Comparison between examination with naked eye, curretage and dermoscopy in determining tumor extension before Mohs micrographic surgery


Department of Dermatology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran


Mohs micrographic surgery (MMS) is a technique for the treatment of cutaneous malignancies. Subtle determination of tumor margin would end to fewer stages of surgery. Our aim was to compare these three ways for determining tumor extension before initiation of MMS, examination with the naked eye, dermoscopy and curettage. Sixty patients who had basal cell carcinoma (BCC) in head and neck area were randomized in three groups (curettage, dermoscopy and examination with the naked eye). Each group encompassed twenty patients. The total number of resection stages in MMS was recorded for each patient. Demographic data of the patients and the total number of resection stages in MMS were statistically analyzed. Based on analysis of variance (ANOVA) test results, there was no significant difference for total number of stages in statistical point of view between three groups (P value = 0.1). In this research, the Pearson correlation coefficient showed that there is a direct relation between the age and resection stages (r = 0.19, P value = 0.04). The Chi-square test showed no differences between three groups in age, residence and radiotherapy history.


1. 1. Bolognia J, Jorizzio J, Rapini R. Bolognia dermatology. 2 nd ed. Chap. 150. In: Otley C, Roenigk R, editors Mohs surgery. Mosby: Elsevier; 2008: p. 2274.  Back to cited text no. 1
2. 2. Guardiano R, Grande D. A Direct Comparison of Visual Inspection, Curettage, and Epiluminescence Microscopy in Determining Tumor Extent Before the Initial Margins Are Determined for Mohs Micrographic Surgery. Dermatol Surg 2010;36:1240-4.  Back to cited text no. 2
3. 3. Bolognia J, Jorizzio J, Rapini R. Bolognia dermatology. 2 nd ed. Chap. 144. In: Goldman G, editor. Wound closure materials and instruments. Mosby: Elsevier; 2008. p. 2188.  Back to cited text no. 3
4. 4. Braun RP, Rabinovitz HS, Oliviero M, Kopf AW, Saurat JH. Dermoscopy of pigmented skin lesions. J Am Acad Dermatol 2005;52:109-21.  Back to cited text no. 4
5. 5. Smith V, Walton S. Treatment of Facial Basal Cell Carcinoma. J Skin Cancer 2011;2011:1-7.  Back to cited text no. 5
6. 6. Pomerantz R, Zell D, McKenzie G, Siegel DM. Optical coherence tomography used as a modality to delineate basalcell carcinoma prior to mohs micrographic surgery. Case Rep Dermatol 2011;3:212-8.  Back to cited text no. 6
7. 7. Micali G, Lacarrubba F, Massimino D, Schwartz RA. Dermatoscopy: Alternative uses in daily clinical practice. J Am Acad Dermatol 2011;64:1135-46.  Back to cited text no. 7
8. 8. Carducci M, Bozzetti M, De Marco G, Foscolo AM, Betti R. Usefulness of margin detection by digital dermoscopy in the traditional surgical excision of basal cell carcinomas of the head and neck including infiltrative/morpheaform type. J Dermatol 2012;39:326-30.  Back to cited text no. 8
9. 9. Caresana G, Giardini R. Dermoscopy-guided surgery in basal cell carcinoma. J Eur Acad Dermatol 2010;24:1395-9.  Back to cited text no. 9
10. 10. Huang CC, Boyce S, Northington M, Desmond R, Soong SJ. Randomized, controlled surgical trial of preoperative tumor curettage of basal cell carcinomas in Mohs micrographic surgery. J Am Acad Dermatol 2004;51:585-91.  Back to cited text no. 10