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Exploring opposing arguments in the call for randomized controlled trials to demonstrate benefit of Mohs micrographic surgery for cutaneous melanoma.
Dermatol Online J
October 2024
Department of Dermatology, Mayo Clinic, Rochester, Minnesota, USA Division of Dermatologic Surgery, Mayo Clinic, Rochester, Minnesota, USA.
The call for robust randomized clinical trials (RCTs) comparing Mohs micrographic surgery (MMS) with wide local excision for treatment of melanoma has stymied the development of guidelines for MMS despite growing evidence of benefit. This commentary explores the controversy by detailing opposing arguments, reviewing the relevant evidence supporting the use of MMS for early-stage melanoma, and discussing the role that RCTs may play in development of national guidelines for surgical treatment options for melanoma. Randomized clinical trials are considered the gold standard of clinical research, but there are no such trials currently to support MMS for melanoma.
View Article and Find Full Text PDFCommentary on "Clinical Versus Histologic Margins for Cutaneous Squamous Cell Carcinoma: Comparing Outcomes for High-Risk Tumors Treated With Mohs Micrographic Surgery".
Dermatol Surg
November 2024
Epiphany Dermatology, Dallas, Texas.
Surviving by a margin: Mohs outperforms wide local excision for lentigo maligna.
Br J Dermatol
October 2024
Division of Dermatologic Surgery, Mayo Clinic, Rochester, MN, USA.
Challenges and opportunities for Mohs surgery implementation in African healthcare systems.
BMC Surg
October 2024
Department of Research and Education, Oli Health Magazine Organization, Kigali, Rwanda.
Article Synopsis
- Skin cancer in African countries is a growing public health concern mainly due to high ultraviolet radiation exposure, and Mohs surgery is an effective treatment method for nonmelanoma skin cancers, but its implementation is limited in Africa.
- Key challenges include a lack of trained healthcare professionals, high surgery costs, and cultural misconceptions about the procedure, though telemedicine is being utilized for post-operative consultations.
- To improve the situation, there is a need for increased investment in healthcare training, better infrastructure, and more localized research in dermatological health in Africa.
Commentary on "Artificial Intelligence in Dermatology: A Systematic Review of Its Applications in Melanoma and Keratinocyte Carcinoma Diagnosis" and "Artificial Intelligence for Mohs and Dermatologic Surgery: A Systematic Review and Meta-Analysis".
Dermatol Surg
September 2024
Division of Dermatologic Surgery, Department of Dermatology, Mayo Clinic, Rochester, Minnesota.
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