The study, led by Omeed Modiri of the David Geffen School of Medicine at UCLA together with colleagues at the Icahn School of Medicine at Mount Sinai, including senior author Jesse M. Lewin, surveyed members of the American College of Mohs Surgery, the professional home of physicians who perform Mohs micrographic surgery. This technique, considered the gold standard for many skin cancers, involves removing thin layers of tissue and examining each one under a microscope until no cancer cells remain. It is a discipline that demands precision, real-time pathological judgment, and careful reconstructive planning, making it an especially revealing setting in which to gauge how surgical specialists perceive AI.

The researchers distributed an anonymous twelve-question survey to ACMS members and analyzed the responses using Fisher’s exact tests, with a p value below 0.05 considered statistically significant. Thirty-six surveys were completed, a modest sample that the authors themselves flag as a key limitation alongside sampling and recall bias inherent to survey-based research. Even so, the results sketch a coherent picture of a specialty in transition. Forty-two percent of respondents reported having already used AI tools in some capacity, and sixty-seven percent of all participants said they were likely to incorporate AI into their clinical practice within two years. In other words, adoption is no longer a hypothetical question for Mohs surgeons; it is a matter of when and how.

The platforms these surgeons gravitate toward say a great deal about what they currently trust AI to do. ChatGPT dominated, used by ninety-six percent of those who reported AI experience, followed by OpenEvidence at thirty percent and Gemini at twenty-two percent. Custom AI models, the kind purpose-built for specific clinical tasks, saw only limited use. This pattern suggests that Mohs surgeons are relying on general-purpose large language models and medical literature search tools rather than bespoke surgical applications, treating AI today less as a scalpel and more as an assistant for information gathering and workflow support.

When asked about the benefits, respondents pointed overwhelmingly to efficiency rather than clinical prowess. Seventy-six percent identified increased efficiency as the most significant advantage of AI in dermatologic surgery, while sixty-two percent cited reduced administrative burden. These figures align with a broader theme in medical AI research: the technology’s most immediate and reliable value often lies in taming the paperwork, documentation, and coding tasks that consume clinician time, rather than in making high-stakes decisions. Prior work by some of the same authors, for example, evaluated how accurately ChatGPT and Gemini assign Current Procedural Terminology billing codes in dermatologic surgery, a quintessentially administrative application where errors are recoverable and oversight is straightforward.

The concerns, however, were sharper and more consistent than the optimism. Eighty-six percent of respondents worried about inaccurate or unreliable information, the highest of any concern measured in the survey. Fifty-four percent flagged patient safety and liability, and forty-nine percent feared the dehumanization of care. These numbers reveal a profession that understands exactly where the fault lines lie. Large language models can generate fluent, confident text that is nonetheless wrong, a phenomenon that becomes far more dangerous when the output informs where to cut tissue or how to reconstruct a face. Liability questions compound the technical ones, since it remains legally murky who bears responsibility when an AI-assisted recommendation contributes to a poor surgical outcome.

Nowhere is this tension more visible than in the gap between expectation and comfort. Seventy-two percent of participants believed AI will change the practice of dermatologic surgery over the next five to ten years, yet only thirty-nine percent reported feeling any degree of comfort with AI-assisted tools guiding surgical margins or repairs. The surgeons, in effect, are saying that transformation is coming whether they like it or not, while drawing a firm line at delegating intraoperative judgment. When it came to patient outcomes, opinions split further: fifty percent believed AI would lead to improvement, nineteen percent expected a neutral effect, twenty-five percent were unsure, and six percent anticipated harm. That distribution captures a specialty that is cautiously hopeful but far from convinced.

Experience appears to shape attitudes, though the survey could not prove it statistically. Surgeons with fewer than five years in practice were 2.83 times more likely to report having used AI tools compared with those in practice longer, a substantial numerical difference that fell short of statistical significance with a p value of 0.21, likely a casualty of the small sample size. Still, the trend fits a familiar pattern across medicine: younger clinicians, trained alongside consumer AI tools, arrive in practice already fluent in them, while more senior surgeons encounter the technology later and often more skeptically. If the trend holds in larger samples, the demographic gradient of AI adoption could become a defining feature of how surgical specialties modernize.

The study’s technical limitations deserve honest weight. Thirty-six respondents represent a small fraction of the ACMS membership, and those motivated to answer a survey about AI are plausibly more interested in the topic than their peers, introducing sampling bias. Recall bias may also color self-reported usage patterns. The authors are transparent about these constraints and call for larger studies to validate the findings, as well as for standardized guidelines evaluating responsible AI use in healthcare. Their caution echoes wider calls in the literature, including proposals for formal requirements to mitigate patient harm risks from AI in medicine and frameworks for adopting large language models safely in clinical settings.

