Mohs Micrographic Surgery

Keyvan NouriEditor

Mohs Micrographic Surgery

EditorKeyvan Nouri, M.D.Department of Dermatology and Cutaneous Surgery University of Miami Leonard M. Miller School of Medicine Miami, FL USA

Sylvester Comprehensive Cancer Center University of Miami Hospital and Clinics Miami, FL USA

ISBN 978-1-4471-2151-0 e-ISBN 978-1-4471-2152-7DOI 10.1007/978-1-4471-2152-7Springer London Dordrecht Heidelberg New York

British Library Cataloguing in Publication DataA catalogue record for this book is available from the British Library

Library of Congress Control Number: 2011944218

© Springer-Verlag London Limited 2012Apart from any fair dealing for the purposes of research or private study, or criticism or review, as per-mitted under the Copyright, Designs and Patents Act 1988, this publication may only be reproduced, stored or transmitted, in any form or by any means, with the prior permission in writing of the publish-ers, or in the case of reprographic reproduction in accordance with the terms of licenses issued by the Copyright Licensing Agency. Enquiries concerning reproduction outside those terms should be sent to the publishers.The use of registered names, trademarks, etc., in this publication does not imply, even in the absence of a specifi c statement, that such names are exempt from the relevant laws and regulations and therefore free for general use.Product liability: The publisher can give no guarantee for information about drug dosage and application thereof contained in this book. In every individual case the respective user must check its accuracy by consulting other pharmaceutical literature.

Printed on acid-free paper

Springer is part of Springer Science+Business Media (www.springer.com)

I dedicate this book to my patients, for whom it is written for.I dedicate this book to my family and friends who have been there for me in every instance of my life.I dedicate this book to my wife Dr. Firouzeh Miremadi and my son Kian Nouri.I dedicate this book to my mother Mrs. Zohreh Khajavi-Noori, my father Dr. Ali Nouri, my sister Dr. Mahnaz Nouri, my uncle Dr. Farrokh Khajavi, my grandparents, and the rest of my dear family.

I love you all.Keyvan Nouri, M.D.

vii

Foreword

The incidence of skin cancers is rising annually. Non-melanoma skin cancers (NMSC)constitute a large majority of all skin cancers, with more than 3,500,00 new cases reported in the United States per year. There has been a noticeable rise in NMSCs among the immunosuppressed population such as transplant patients, HIV/AIDS patients etc.

The technique of Mohs micrographic surgery was invented by Frederic E. Mohs while he was working as a cancer research assistant during his medical school in the early 1930s. His observation that the microscopic details of the tissue were retained upon an intratumoral injection of 20% zinc chloride, led to the genesis of the idea of excising cancer under microscopic control.

Later in 1953, Dr. Mohs demonstrated the fresh tissue technique while performing Mohs on a basal cell carcinoma (BCC) on the eyelid. A 5-year cure rate of 100% using the fresh-tissue technique to excise eyelid carcinomas was reported in 1969. Wide acceptance of the fresh-tissue technique increased substantially and has become a very popular method in the United States. It is considered the technique of choice and stan-dard of care for NMSCs with certain criteria due to the fact that it provides the highest cure rate and maximal tissue conservation with smallest possible defect. Mohs Surgery has been used for NMSCs, some forms of melanoma and other rare cutaneous tumors.

Mohs Micrographic Surgery has become more and more popular dramatically. Fellowships have been set up for teaching Mohs Micrographic Surgery, and recently these techniques under the auspices of American College of Graduate Medical Education (ACGME) has been renamed Procedural Dermatology. The main components of Procedural Dermatology aim at developing profi ciency and skill in Mohs Surgery.

Mohs Micrographic Surgery by Keyvan Nouri is the most up to date, comprehen-sive and easy to comprehend textbook in the area of Mohs surgery. It includes sec-tions on Fundamentals of Mohs Micrographic Surgery, Laboratory Processing, Mohs Micrographic Surgery by tumor and site, Pitfalls of Mohs Micrographic Surgery, Reconstructive and Adjuvant Techniques, Training and Certifi cation in Mohs Micrographic Surgery and Patient Safety and Medicolegal Issues. The authors of the book are some of the most reputable surgeons in the fi eld. The book also includes a section on International Perspective of Mohs Micrographic Surgery which highlights the Mohs surgical practices in various parts of the world.

