By Francisco J. Agullo
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2004). Surgical methods are recommended to treat recurrence. Wide BCC excision with a scar and a margin ranging from 5 to 10 mm or Mohs micrographic surgery which is significantly more successful are performed. 6 Mohs micrographic surgery (excision controlled histopathologically) The history how this method came into existence and evolved is tightly associated with its creator. In 1930s Frederic E. Mohs, who was a medicine student at those times, studied the effects of different substances on cancer cells in rats.
The specimen resected in this way is subject to histopathological evaluation during which a histopathological subtype of BCC is confirmed as well as procedure completeness. The tissue defect formed after lesion excision is closed according to the reconstructive ladder. 2 Margin of clinically normal surrounding tissue It is obvious that the extent of neoplastic infiltration affects the range of a peripheral and deep margin. g. for primary morpheaform BCC resected with a 3-mm margin only 66% of radical excisions observed, with a 5-mm margin – 82% and with a 13-15-mm more than 95%.
Moreover, it is also necessary to inform a patient about the need of skin self-examination. It is of special importance not only because of recurrence monitoring but also due to the risk of 36 Current Concepts in Plastic Surgery development of another BCC which is ten times higher in patients with a previous BCC than in the general population (Marcil & Stern, 2000). This risk is also significantly higher in elderly patients, in patients with multiple BCCs and with the lesion diameter > 1cm (Van Iersen, 2005).