What emerges from this report is not a story of resistance or revolution but of calibrated pragmatism. Mohs surgeons, whose work demands microscopic precision and carries visible, personal consequences for patients, are welcoming AI into the margins of their practice, the scheduling, the documentation, the literature searches, while keeping it at arm’s length from the margin of excision. That distinction may prove to be the template for surgical AI adoption more broadly: efficiency gains first, decision support last, and rigorous validation, clear liability frameworks, and preserved human judgment as the non-negotiable conditions in between. As one of the first systematic looks at AI attitudes within this specialty, the survey suggests that the next five to ten years will test whether AI developers can earn the trust that these surgeons are not yet ready to give.

Subject of Research: A survey of American College of Mohs Surgery members on the current use, perceived benefits, and risks of artificial intelligence in dermatologic surgery.

Article Title: Current impact and future outlook of artificial intelligence among American College of Mohs Surgery members

Article References: Modiri, O., McGeough, O., Elder, A., Ensslin, C., & Lewin, J. M. (2026). Current impact and future outlook of artificial intelligence among American College of Mohs Surgery members. Archives of Dermatological Research, 318(1), Article 458. https://doi.org/10.1007/s00403-026-04791-5

Image Credits: AI Generated

DOI: 10.1007/s00403-026-04791-5

Keywords: artificial intelligence, Mohs surgery, dermatologic surgery, ChatGPT, large language models, survey, skin cancer, clinical practice, patient safety, surgical margins, healthcare workflow, American College of Mohs Surgery

The methodology behind the review was rigorous. The authors followed PRISMA guidelines, searching PubMed from database inception through August 2025 with terms combining Mohs micrographic surgery and patient satisfaction. Two independent reviewers screened the initial 183 records against predefined criteria, with disagreements resolved by consensus or a third reviewer. Eligible studies had to be peer-reviewed, published in English, conducted within the context of Mohs surgery, and designed to evaluate the effect of a perioperative intervention on patient satisfaction. The final set comprised fifteen randomized controlled trials, three retrospective observational studies, and one comparative study, with sample sizes ranging from just 24 participants to 1,250. Risk of bias was assessed independently by two reviewers using the National Institutes of Health Quality Assessment Tool, an important quality check given the heterogeneity of the underlying literature.

Measuring satisfaction proved to be a challenge in itself. The included studies employed a patchwork of instruments: twelve used Likert scales, two used patient satisfaction questionnaires, two used visual analog scales, two used investigator-developed surveys, and one used the FACE-Q Skin Cancer module. This instrument heterogeneity meant the authors could not pool results statistically and instead performed a qualitative synthesis. Perhaps the most striking finding, however, was not about any single intervention at all. Patient satisfaction was uniformly high across the board, regardless of what treatment patients received. The authors attribute this to a ceiling effect arising from the exceptionally high baseline satisfaction already observed in Mohs populations, where cure rates for primary basal cell carcinoma reach as high as 99 percent and 92 to 99 percent for squamous cell carcinoma.

Against that ceiling, four interventions broke through with statistically significant improvements in satisfaction. The first emerged in the preoperative phase: education using three-dimensional printed anatomical models. In a randomized trial by Biro and colleagues, 42 patients who received education via a 3D printed model of their own surgical anatomy showed improved procedural understanding, reduced preoperative anxiety, and significantly higher satisfaction on a Likert-type scale compared with 40 controls who received verbal education alone, a difference that reached statistical significance at p less than 0.03. The tactile and visual engagement of holding a physical replica of the surgical site appears to address multiple dimensions of the preoperative experience simultaneously, a quality that videos and pamphlets have struggled to replicate.

The second significant intervention was remarkably simple: letting patients look at their own surgical defect in a mirror before reconstruction begins. In a multicenter prospective cohort study, Veldhuizen and colleagues found that patients who viewed their facial skin cancer defect prior to closure reported dramatically higher satisfaction with their appearance, with an odds ratio of 8.66, and the effect persisted at twelve-month follow-up. This finding challenges the intuition that seeing a wound might be distressing. Instead, it appears that confronting the reality of the defect before it is repaired helps patients calibrate their expectations and appreciate the reconstruction, a form of psychological inoculation against the shock of the immediate postoperative appearance.