To sum, I strongly recommend the textbook Mohs Micrographic Surgery by Dr. Keyvan Nouri and published by Springer as one of the best textbooks in this area. I congratulate Dr. Nouri and all the authors and publishers for putting together such a comprehensive and illustrious textbook.

Perry Robins Professor Emeritus of Mohs Micrographic Surgery of NYU medical center

President of Skin Cancer Foundation

ix

Preface

Mohs micrographic surgery has revolutionized the practice of cutaneous oncology with its method of accurate, staged intraoperative histological analysis. The indica-tions for the procedure and technique have been drastically expanded, yet the under-lying principles put forth by Dr. Frederic Mohs approximately prior to 70 years remain largely unchanged. The technique evolved from the fi xed tissue method utiliz-ing zinc chloride for chemosurgery to the present day fresh frozen tissue technique. With the advent of the fresh frozen tissue technique, the ability to conduct extensive reconstructive surgery became available to dermatologic surgeons. As a result, der-matologists began performing extensive procedures that had previously been carried out by other specialties. The dermatologic surgeons then began forming organiza-tions that were dedicated to advances in the fi eld of dermatologic surgery and cutane-ous oncology. Now immunostains are beginning to be implemented, which have expanded the utility of Mohs surgery to treat certain forms of melanomas and other rare or unusual tumors. Nearly 3.5 million new cases of skin cancer are diagnosed per annum, of which a large percentage will be treated by Mohs micrographic surgery. The indications for Mohs micrographic surgery are moving beyond the traditional basal cell and squamous cell carcinoma to include: dermatofi brosarcoma protuber-ans, microcystic adnexal carcinoma, atypical fi broxanthoma, sebaceous carcinoma, extramammary Paget’s disease, and Merkel cell carcinoma.

This textbook attempts to explore Mohs micrographic surgery in all of its realms and presents a thorough representation of the surgical practice. Each chapter is easy to read with summary boxes to emphasize the major points. The chapters are written by well-known experts in their respective fi elds. We have included an international section to highlight the progression of Mohs surgery throughout the world. As we have transgressed into the modern era of the practice of Mohs surgery, the medicole-gal issues along with the relevant ethical and patient safety considerations are also explored.

Overall, the reader should enjoy an up-to-date, reliable source of information dis-cussing the important aspects of Mohs surgery. The reader will obtain a detailed understanding of this surgical practice, which will undoubtedly improve patient care.

Miami, FL, USA Keyvan Nouri, M.D.

xi

Acknowledgements

I sincerely thank all the authors of this textbook. These individuals are world-renowned in their respective specialties and without their time and energy, writing this book would have not been possible. These individuals have made this a comprehensive, up-to-date, and reliable source on Mohs micrographic surgery. I truly appreciate their hard work and thank them for their contributions.

Throughout my career, my family has always supported my many endeavors. I cannot thank them enough for their kind encouragement and love.

I would like to give a special thanks to Dr. Lawrence A. Schachner, Chairman of the Department of Dermatology and Cutaneous Surgery at the University of Miami Miller School of Medicine. He has been my mentor throughout my professional career. His guidance and role as an advisor over the years have infl uenced my efforts.

I am grateful to Dr. William H. Eaglestein, former Chairman of Dermatology at the University of Miami School of Medicine for helping and guiding me since my start in dermatology. I appreciate all of his guidance and support.

Thank you to Dr. Perry Robins, Dr. Robin Ashinoff, Dr. Vicki Levine, Dr. Seth Orlow, the late Dr. Irvin Freedberg, Dr. Hideko Kamino, and the entire faculty and staff at New York University School of Medicine Department of Dermatology. You have all created a wonderful learning and friendship experience during my surgery fellowship.

