Talk:Mohs surgery

Staining Conventions
A legend or minimally a description of what this table shows should be provided. The referenced work appears to indicate this is a convention for marking tissue with symbols and/or dyes. I would be happy to write this, but I am uncertain what exactly is being described. --Smcnair (talk) 23:34, 2 September 2014 (UTC)


 * Does anyone know what the colours in the staining mean? It would be cool if someone with the knowledge and citations could add it. Unfortunately my Google fu isn't that strong. Thanks. 2.97.224.2 (talk) 13:48, 9 December 2014 (UTC)

Non-neutral descriptions
"Few individuals argue about the cure rate for Mohs, especially pathologists familiar with the procedure.[1] However, in recent years, a few surgeons attempted to throw the baby out with the bath water by claiming that Mohs surgery is no better than standard excision based on one study" and "tremendous cure rates" and "we really have to question if methodology practiced by Mohs surgeons around the world is of the same standard. We also will have to question if the standard 2 sections performed by some Mohs surgeons is adequate to control for false negative Mohs reports."

This section was written to promote the technique using quite unprofessional language. Please read WP:PEACOCK and rewrite this text. Tim Vickers (talk) 06:06, 7 December 2009 (UTC)

Inappropiate Tone
This does not sound like an encyclopedia entry:  Comparison to other modalities of treatment It often occurs in medicine as in real life, "When you go to Midas, you get a muffler". --Becalmed (talk) 08:55, 10 December 2009 (UTC)

Administrator wants to delete all images
This is his comment:  Fastilysock (talk | contribs) (43,497 bytes) (rm UE images which do not significantly enhance a reader's understanding of article) (undo).

I believe that the images are essential for the understanding of Mohs surgery, ccpdma, and bread loafing. To delete it without discussion is a little bit harsh. Please share your opinion.--Northerncedar (talk) 02:58, 5 January 2010 (UTC)


 * The pictures are important. But not the ones on this web. Preferably to remove them all and have real pictures or better drawings Tototoudemy (talk) 16:21, 28 June 2024 (UTC)

A picture is worth a thousand words. If one can find a better non-copyrighted picture to replace these, feel free to do so.--Northerncedar (talk) 02:59, 5 January 2010 (UTC)


 * These three pictures are useless without further explanations: Divided Mohs Section and the 2 "pac man" pictures, and I would also be in favor of removing them. JEH (talk) 01:41, 28 April 2024 (UTC)

Mohs surgery team recent edits
Mohs surgery should be presented in a generic term in a way that reflects the nature of the surgery. By simply noting the way how it is done in the USA by the standards of certain organization is not a reflection of how it can be performed outside of the "american standard", or certain countries' standard. It can be multidisciplinary. It can be performed by non-dermatologist (look at Dr. Mohs). It can and has been performed by a joint effort between a surgeon and a pathologist. It can, and has been performed by a Mohs surgeon and a reconstructive surgeon. By simply noting that it is done by a Mohs surgeon and a histotechnician reflects the nature of how it is done in one's office - and not the reality of life. The team can be one person - the doctor who wears all 4 hats. By 2 - the mohs surgeon and a tech. By 2, a plastic surgeon and a pathologist. Or by any combination of the 4. To restrict it to the narrow definition as it is practiced in the USA or Israel is wrong. As commented by Dr. Alcalay, ("8:51, 30 January 2010 Alcalay →The Mohs Surgery Team: True Mohs surgery is performed by a single physician that acts in 2 different disciplines: surgeon and pathologist. the information that was written wad incorrect for the...") is suggesting that any other combination using Dr. Mohs method is not Mohs surgery might sound overly arrogant. Wikipedia should not encourage the monopoly by any professional group a skill that is beneficial for all patients. By restricting the Mohs surgery definition, one is embracing the stand of certain trade organization (American College of Mohs...). By restricting Mohs surgery training to dermatologists, one is going against the spirit of Dr. Mohs teachings. An acceptable edit would be: "...by limiting the number of team members to one or two highly trained people, less errors are introduced and quality is maintained." But simply to state that one has a Mohs surgeon (a man by all means), and a technician - means that any other ways is wrong?? --Northerncedar (talk) 00:42, 1 February 2010 (UTC)

Claims that Medicare CPT codes requires that Mohs surgery be done by one surgeon does not define MOHS surgery. (03:09, 13 February 2010 Hungryman12 →The Mohs Surgery Team: corrects Medicare CPT definition that Mohs pathology interpretation must be done by the same physician who performs the cancer surgery.) It is an attempt by medicare insurance of the USA to prevent fraudulent billings by multiple practicioner's in a multi-doctor practice to minimize the 50% fee adjustment schedule of closures and Mohs reimbursement. By using fraudulent billing (3 physicians performing the Mohs procedure), a practice can double his reimbursement for Mohs surgery. This CPT definition is simply trying to prevent billing fraud, and by it self does not define Mohs surgery. Dr. Mohs never required that the process must be done by one physician nor by only dermatologists. Another attempt by a member of a trade organization in the USA to limit Mohs surgery to their own members.--Northerncedar (talk) 11:27, 13 February 2010 (UTC)

Edit war continues with :  20:33, 27 February 2010 98.231.69.242 (talk) (51,927 bytes) (this previously stated that the team included a mohs surgeon, a pathologist, and a reconstructive surgeon. It is NOT considered Mohs surgery if the same individual does not perform the tissue removal). This author should have participated in discussion first.--Northerncedar (talk) 03:56, 28 February 2010 (UTC)

