Chapter

Mohs Micrographic Surgery

pp 509-518

Date:

International Perspective of Mohs Micrographic Surgery: Australia and New Zealand

  • Greg Julian GoodmanAffiliated withDermatology Institute of Victoria Email author 
  • , Vanessa A. MorganAffiliated withSkin and Cancer Foundation
  • , Tim J. RutherfordAffiliated withVictorian Dermatology & Surgery
  • , Edward J. UpjohnAffiliated withSkin and Cancer Foundation
  • , Paul J. M. SalmonAffiliated withDermatologic Surgery, Skin Cancer Institute

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Abstract

Mohs micrographic surgery (MMS) in Australia and New Zealand is of utmost importance given their extreme prevalence and incidence figures for skin cancer.

MMS is a rapidly growing subspecialty in Australia with surgeons exhibiting variable activity with the average number of cases per year being 201–300 of which 98% of tumors treated are located on head, neck, digits, or genitals.

The Mohs national database was established in 1993 to log the total number of cases performed in Australia and collected data on over 12,000 cases of Mohs surgery between 1993 and 1999.

Five-year follow-up studies have shown that 5-year recurrence rates for BCCs were 1.4% for primary and 4% for recurrent tumors. For SCCs, 5-year recurrence rates were 3.9% overall and 8% in those with perineural invasion. Perineural invasion was seen in 2.74% of BCCs and 5.95% of SCCs.

Mohs micrographic surgery and secondary intention wound healing of the nail apparatus for in situ and invasive SCC produce excellent wound healing and cure rate with retention of function.

New Zealand also has a very high rate of skin cancer, and MMS in New Zealand needs to be seen in the context of individuals with widespread sun-damaged skin. Multiple facial tumors in a patient are very common. A dysplastic field also influences repair options.

Keywords

Micrographic surgery Nails Australian Mohs database