I would like to thank the faculty, dermatology residents, and staff of the Department of Dermatology and Cutaneous Surgery at the University of Miami Miller school of Medicine for their teaching, expertise, and friendship. I give special acknowledge-ments to the Mohs and Laser Center staff at the Sylvester Cancer Center for their hard work and support on a daily basis. I would also like to thank Maria D. Garcia, my administrative assistant, for her diligence and hard work and the rest of the Mohs staff, including Cathy Mamas, Juana Alonso, Tania Garcia, Veronica Sanchez, Liseth Velasquez, Tatania Carmouze and Lisbeth Napoles. Thank you for making my job a pleasure.

Thank you to Dr. Sonal Choudhary and Michael Patrick McLeod, my research fel-lows, as well as Dr. Yasser Al-qubaisy, my clinical fellow, for all their hard work and dedication to composing the book. Also, I would like to thank the medical student, Marilyn Zabielinski, and international fellow Dr. Katlein Franca, for their contributions.

I would also like to acknowledge the publishing staff Mr. Grant Weston, Ms. Linda Jacobs, Ms. Cate Rogers, and the entire Springer Publishing team for having done a superb job with the publication. It has been a pleasure working with them and this excellent project to compile the textbook.

Keyvan Nouri, M.D.

xiii

Contents

1 An Introduction to Mohs Micrographic Surgery . . . . . . . . . . . . . . . . . . 1Michael P. McLeod, Sonal Choudhary, and Keyvan Nouri

2 Indications for Mohs Micrographic Surgery . . . . . . . . . . . . . . . . . . . . . 5Michael P. McLeod, Sonal Choudhary, Yasser A. Alqubaisy, and Keyvan Nouri

3 Preoperative Evaluation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13Sean R. Christensen and Sumaira Z. Aasi

4 Mohs Micrographic Surgery Operative Room Setup . . . . . . . . . . . . . . 35Tobechi L. Ebede, Indira Singh, and Kishwer S. Nehal

5 Anesthetic Considerations: Local Versus Regional . . . . . . . . . . . . . . . . 53Michael P. McLeod, Sonal Choudhary, Yasser A. Alqubaisy, and Keyvan Nouri

6 Cutaneous Anatomy in Mohs Micrographic Surgery . . . . . . . . . . . . . . 61Diana Bolotin and Murad Alam

7 Mohs Surgery: Fixed Tissue Technique . . . . . . . . . . . . . . . . . . . . . . . . . 77Pearon G. Lang and Martin Braun III

8 Fresh Tissue Technique . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83Michael P. McLeod, Katlein França, and Keyvan Nouri

9 Special Considerations for Mohs Micrographic Surgery in Organ Transplant Recipients . . . . . . . . . . . . . . . . . . . . . . . . 87Thomas Stasko and Daniel L. Christiansen

10 Mohs Micrographic Surgery in Ethnic Skin . . . . . . . . . . . . . . . . . . . . . 99Brooke A. Jackson

11 Histopathology Laboratory Setup and Necessary Instrumentation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 105Marilyn Zabielinski, Michael P. McLeod, Sonal Choudhary, and Keyvan Nouri

12 Tissue Transport and Initial Processing Cryostat Preparation of Slides . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 117Michael P. McLeod, Sonal Choudhary, Katlein França, and Keyvan Nouri

13 Histopathologic Interpretation of Mohs Slides . . . . . . . . . . . . . . . . . . . 123Ashraf M. Hassanein and Hatem A. Hassanein

xiv Contents

14 Tissue Specimen Documentation, Record Keeping, and Sample Storage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 149Jeremy S. Youse, Robert H. Cook-Norris, Richelle M. Knudson, and Randall K. Roenigk

15 Immunostains . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 161Kapila V. Paghdal, Basil S. Cherpelis, and L. Frank Glass

16 Basal Cell Carcinoma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 177Michael P. McLeod, Sonal Choudhary, Yasser A. Alqubaisy, and Keyvan Nouri

17 Squamous Cell Carcinoma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 189Nicole R. LeBoeuf, Lorraine M. Jennings, Andrew E. Werchniak, and Chrysalyne D. Schmults

18 Mohs Micrographic Surgery for the Treatment of Cutaneous Melanoma . . . . . . . . . . . . . . . . . . . . . . 211Michael Campoli, Scott Freeman, David G. Brodland, and John Zitelli

