Clinical Dermatology

Mohs Micrographic Skin Cancer Surgery

There are many ways to treat skin cancer and every case is different. In some cases, Mohs Surgery is the best choice. Redding Derm’s main clinic contains a fully operational Mohs Lab and has been offering Mohs Surgery services since 1997.

Mohs Micrographic Skin Cancer Surgery

Among the many ways to treat skin cancer, Mohs Surgery is one that has become increasingly popular among dermatologists and their patients. Mohs Surgery is technically complicated and requires customized laboratory and surgical facilities. Since 1997, Redding Derm has performed Mohs Surgery on hundreds of patients. Redding Derm’s main office hosts a California and federally licensed and inspected Mohs Laboratory.

Since 1997, Redding Derm has performed Mohs Surgery on hundreds of patients.

Mohs Surgery is named after Frederic Mohs, a Wisconsin based surgeon who developed a technique for removing skin cancers in layers. The technique uses microscopic tracking to ensure complete tumor removal with maximal healthy tissue preservation. Mohs Surgery has been extensively refined over the years and today is considered by many in dermatology to be the ‘gold standard’ of skin cancer removal. At Redding Derm, Mohs Surgery is simply viewed as one of many options available in the management of skin cancer. For most skin cancer, Mohs Surgery is not the best treatment option, but for some cases it is the ideal or only option. Recently, new methods of skin cancer treatment such as imiquimod topical immunotherapy have resulted in Mohs Surgery being recommended less frequently.

Dr. Kraffert Examining Skin Sample Patients undergoing Mohs Surgery at Redding Derm typically arrive in the early morning. Over the course of the morning, the tumor is removed in one or more stages. Excision of the clinical tumor with graphically plotted tissue orientation and subsequent preparation of graphically oriented microscopic slides of the entire excision margin is the first step of Mohs Surgery.  Next, meticulous microscopic interpretation of excision margin pathology with subsequent graphic representation of any residual tumor at the excision margin is used as a guide for further removal, if needed. These two steps are repeated as necessary until a complete tumor-free excision margin is obtained. Maps, photographs, and microscopic imaging are used to carefully plot the extent of tumor and plan removal in a way that preserves as much uninvolved tissue as possible. This normal tissue preservation is very important because tumor removal results in a surgical wound. Closing this resultant wound in a way that provides an optimized cosmetic and functional outcome can be very challenging. The smaller the surgical wound, generally speaking, the easier it is to close.

Redding Derm is the first Mohs Surgery facility in California established north of Sacramento. We are careful to recommend Mohs Surgery only when it is a ‘best choice’ for a particular patient or tumor. Redding Derm is able to perform Mohs Surgery on most Mohs Surgery candidates. We collaborate closely with our full time Mohs Surgery colleagues in Sacramento for management of extremely large or challenging cases.