The third winning intervention targeted a sensory detail most surgeons never consider: smell. Because Mohs patients are awake, the acrid burning odor of electrocautery can be an unpleasant and memorable part of the procedure. In a cleverly designed comparative study, researchers attached a smoke evacuator to the electrocautery pen and activated it only during the closure stage, while maintaining the vacuum sound throughout all stages of the operation to preserve blinding. The results were dramatic. All patients perceived a burning odor during excision compared with only 40 percent during closure, patients were far less likely to report an unpleasant smell when the evacuator was active, 66.6 percent versus 16.6 percent at p less than 0.0001, and 76.7 percent rated the closure stage as more pleasant. Sometimes the difference between a good and bad surgical memory is literally the air in the room.

The fourth significant intervention came after the operation was over. Asilian and colleagues tested an oral wound-healing supplement containing bromelain, Centella asiatica, hyaluronan, vitamin C, zinc, and copper in a randomized, double-blinded, placebo-controlled trial. Patients receiving the supplementation showed significantly improved wound healing on the Early Healing Score and, critically, significantly higher satisfaction at two weeks on a visual analog scale, 9.08 versus 7.42 at p less than 0.001, the largest direct satisfaction effect in the entire review. The authors urge caution, however, noting that the small sample size and short follow-up duration mean this result requires confirmation in larger trials before it changes clinical practice.

Just as instructive are the interventions that failed to lift satisfaction scores but proved valuable in other ways. Educational videos, whether watched at home or integrated into the informed consent process, did not improve satisfaction across three randomized trials, yet patients consistently rated the content as informative and recommended it for future patients, suggesting value in preparedness even when the metric being tracked remained flat. Preoperative phone calls similarly showed no satisfaction benefit in two trials. Intraoperative anxiolytics told an interesting story: in a seven-armed randomized trial comparing lorazepam, diazepam, alprazolam, gabapentin, pregabalin, melatonin, and placebo, single-dose benzodiazepines and GABA-agonist medications proved safe and effective for reducing perioperative anxiety, even though satisfaction scores were uniformly high in every arm. A separate trial found significant within-group anxiety reduction with midazolam at p equal to 0.002, an effect absent in the placebo arm. Anxiety and satisfaction, the review makes clear, are related but distinct constructs that warrant independent measurement.

Other null results carried their own lessons. Handholding and stress balls made no difference to satisfaction or anxiety. Intravenous anesthesia was associated with significantly higher postoperative anxiety than local anesthesia, though possibly confounded by larger defect sizes. Postoperative telephone follow-up did not raise satisfaction, but same-night calls proved most effective at identifying active pain, offering a practical surveillance tool for early complication detection. A film-forming silicone gel dressing improved objective wound healing significantly without increasing contact dermatitis rates compared with triple antibiotic ointment, yet produced no corresponding satisfaction gain, a striking dissociation between clinical outcomes and what patients actually report feeling. Even surgical technique mattered less than expected for overall satisfaction, though melolabial island flap reconstruction yielded better donor site scar satisfaction than the paramedian forehead flap at p equal to 0.026.

The review’s authors are candid about the limitations constraining their conclusions. The analysis relied on a single database, PubMed, and was not prospectively registered, limiting methodological transparency. Only English-language publications were included, introducing language bias, and publication and outcome reporting biases may have underrepresented null results. The predominance of small, single-center randomized trials with heterogeneous instruments and bundled intervention designs makes it difficult to attribute effects to individual components. Their prescription for the field is clear: adequately powered, multicenter trials that isolate individual interventions, incorporate anxiety and preparedness as co-primary outcomes, employ standardized validated instruments, and account for demographic risk factors such as female sex, age of 65 or younger, and smoking, which are associated with worse scar-related outcomes. For now, the message for surgeons is refreshingly practical: hand patients a printed model of their own anatomy, let them look at the defect before you fix it, clear the smoke from the air, and the awake patient on your table may remember the operation far more fondly.

Subject of Research: Perioperative interventions and patient satisfaction in Mohs micrographic surgery for skin cancer

Article Title: Patient-centered perioperative interventions for mohs micrographic surgery: a systematic review

Article References: Patient-centered perioperative interventions for mohs micrographic surgery: a systematic review. (n.d.). https://doi.org/10.1007/s00403-026-04972-2

Image Credits: AI Generated

DOI: 10.1007/s00403-026-04972-2

Keywords: Mohs micrographic surgery, patient satisfaction, systematic review, skin cancer, perioperative care, 3D printed models, smoke evacuation, wound healing, patient-reported outcomes, dermatologic surgery, anxiety reduction, surgical education

The review, conducted by a team of researchers led by Abhinav Janappareddi of the University of Washington School of Medicine, systematically combed the medical literature through PubMed and Scopus to identify every study that had reported outcomes for hidradenocarcinoma treated with Mohs micrographic surgery. The search identified seven studies published between 2004 and 2021, and from those studies the team extracted eighteen documented cases in which patients with hidradenocarcinoma underwent the Mohs procedure. The headline finding is striking: across all eighteen cases, the authors found no reported recurrences and no reported metastases during follow-up.