19 Dermatofi brosarcoma Protuberans . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 225Novie Sroa and Nathalie C. Zeitouni

20 Microcystic Adnexal Carcinoma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 243Ioulios Palamaras and Richard J. Barlow

21 Atypical Fibroxanthoma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 253Richelle M. Knudson, Robert H. Cook-Norris, Jeremy S. Youse, and Randall K. Roenigk

22 Extramammary Paget Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 263Bradley G. Merritt and David G. Brodland

23 Leiomyosarcoma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 279Marc Rubenzik, Boonyapat Limthongkul, and Tatyana R. Humphreys

24 Merkel Cell Carcinoma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 287Stephanie A. Diamantis and Victor J. Marks

25 Selected Sweat Gland Carcinomas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 295Howard A. Oriba and Stephen N. Snow

26 Sebaceous Carcinoma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 315Stephen N. Snow and Yaohui Gloria Xu

27 Mohs Micrographic Surgery for the Eyelid . . . . . . . . . . . . . . . . . . . . . . 331Michael P. McLeod, Marilyn Zabielinski, Sonal Choudhary, and Keyvan Nouri

28 Mohs Surgery for Periungual and Subungual Skin Cancer . . . . . . . . . 341Steven Chow and Richard G. Bennett

29 Genitalia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 353Irene Vergilis-Kalner and Arash Kimyai-Asadi

30 Deep Structures of the Head and Neck . . . . . . . . . . . . . . . . . . . . . . . . . . 363Sarah G. Baker, Douglas M. Sidle, and Simon Yoo

Contents xv

31 Complications of Mohs Micrographic Surgery . . . . . . . . . . . . . . . . . . . 383Adam A. Ingraffea and Hugh M. Gloster Jr

32 Eyelid Reconstruction After Mohs Micrographic Surgery . . . . . . . . . . 395Jennifer I. Hui and David T. Tse

33 Flaps . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 405Jessica M. Sheehan and Thomas E. Rohrer

34 Skin Grafting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 433Susana M. Leal-Khouri and Sarah E. Grummer

35 Side to Side Closure After Mohs Surgery . . . . . . . . . . . . . . . . . . . . . . . . 443Michael P. McLeod, Katlein França, Sonal Choudhary, Yasser A. Alqubaisy, and Keyvan Nouri

36 Prosthetic Rehabilitation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 447Glenn E. Turner and Jeffrey E. Rubenstein

37 Combination Therapy for the Nonsurgical Treatment of Skin Cancers: Latest Research at Mount Sinai . . . . . . . . . . . . . . . . 465Ellen S. Marmur and Hooman Khorasani

38 Training and Regulation in Mohs Surgery . . . . . . . . . . . . . . . . . . . . . . . 475Suzanne M. Olbricht

39 Establishing a Mohs Practice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 479Pearon G. Lang, Martin Braun III, Carlette M. Geddis, and Jamie L. Benenhaley

40 International Perspective of Mohs Micrographic Surgery: South America . . . . . . . . . . . . . . . . . . . . . . . . . 493Luis Fernando F. Kopke and Gaston Nestor Galimberti

41 International Perspective of Mohs Micrographic Surgery: Europe . . 497James A.A. Langtry

42 International Perspective of Mohs Micrographic Surgery: East Asia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 503Satoru Aoyagi

43 International Perspective of Mohs Micrographic Surgery: Australia and New Zealand . . . . . . . . . . . . . . . . . . . . . . . . . . . 509Greg Julian Goodman, Vanessa A. Morgan, Tim J. Rutherford, Edward J. Upjohn, and Paul J.M. Salmon

44 Information for Patients and Safety Considerations . . . . . . . . . . . . . . . 519Ilya Reyter, Abel Torres, and Neda Mehr

45 Ethical Issues Related to Mohs Skin Cancer Surgery . . . . . . . . . . . . . . 529David J. Goldberg

46 Medicolegal Issues Regarding Mohs Micrographic Surgery . . . . . . . . 537Ilya Reyter, Tanya Nino, and Abel Torres

47 Psychological Issues Regarding Mohs Micrographic Surgery . . . . . . . 549Misha M. Heller, Tina Bhutani, Eric S. Lee, and John Koo

Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 561

xvii

Contributors

Sumaira Z. Aasi , M.D. Department of Dermatology , Yale University , New Haven , CT , USA

Murad Alam , M.D., M.Sci. Department of Dermatology , Northwestern University , Chicago , IL , USA

Yasser A. Alqubaisy , M.D. Department of Dermatology and Cutaneous Surgery , University of Miami Hospital , Miami , FL , USA

Satoru Aoyagi , M.D., Ph.D. Department of Dermatology , Hokkaido University Graduate School of Medicine , Sapporo , Japan

Sarah G. Baker , M.D. Department of Dermatology , Northwestern University , Chicago , IL , USA

Richard J. Barlow , M.B., B.C.H., M.D., FRCP St. John’s Institute of Dermatology , St. Thomas’ Hospital , London , UK

Jamie L. Benenhaley Trident Dermatology , Charleston , SC , USA

Richard G. Bennett , M.D. Department of Dermatology , UCLA and USC , Santa Monica , CA , USA

Tina Bhutani , M.D. Department of Dermatology , UCSF Psoriasis and Skin Treatment Center , San Francisco , CA , USA

Diana Bolotin , M.D., Ph.D. Department of Dermatology , Northwestern University , Chicago , IL , USA

Martin Braun III, M.D. Braun Dermatology , George Washington University , Washington , DC , USA

David G. Brodland , M.D. Departments of Dermatology and Otolaryngology, Shadyside Medical Center , University of Pittsburgh Medical Center , Pittsburgh , PA , USA

Michael Campoli , M.D., Ph.D. Fellows, Zitelli & Brodland, P.C. , Pittsburgh , PA , USA

Basil S. Cherpelis , M.D. Dermatology and Cutaneous Surgery , University of South Florida , Tampa , FL , USA

Sonal Choudhary , M.D. Department of Dermatology and Cutaneous Surgery , University of Miami Leonard M. Miller School of Medicine , Miami , FL , USA

Steven Chow , M.D., M.S. Department of Dermatology , University of Southern California , Santa Monica , CA , USA

xviii Contributors

Sean R. Christensen , M.D., Ph.D. Department of Dermatology , Yale University School of Medicine , New Haven , CT , USA

Daniel L. Christiansen , M.D. Department of Medicine, Division of Dermatology , Vanderbilt Medical Center , Nashville , TN , USA

Robert H. Cook-Norris , M.D. Department of Dermatology , Mayo Clinic , Rochester , MN , USA

Stephanie A. Diamantis , M.D. Department of Dermatology , Geisinger Medical Center , Danville , PA , USA

Tobechi L. Ebede , M.D. Dermatology Service , Memorial Sloan Kettering Cancer Center , New York , NY , USA

Katlein França , M.D. Department of Dermatology and Cutaneous Surgery , University of Miami Leonard M. Miller School of Medicine , Miami , FL , USA

Scott Freeman , M.D. Fellows, Zitelli & Brodland, P.C. , Pittsburgh , PA , USA

Gaston Nestor Galimberti , M.D. Department of Dermatology , School of Medicine Italian Hospital , Buenos Aires , Argentina

Carlette M. Geddis , B.S., H.T.L. Trident Dermatology , Charleston , SC , USA

L. Frank Glass , M.D. Dermatology and Cutaneous Surgery , University of South Florida , Tampa , FL , USA

Hugh M. Gloster Jr., M.D. Department of Dermatology , University of Cincinnati , Cincinnati , OH , USA

David J. Goldberg , M.D., J.D. Department of Dermatology , Mount Sinai School of Medicine , New York , NY , USA

Greg Julian Goodman , M.B.B.S. (Hons), M.D., FACD, Grad. Dip. Clin. Epi. Dermatology Institute of Victoria , South Yarra , VIC , Australia

Sarah E. Grummer , M.D. Department of Mohs Surgery, Dermatology and Plastic Surgery , Key Biscayne, Dade , FL , USA

Ashraf M. Hassanein , M.D., Ph.D. Medical Director, Florida Pathology and Dermatologic Surgery & Aesthetics Institute , The Villages , FL , USA

