Surgical Margins of Nonmelanoma Skin Cancers in Mohs Surgery: Dermoscopy Versus Naked Eye.

IF 2.5 3区医学 Q2 DERMATOLOGY

Dermatologic Surgery Pub Date : 2024-10-16 DOI:10.1097/DSS.0000000000004455

Kawaiola C Aoki, Danielle Lazzara, Gregory Bartos, Eduardo Weiss, Eli R Saleeby

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引用次数: 0

Abstract

Background: Mohs micrographic surgery (MMS) offers high cure rates for nonmelanoma skin cancer (NMSC) but relies on precise margin assessment, traditionally initiated by the naked eye. Dermoscopy has emerged as a potential tool to improve margin delineation.

Objective: To compare the efficacy of dermoscopic versus naked eye evaluation in marking initial MMS margins for NMSC.

Methods: A multicenter, prospective study on patients with NMSC undergoing MMS was conducted. Patients were randomized into dermoscopy and naked eye groups. Statistical analysis was performed using statistical package for social sciences.

Results: A total of 127 patients were enrolled, with 63 in the naked eye group and 64 in the dermoscopy group. No significant differences in age, sex distribution, or histological subtype were found. The average number of MMS stages and accuracy of initial margins were comparable between groups.

Discussion: Despite its potential, the authors' study found no significant reduction in total MMS stages using dermoscopy. Novel imaging modalities or standardized dermoscopic criteria should be explored to enhance margin assessment accuracy and improve outcomes in NMSC treatment.

Conclusion: Dermoscopic evaluation of presurgical margins does not effectively assess lateral/deep margins nor contribute to a reduction in total MMS stages. Improving the authors' understanding of presurgical margin assessment techniques can lead to better treatment outcomes for NMSC.

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莫氏手术中非黑色素瘤皮肤癌的手术边缘：皮肤镜与肉眼对比

背景：莫氏显微放射手术（MMS）对非黑色素瘤皮肤癌（NMSC）的治愈率很高，但它依赖于精确的边缘评估，而传统的边缘评估是通过肉眼进行的。皮肤镜已成为改善边缘划分的潜在工具：比较皮肤镜与肉眼评估在标记 NMSC 最初 MMS 边缘方面的效果：对接受MMS治疗的NMSC患者进行了一项多中心前瞻性研究。患者被随机分为皮肤镜组和肉眼组。使用社会科学统计软件包进行统计分析：共有 127 名患者入组，其中肉眼组 63 人，皮肤镜组 64 人。在年龄、性别分布和组织学亚型方面没有发现明显差异。两组患者的MMS平均分期数和初始边缘的准确性相当：讨论：尽管皮肤镜具有潜力，但作者的研究并未发现它能显著减少MMS的总分期数。应探索新的成像模式或标准化的皮肤镜标准，以提高边缘评估的准确性，改善NMSC治疗的结果：结论：皮肤镜对手术前边缘的评估不能有效地评估侧缘/深缘，也无助于减少MMS的总分期。提高作者对术前边缘评估技术的理解可改善 NMSC 的治疗效果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Dermatologic Surgery 医学-皮肤病学

CiteScore

3.10

自引率

16.70%

发文量

547

期刊介绍： Exclusively devoted to dermatologic surgery, the Dermatologic Surgery journal publishes the most clinically comprehensive and up-to-date information in its field. This unique monthly journal provides today’s most expansive and in-depth coverage of cosmetic and reconstructive skin surgery and skin cancer through peer-reviewed original articles, extensive illustrations, case reports, ongoing features, literature reviews and correspondence. The journal provides information on the latest scientific information for all types of dermatologic surgery including: -Ambulatory phlebectomy- Blepharoplasty- Body contouring- Chemical peels- Cryosurgery- Curettage and desiccation- Dermabrasion- Excision and closure- Flap Surgery- Grafting- Hair restoration surgery- Injectable neuromodulators- Laser surgery- Liposuction- Microdermabrasion- Microlipoinjection- Micropigmentation- Mohs micrographic surgery- Nail surgery- Phlebology- Sclerotherapy- Skin cancer surgery- Skin resurfacing- Soft-tissue fillers. Dermatologists, dermatologic surgeons, plastic surgeons, oculoplastic surgeons and facial plastic surgeons consider this a must-read publication for anyone in the field.