Mohs surgery is named after Dr. Frederic Mohs, who pioneered a technique for removing cancers termed “chemosurgery” and first published his technique in 1941.1 Dr. Mohs’ initial method involved applying a zinc chloride paste directly to the patient’s tumor to chemically fix the tissue, after which the patient was allowed to return home. On the following day, the patient came back to the office. The tumor was then removed in precise, serial layers that were horizontally oriented and systematically mapped. This allowed all peripheral and deep margins of the specimen—essentially the interface between the patient and his or her tumor—to be examined under the microscope. If any part of the tumor remained, these steps were repeated until all peripheral and deep margins were clear. The goal of “chemosurgery” was to remove the tumor in its entirety, while preserving the surrounding normal skin. In this original technique, necrotic wounds created by zinc chloride paste were allowed to heal by second intention, as they were unsuitable for surgical reconstruction.
KeywordsMerkel Cell Carcinoma Zinc Chloride Permanent Section Dermatofibrosarcoma Protuberans Sebaceous Carcinoma
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