Hatem A. Hassanein , B.Sc. Department of Microbiology and Biomedical Sciences , University of South Florida College of Medicine, Tampa , FL , USA

Misha M. Heller , B.A. Department of Dermatology , UCSF Psoriasis and Skin Treatment Center , San Francisco , CA , USA

Jennifer I. Hui , M.D. Department of Ophthalmic Plastic, Orbital Surgery and Oncology service , Bascom Palmer Eye Institute , Miami , FL , USA

Tatyana R. Humphreys , M.D. Department of Dermatology , Thomas Jefferson University , Philadelphia , PA , USA

Adam A. Ingraffea , M.D. Department of Dermatology , University of Cincinnati , Cincinnati , OH , USA

Contributors xix

Brooke A. Jackson , M.D. Department of Dermatology, Skin Wellness Center of Chicago, SC , Chicago , IL , USA

Northwestern Medical School , Chicago , IL , USA

Lorraine M. Jennings , M.B., B.Ch., B.A.O. (Hons) Department of Mohs Micrographic Surgery, Department of Dermatology , Dana Farber Cancer Institute/Brigham and Women’s Hospital , Boston , MA , USA

Hooman Khorasani , M.D. Department of Dermatology , The Mount Sinai Medical Center , New York , NY , USA

Arash Kimyai-Asadi , M.D. DermSurgery Associates , Houston , TX , USA

Richelle M. Knudson , M.D. Department of Dermatology , Mayo Clinic , Rochester , MN , USA

John Koo , M.D. Department of Dermatology , UCSF Psoriasis and Skin Treatment Center , San Francisco , CA , USA

Luis Fernando F. Kopke , M.D. Coordinator of the Department of Micrographic Surgery of the Brazilian Society of Dermatology , President of the Brazilian Society of Dermatologic Surgery, Florianopolis , Santa Catarina , Brazil

Pearon G. Lang , M.D., B.A., M.D. Trident Dermatology , Charleston , SC , USA

James A. A. Langtry , M.B.B.S., FRCP Department of Dermatology , Royal Victoria Infi rmary , Newcastle Upon Tyne, Tyne and Wear , UK

Susana M. Leal-Khouri , M.D., FAAD Department of Dermatology and Cutaneous Surgery , University of Miami , Key Biscayne, Dade , FL , USA

Florida International University School of Medicine , Key Biscayne, Dade , FL , USA

Nicole R. LeBoeuf , M.D. Department of Dermatology , Dana Farber Cancer Institute/Brigham and Women’s Hospital , Boston , MA , USA

Eric S. Lee , B.S. Department of Dermatology , UCSF Psoriasis and Skin Treatment Center , San Francisco , CA , USA

Boonyapat Limthongkul , M.D. Department of Dermatology , Thomas Jefferson University , Philadelphia , PA , USA

Victor J. Marks , M.D. Department of Dermatologic Surgery , Geisinger Health System , Danville , PA , USA

Ellen S. Marmur , M.D. Division of Dermatologic & Cosmetic Surgery, Department of Dermatology , The Mount Sinai Medical Center , New York , NY , USA

Michael P. McLeod , B.S., M.S. Department of Dermatology and Cutaneous Surgery , University of Miami Leonard M. Miller School of Medicine , Miami , FL , USA

xx Contributors

Neda Mehr , M.D. Department of Dermatology , Loma Linda University School of Medicine , Loma Linda , CA , USA

Bradley G. Merritt , M.D. Department of Dermatology , UNC – Chapel Hill , Chapel Hill , NC , USA

Vanessa A. Morgan , M.B.B.S., FRCP Skin and Cancer Foundation , Carlton , VIC , Australia

Kishwer S. Nehal , M.D. Dermatology Service , Memorial Sloan Kettering Cancer Center , New York , NY , USA

Tanya Nino , M.D. Department of Dermatology , Loma Linda University School of Medicine , Loma Linda , CA , USA

Keyvan Nouri , M.D. Department of Dermatology and Cutaneous Surgery , University of Miami Leonard M. Miller School of Medicine , Miami , FL , USA