To appreciate why that number matters, it helps to understand what the conventional alternative achieves. Wide local excision, the most commonly reported treatment for hidradenocarcinoma, removes the visible tumor together with a predetermined margin of surrounding tissue, typically several centimeters in every direction. The excised specimen is then examined by a pathologist, who checks whether the margins are free of tumor. Recurrence rates for hidradenocarcinoma treated this way range from 10 to 50 percent in the published literature, a spread that reflects both the biology of the tumor and the difficulty of ensuring that invisible fingerlike extensions of cancer have been completely removed.

Mohs micrographic surgery takes the opposite approach to margin control. Instead of removing a fixed block of tissue and waiting for pathology results, the Mohs surgeon removes the tumor in thin layers. Each layer is immediately frozen, sectioned, stained, and examined under the microscope while the patient waits in the office. The microscope is used to map exactly where tumor cells remain, and only those specific areas are excised in the next layer. The process repeats until every margin is microscopically clear. The result is a surgical technique that achieves complete margin assessment, rather than the sampling assessment that conventional pathology provides, while sparing as much healthy tissue as possible.

That tissue-sparing quality is particularly valuable for hidradenocarcinoma because of where these tumors tend to appear. The review notes that cases have arisen on the scalp, the forehead, the nose, the vulva, and the abdominal wall, sites where wide excision can be disfiguring or technically challenging. One of the studies included in the review described the challenge of treating hidradenocarcinoma on a rhinophymatous nose, where distorted anatomy made histologic interpretation genuinely difficult, a situation the authors of that report called a histologic conundrum. Another described a multidisciplinary approach combining Mohs surgery with other specialties to manage a hidradenocarcinoma of the scalp. In each of these scenarios, the ability to trace tumor extensions microscopically, layer by layer, offers a rational advantage over removing a large fixed margin and hoping it was enough.

The biology of hidradenocarcinoma helps explain why margin control is so critical. The tumor is known by several names in the literature, including malignant hidradenoma, malignant acrospiroma, clear cell eccrine carcinoma, and primary mucoepidermoid cutaneous carcinoma, reflecting a long history of debate about its exact classification. What unites these labels is that the tumor arises from the eccrine or apocrine sweat duct apparatus and behaves with a propensity for local infiltration and, in a meaningful minority of cases, metastasis to lymph nodes and distant organs. Reported cases in the broader literature describe patients requiring surgery combined with chemotherapy for metastatic disease, or wide excision plus adjuvant radiotherapy for tumors of the trunk. Against that backdrop, a surgical series with zero recurrences is not a trivial statistical curiosity but a signal worth investigating.

The authors of the review are careful, appropriately, not to overclaim. Eighteen cases spread across seven studies is a small foundation, and the studies themselves are largely case reports and small case series, the weakest tier of the clinical evidence hierarchy. Patients were not randomized to Mohs surgery versus wide local excision, follow-up durations varied, and publication bias likely favors the reporting of successful outcomes. The authors explicitly state that the generalizability of current findings is limited by the existing literature, and they frame their result not as a practice-changing conclusion but as a call for larger, controlled studies to better define the role of Mohs micrographic surgery in hidradenocarcinoma management, whether as a sole treatment or in combination with adjunct therapies such as sentinel lymph node mapping or radiotherapy.

That caution is consistent with how the field has historically handled ultra-rare tumors. When a cancer is so uncommon that no single institution can accumulate a meaningful series, the evidence base is built case by case, and narrative reviews like this one serve as the mechanism for aggregating scattered experience into something approaching a signal. The Mayo Clinic experience included in the review, covering Mohs treatment of hidradenocarcinoma from 1993 to 2013, represents one of the largest single-institution contributions, and even it contributed only a handful of cases. A more recent case series from Scripps Clinic, published in 2024, similarly combined institutional experience with a systematic review of the literature, underscoring how slowly the evidence accumulates for a tumor that most dermatologists may see once, if ever, in a career.