Old sources
Some of these sources are from 1999, 1991 or even 1978. I don't think 15- and 20-year-old textbooks are a reliable source for current outcomes, although Mohs' original work might be of historical interest. Most CME courses expire after 3 years. I think we need something more recent, especially for controversial material. --Nbauman (talk) 02:09, 19 January 2014 (UTC)
 * I just deleted a section called "Where Moh's surgery is allowed". This section gave a list of places on the body and talked about insurance coverage for the procedure in those places. I am noting this here because perhaps it could be useful for someone else to consider whether parts of this could be sourced and reintegrated. Right now, this content is unsourced and the dead link associated with it seems to not be a reliable source.  Blue Rasberry    (talk)   21:16, 6 February 2014 (UTC)

History
The history section looks a lot like an attempt to crowbar Hoxsey into an article on legitimate medical practice. Do we even have sources linking Hoxsey to Mohs? Hoxsey therapy and cansema are unambiguous quackery, long since discredited and illegal to promote in the US, UK and numerous other jurisdictions. There may be a case for rewriting it to reference black salve if there are credible sources but the space expended to explain the difference is likely to overwhelm the coverage of the salves themselves. It's clear that Mohs surgery has no real relationship to black salve. Guy (Help!) 08:26, 6 May 2015 (UTC)
 * i agree that there is no relationship and that content should come out. Jytdog (talk) 10:04, 6 May 2015 (UTC)
 * That was my original reaction, but when I went searching on the web and in Google books, I saw several refs that made the connection. Rather then validating Hoxsey, the section shows that Mohs surgery is an accepted practice with a successful track record using a similar paste and Hoxsey just smears the paste on and hopes for the best, and is a discredited practice. We can make it clearer that Hoxsey has a lousy track record. Richard-of-Earth (talk) 19:48, 6 May 2015 (UTC)
 * I just looked at the changes Guy made and those are just what I was thinking. The whole article seems overly detailed and it keeps going over the technique again and again. It could use trimming and summarizing. If people want to know in depth how the process works, they should read a book. I hate the diagrams, they make it confusing. Richard-of-Earth (talk) 19:56, 6 May 2015 (UTC)

http://ec2-67-202-57-88.compute-1.amazonaws.com/index.php/Mohs_surgery
Is this copyright infringement, or is it a Wikipedia mirror? FoCuS contribs ;  talk to me!  16:46, 2 October 2015 (UTC)
 * Mirror. the article was created on 10 October 2007 (see here) and it closely mirrors the way the Wikipedia article looked at the same time. (see here) Richard-of-Earth (talk) 17:32, 2 October 2015 (UTC)

Photo of outcome of ear- too optimistic
There is a fine balance between objective presentation of Mohs surgery, its values, and limitations. I have strived for years to keep biases, politics, and false statements from this page. The procedure has suffered a black eye from over marketing and is no longer respected because of such implications as the best, the only, and the one way to approach both basal and squamous cell cancer. Which it is not. The photo, although real. And correct in its application is not representative of the typical outcome of the cases where it is truly necessary. Simple excision of a small basal cell cancer with correctly placed margin will give equivalent results. It is the cure rate and narrow margins that is emphasized by frozen section. It irks me as a Mohs surgeon on the marketing push of some of my peers that there is no better approach that prevents me from posting my own cases. As the outcome has to do with the reconstruction and not the Mohs method. A well painted car does not speak of the motor. Nor does the scar speaks of the method. I strive to keep politics and commercialism out of this page since its early day when it was sabotaged daily by Mohs hater. Then the push to have only “one” ownership, then of politics of the societies. This photo is misleading. And patients AND doctors will pay the price for unrealistic expectations. Please do not repost it as it does nothing for the advancement of Mohs surgery. I have contributed over 80 percents if not more of the framework and references of this page. Northerncedar (talk) 02:01, 25 November 2017 (UTC) Northerncedar (talk) 02:10, 25 November 2017 (UTC)
 * I am the patient in question and took this photo of my own ear following my surgery. A sample of one can of course never be fully representative of the range of outcomes but I discussed my situation at length with my own surgeon and he never indicated that my surgery or its results were outside the norm. I have edited and expanded hundreds of Wikipedia articles and contributed many of my photos which are present in many Wikipedia articles. I think this article needs more photos, not zero photos. I simply cannot understand how the article is better off with no photo than with a perfectly legitimate and accurate photo of the ear of a Mohs patient. Cullen328   Let's discuss it  05:13, 25 November 2017 (UTC)
 * Do you have another image you own which you wish to use? Doc James  (talk · contribs · email) 08:08, 25 November 2017 (UTC)

External links modified (February 2018)
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 * Added tag to http://wwwu.tsgh.ndmctsgh.edu.tw/commcpc/images/nccn/Non-Melanoma%20Skin%20Cancer-2007.pdf
 * Added tag to http://wwwu.tsgh.ndmctsgh.edu.tw/commcpc/images/nccn/dfsp%20NCCN%202004.pdf
 * Added tag to http://wwwu.tsgh.ndmctsgh.edu.tw/commcpc/images/nccn/Non-Melanoma%20Skin%20Cancer-2007.pdf
 * Added archive https://web.archive.org/web/20090202191543/http://www.bccancer.bc.ca/HPI/CancerManagementGuidelines/Skin/NonMelanoma/ManagementPolicies/start.htm to http://www.bccancer.bc.ca/HPI/CancerManagementGuidelines/Skin/NonMelanoma/ManagementPolicies/start.htm

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quick review
I trimmed a bunch of excessive detail per WP:NOTHOWTO / [{WP:NOTMANUAL]]. The sources here are very outdated, especially in the outcomes section. Yikes. Will look for reviews etc to update this throughout... Jytdog (talk) 05:23, 20 November 2018 (UTC)