Sylvester Comprehensive Cancer Center, University of Miami Hospital and Clinics , Miami , FL , USA

Suzanne M. Olbricht , M.D. Department of Dermatology , Lahey Clinic , Burlington , MA , USA

Howard A. Oriba , M.D. Department of Mohs Surgery , The Skin Cancer Center , Sun City Center , FL , USA

Kapila V. Paghdal , M.D., Pharm.D. Dermatology and Cutaneous Surgery , University of South Florida , Tampa , FL , USA

Ioulios Palamaras , M.D., Ph.D. St. John’s Institute of Dermatology , St. Thomas’ Hospital , London , UK

Ilya Reyter , M.D. Department of Dermatology , Loma Linda University School of Medicine , Loma Linda , CA , USA

Randall K. Roenigk , M.D. Division of Dermatologic Surgery, Department of Dermatology , Mayo Clinic , Rochester , MN , USA

Thomas E. Rohrer , M.D. SkinCare Physicians , Chestnut Hill , MA , USA

Jeffrey E. Rubenstein , D.M.D., M.S. Department of Restorative Dentistry , University of Washington , Seattle , WA , USA

Marc Rubenzik , M.D., Ph.D. Department of Dermatology , Thomas Jefferson University , Philadelphia , PA , USA

Tim J. Rutherford , M.B.B.S. (Hons), FACD Victorian Dermatology & Surgery , Malnern , VIC , Australia

Paul J. M. Salmon , MBChB, FRACP, FAAD, FACMS Dermatologic Surgery , Skin Cancer Institute , Tauranga Bay of Plenty , New Zealand

Chrysalyne D. Schmults , M.D., M.S.C.E. Department of Dermatologic Surgery , MOHS Micrographic Surgery Center, Brigham and Women’s Hospital , Boston , MA , USA

Contributors xxi

Jessica M. Sheehan , M.D. Northshore Center for Medical Aesthetics , Northbrook , IL , USA

Douglas M. Sidle , M.D., FACS Department of Otolaryngology – Head & Neck Surgery , Northwestern Feinberg School of Medicine , Chicago , IL , USA

Indira Singh , B.A. Dermatology Service , Memorial Sloan Kettering Cancer Center , New York , NY , USA

Stephen N. Snow , M.D. Department of Dermatology , University of Wisconsin School of Medicine & Public Health , Madison , WI , USA

Novie Sroa , M.D. Department of Dermatology , Roswell Park Cancer Institute , Buffalo , NY , USA

Thomas Stasko , M.D. Department of Medicine, Division of Dermatology, Vanderbilt University , Nashville , TN , USA

Abel Torres , M.D. Department of Dermatology , Loma Linda University School of Medicine , Loma Linda , CA , USA

David T. Tse , M.D., FACS Department of Ophthalmic Plastic, Orbital Surgery and Oncology service , Bascom Palmer Eye Institute , Miami , FL , USA

Glenn E. Turner , D.M.D., M.S.D. Department of Prosthodontics , University of Florida College of Dentistry , Gainesville , FL , USA

Edward J. Upjohn , M.B.B.S., M.Med., FACD Skin and Cancer Foundation , Carlton , VIC , Australia

Irene Vergilis-Kalner , M.D. Assistant Professor of Dermatology , Department of Dermatology , UMDNJ , New Jersey

Andrew E. Werchniak , M.D. Department of Dermatology , Dana Farber Cancer Institute/Brigham and Women’s Hospital , Boston , MA , USA

Yaohui Gloria Xu , M.D., Ph.D. Department of Dermatology , University of Wisconsin , Madison , WI , USA

Simon Yoo , M.D. Department of Dermatology, Otolaryngology, Surgery , Northwestern University , Chicago , IL , USA

Jeremy S. Youse , M.D. Department of Dermatology , Mayo Clinic , Rochester , MN , USA

Marilyn Zabielinski , B.S. University of Miami, Miami, Miami , FL , USA

Nathalie C. Zeitouni , MDCM, FRCPC Department of Dermatology , Roswell Park Cancer Institute , Buffalo , NY , USA

John Zitelli , M.D. Fellows, Zitelli & Brodland, P.C. , Pittsburgh , PA , USA