For clinicians, the practical takeaway is nuanced. Wide local excision remains the most commonly reported and most widely accepted treatment, and no guideline currently recommends replacing it with Mohs surgery on the strength of eighteen cases. But the review gives surgeons treating a hidradenocarcinoma in a cosmetically or functionally sensitive location, such as the face, scalp, or genital skin, a documented body of experience supporting Mohs micrographic surgery as a reasonable alternative, particularly when the goal is complete microscopic margin control without sacrificing large amounts of tissue. It also reinforces the importance of long-term surveillance regardless of the surgical approach, because even the most optimistic case series cannot yet rule out late recurrences or metastases.

For patients, the message is one of cautious optimism. A cancer that has historically recurred in as many as half of treated cases may, in the documented experience of Mohs surgery to date, have been cured in every reported instance. That gap between 10 to 50 percent recurrence and zero recurrences is exactly the kind of discrepancy that motivates the larger, controlled studies the authors are calling for. Until those studies exist, the eighteen patients whose outcomes form the backbone of this review represent both the best evidence available and a compelling argument that the microscope, used layer by layer in the operating room, may deserve a larger role in the fight against one of dermatology’s rarest and most feared tumors.

Subject of Research: Treatment of hidradenocarcinoma with Mohs micrographic surgery

Article Title: Hidradenocarcinoma: a narrative review of treatment with Mohs micrographic surgery

Article References: Janappareddi, A., Kamineni, D. P., Kaur, P., Collins, C. L., Almatroud, L., Verzosa, M. S., Oh, A., Sanka, S. A., Kooner, A., Wan, L., Bondugula, N., & Engledow, E. (2026). Hidradenocarcinoma: a narrative review of treatment with Mohs micrographic surgery. Archives of Dermatological Research, 318(1), Article 466. https://doi.org/10.1007/s00403-026-04955-3

Image Credits: AI Generated

DOI: 10.1007/s00403-026-04955-3

Keywords: hidradenocarcinoma, Mohs micrographic surgery, wide local excision, sweat gland cancer, eccrine carcinoma, dermatologic surgery, cancer recurrence, skin cancer, narrative review, adjuvant therapy, dermatology, malignant acrospiroma

The study, published as a short report in the Archives of Dermatological Research, examined patients with stage T1a and T1b melanomas—lesions that are, by definition, thin and caught early—who were treated with Mohs micrographic surgery between 2008 and 2018 at a single tertiary care academic institution. The researchers combed patient charts to record three key variables for each case: the initial margin used when Mohs surgery began, whether the melanoma recurred, and whether the patient ultimately died of melanoma. Statistical analysis then tested whether the width of the starting margin influenced the risk of dying from the disease. The answer, according to the data, was no.

Only two of the 326 patients died from melanoma during the follow-up period, and both of those patients had received relatively generous initial margins of 8 millimeters and 10 millimeters respectively. That detail is striking because it runs counter to the intuitive logic that wider margins should offer greater protection. With such a small number of events, the study cannot definitively prove that margin size is irrelevant to survival, but the near-total absence of melanoma deaths across a decade of patients—regardless of whether surgeons started with margins smaller or larger than one centimeter—adds to a growing body of evidence that the initial margin in Mohs surgery is not a critical determinant of survival outcomes.

To understand why this finding is significant, it helps to consider what makes Mohs micrographic surgery fundamentally different from a conventional wide local excision. In a standard excision, the surgeon removes the tumor along with a predetermined cuff of healthy-appearing skin, and the specimen is sent to a pathology laboratory where tissue is sampled at intervals—often through vertical sectioning that examines only a small fraction of the true margin. If malignant cells remain at the surgical edge, they may escape detection. Mohs surgery, by contrast, is built around complete margin control. The surgeon removes the visible tumor with a thin initial layer, then processes that tissue so that 100 percent of the peripheral and deep margins can be examined under the microscope while the patient waits. If cancer cells are identified anywhere along the margin, the surgeon maps their location and removes another thin layer precisely where the disease persists, repeating the process until the margins are entirely clear.

It is this exhaustive margin evaluation, the study’s authors argue, that likely explains why the initial margin width does not influence melanoma-specific mortality. When the first excision is narrow and tumor extends beyond it, the Mohs technique detects and removes those residual cells in subsequent stages. When the first excision is wide, fewer stages may be needed, but the final result—histologically clear margins—is the same. In other words, the initial margin functions less as a therapeutic boundary and more as a starting point for an iterative process whose endpoint is defined by microscopic confirmation rather than by a measurement taken before the first cut. The safety net of complete margin evaluation means that a conservative starting margin does not translate into a higher risk of leaving disease behind.

