Mohs Surgery for Nail Tumors

  • Nathaniel J. Jellinek
  • Katharine B. Cordova
  • Siobhan C. Collins
  • Thomas Knackstedt


The virtues of Mohs surgery are well established and applicable to the nail unit and periungual tissues. When compared to traditional wide excision, Mohs surgery offers definitive examination of the entire cut surgical margin while sparing uninvolved tissues. There are specific techniques that can specifically maximize efficiency and improve outcomes when utilized on nail tumors. These involve tumor extirpation without plate avulsion and selective bone excision as a part of the Mohs layers. These techniques are demonstrated with pictures and videos.


Nail surgery Mohs surgery Squamous cell carcinoma Melanoma En face sections Local anesthesia Tissue sparing Skin graft Second intention healing Bone Radiation therapy Amputation 

Supplementary material

Video 36.1

Mohs surgery performed with the nail plate intact (MP4 1,309,653 kb)

Video 36.2

Excision of bone and soft tissue at the depth of a Mohs surgery (MP4 755,648 kb)


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Nathaniel J. Jellinek
    • 1
    • 2
    • 3
  • Katharine B. Cordova
    • 4
  • Siobhan C. Collins
    • 5
  • Thomas Knackstedt
    • 6
  1. 1.Dermatology Professionals, Inc.East GreenwichUSA
  2. 2.The Warren Alpert Medical School at Brown University, Department of DermatologyProvidenceUSA
  3. 3.University of Massachusetts Medical School, Department of DermatologyWorcesterUSA
  4. 4.Beatrice Keller ClinicPhoenixUSA
  5. 5.Dermatology Surgical Associates, LLCGlastonburyUSA
  6. 6.Department of DermatologyCleveland ClinicClevelandUSA

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