interpretations of pigmented lesions and nonmelanoma skin cancer based on biopsy technique. Part I of this 2-part continuing medical education article addresses common pitfalls involving site selection and biopsy technique in the diagnosis of bullous diseases, vasculitis, panniculitis, connective tissue diseases, drug eruptions, graft-versus-host disease, staphylococcal scalded skin syndrome, hair disorders, and neoplastic disorders.

Adverse events associated with mohs micrographic surgery: multicenter prospective cohort study of 20,821 cases at 23 centers.

Importance: Detailed information regarding perioperative risk and adverse events associated with Mohs micrographic surgery (MMS) can guide clinical management. Much of the data regarding complications of MMS are anecdotal or report findings from single centers or single events.

Objectives: To quantify adverse events associated with MMS and detect differences relevant to safety.

Mohs surgery for melanoma in situ.

Mohs micrographic surgery is a valuable option for the treatment of melanoma in situ, especially lesions of the lentigo maligna subtype that are clinically ill defined. Complete peripheral margin assessment of a tumor's borders by means of frozen or permanent sections can help reduce the surgical defect size and maximize cure rate as compared with standard excision with preset 5-mm margins. This article reviews the different variations of Mohs micrographic surgery that are currently used for melanoma in situ.

Treatment options in melanoma in situ: topical and radiation therapy, excision and Mohs surgery.

Background: The treatment of melanoma in situ (MIS), particularly the lentigo maligna (LM) subtype, has been a controversial subject in the literature for over a decade. Surgical excision with 5 mm margins is the standard of care in the USA, while several variations of Mohs surgery are frequently used to treat clinically ill-defined lesions. Radiation is much less frequently used.

Nonmelanoma skin cancer.

This article provides readers with a comprehensive review of the evaluation and management of nonmelanoma skin cancers. Treatment recommendations are heavily based on the most recent guidelines from the National Comprehensive Cancer Network. Merkel cell carcinoma and dermatofibrosarcoma protuberans are also discussed.