The choice of initial margins in Mohs surgery for melanoma has long been both variable and controversial. Many surgeons opt for starting margins of less than one centimeter, reasoning that the technique’s complete margin assessment makes large initial cuffs unnecessary and that smaller initial excisions spare more healthy tissue—a consideration of particular importance on the face, ears, and other cosmetically and functionally sensitive sites where melanomas are common. Others have argued for wider initial margins, extrapolating from guidelines developed for wide local excision, where the margin itself is the primary safeguard against residual disease. The new findings lend support to the former camp, suggesting that conservative starting margins in Mohs surgery do not compromise survival.

The results also align with a broader shift in the evidence base surrounding Mohs surgery for melanoma. A 2022 systematic review and meta-analysis found that local recurrence of melanoma is higher after wide local excision than after Mohs micrographic surgery or staged excision, challenging the assumption that the traditional approach offers superior local control. A 2023 systematic review and meta-analysis focused specifically on margins concluded that disease-specific survival after Mohs surgery is not impacted by initial margin selection, and a separate National Cancer Database analysis published the same year found no survival benefit associated with wide-margin Mohs surgery for melanoma. Studies comparing the two techniques directly have reported that Mohs surgery is associated with excellent efficacy and low recurrence rates, and some database analyses have even suggested improved overall survival for melanomas of the head, neck, trunk, and extremities treated with the Mohs approach compared with wide local excision.

Historically, the use of Mohs micrographic surgery for melanoma was itself contentious, with early guidelines favoring wide local excision as the standard of care for all invasive melanomas. Concerns centered on whether the technical demands of processing melanoma tissue—interpreting atypical melanocytes at margins is more subtle than assessing epithelial cancers such as basal cell or squamous cell carcinoma—could be met reliably. Over time, refinements in technique, including the use of immunohistochemical stains that highlight melanocytes, and accumulating outcome data have eroded that skepticism. A 2021 systematic review catalogued the many technical variations now in use for Mohs surgery for melanoma, and current practice guidelines have evolved to acknowledge the technique’s role, particularly for melanomas arising in anatomically constrained locations where wide excision would cause significant morbidity.

The authors of the new report are careful to note the limitations of their work. The study was retrospective, relying on chart review rather than prospective randomization, which introduces the possibility of unmeasured confounding. The cohort, while sizable for a single institution, was limited in number, and the range of initial margin sizes actually used by surgeons constrained the statistical power to detect small effects. Most importantly, only two melanoma deaths occurred in the entire cohort, which means the analysis rests on an extremely small number of events. A truly definitive answer to the margin question would require a much larger, ideally multi-center or randomized comparison. Nevertheless, the consistency of the finding with prior meta-analytic evidence strengthens the case that initial margin selection is not a survival-critical variable in this setting.

For patients with thin melanomas, the practical implications are encouraging. The study suggests that surgeons using Mohs micrographic surgery can select conservative initial margins without fear of compromising survival, provided the technique’s complete margin evaluation is performed rigorously. Smaller initial excisions mean less tissue removed, smaller defects to reconstruct, and potentially better cosmetic and functional outcomes—benefits that are especially meaningful when melanomas arise on the face and other visible or functionally critical sites. As evidence accumulates that margin selection in Mohs surgery for early melanoma does not affect disease-specific mortality, the conversation among surgeons may shift from how wide to start toward how to optimize the iterative margin-mapping process itself, ensuring that the microscopic certainty that defines the technique remains its true protective power.

Subject of Research: The effect of initial Mohs micrographic surgery margin size on disease-specific mortality in patients with early-stage melanoma.

Article Title: Impact of initial Mohs micrographic surgery margins for melanoma on disease specific mortality

Article References: Cull, D., Campbell, E., Bangalore-Kumar, A., Trischman, T., Asamoah, E., Vidal, N. Y., & Demer, A. (2026). Impact of initial Mohs micrographic surgery margins for melanoma on disease specific mortality. Archives of Dermatological Research, 318(1), Article 453. https://doi.org/10.1007/s00403-026-04904-0

Image Credits: AI Generated

DOI: 10.1007/s00403-026-04904-0

Keywords: Mohs micrographic surgery, melanoma, surgical margins, disease-specific mortality, skin cancer, wide local excision, T1 melanoma, margin control, dermatologic surgery, melanoma survival, recurrence, surgical oncology