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Maral Kibarian Skelsey, MD     skin cancer specialist     mohs & dermatologic surgery
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"When my family practice physician recommended a dermatological evaluation of suspicious spots on my legs, I had the good fortune of a referral to Dr. Maral Skelsey, who introduced me to Mohs Micrographic Surgery for basal cell carcinoma. While the prospect of cancer is terrifying, the capable, professional care provided by Dr. Skelsey and her staff was reassuring to me from the start. They regularly examine and treat my sun damaged skin and, when necessary, use Mohs procedures to remove basal cell carcinoma. My six Mohs surgeries have been highly satisfactory and I fully trust the Dermatologic Surgery Center of Washington to keep me free of cancer in the future."

Margaret Vining
Curator, National Museum of American History
Smithsonian Institution

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mosh surgery

WHAT IS MOHS MICROGRAPHIC SURGERY

Mohs micrographic surgery—named after Frederic E. Mohs, MD, professor emeritus of surgery at the University of Wisconsin — requires highly specialized training and is acknowledged as the most effective and advanced treatment for skin cancer. Developed in 1956, this technique has been refined and today it offers the highest cure rate — 99 percent for basal and squamous cell carcinoma, the two most common skin cancers and a 95 percent cure rate for melanoma.

Mohs surgery is a highly precise procedure of layer by layer tissue removal. Each layer is then frozen and then examined under the microscope to determine if any cancer cells persist. The process effectively removes all cancer cells while saving the surrounding healthy tissue. A Mohs surgeon then uses special training in reconstructive surgery to restore the wound area to its normal healthy appearance.

Diagram of the Mohs Surgery Process

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MOHS SURGERY — SURGICAL PROCESS
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Mohs surgery is usually an outpatient procedure performed in a physician’s office. Typically, it starts early in the morning and can be completed the same day, depending on the extent of the tumor and the amount or reconstruction necessary. Local anesthesia is administered around the area of the tumor so the patient is awake during the entire procedure.

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MOHS SURGERY — POST SURGICAL
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As soon as the affected area is declared cancer-free, the Mohs surgeon discusses post-surgical options with the patient such as:

  • a small, simple wound may be allowed to heal on its own.
  • a slightly larger wound may be closed with stitches.
  • larger wounds may require a skin graft or a flap.
  • if the tumor is very large, another surgeon with special skills may be called upon to assist with reconstruction.

Post-reconstructive check-ups are recommended in order to monitor the patient's progress and spot any possible cancer recurrence in a timely manner.

Nearly 50 percent of patients with one skin cancer will develop another within five years. Follow up is extremely important for early detection of any new lesions.

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