What's New in Mohs Surgery: Updates and Advances in Treatment for Melanoma and Squamous Cell Carcinomas

The presentation provides an overview of the latest advancements in Mohs surgery, particularly concerning melanoma and squamous cell carcinomas. It discusses the notable rise in the use of Mohs surgery for early invasive melanoma, with research demonstrating local recurrence rates significantly lower than those achieved with wide local excision. Advances in immunohistochemistry (IHC) have enhanced the effectiveness of frozen section Mohs surgery, which is now favored for challenging melanoma cases. High-risk squamous cell carcinoma is also addressed, emphasizing Mohs surgery's superior outcomes over traditional excision methods, including improved disease-specific survival and reduced recurrence rates. In contrast, the treatment of low-risk squamous cell cancers showcases surgical excision's advantages over topical therapies, though cosmetic outcomes may vary. The presentation briefly mentions Merkel cell carcinoma treatment through Mohs surgery, especially around the head and neck, highlighting its benefits in achieving better functional and cosmetic results. Additionally, the talk reviews perioperative care, emphasizing that routine preoperative antibiotics are unnecessary and that full anticoagulation can typically be maintained during surgeries with minimal complications. Discussing postoperative pain management, the speaker advocates for non-opioid pain relief strategies instead of narcotics, highlighting a regimen involving NSAIDs and acetaminophen. Overall, the updates reflect an evolving practice in dermatologic surgery, focusing on improved patient outcomes and minimizing unnecessary interventions.