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      Double-Bladed Scalpel in Mohs Micrographic Surgery

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          Abstract

          Mohs micrographic surgery is a tissue-sparing technique that allows for excision of cutaneous tumors under complete microscopic margins control. Mohs surgery boasts high cure rates and maximum tissue conservation. We introduce the double-blade scalpel in Mohs surgery as a timesaving and easy way to harvest tissue strips of uniform width and therefore increase the intraoperative efficiency of the procedure.

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          Most cited references17

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          Guidelines for the management of basal cell carcinoma.

          This article represents a planned regular updating of the previous British Association of Dermatologists guidelines for the management of basal cell carcinoma. These guidelines present evidence-based guidance for treatment, with identification of the strength of evidence available at the time of preparation of the guidelines, and a brief overview of epidemiological aspects, diagnosis and investigation.
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            Nonmelanoma skin cancer.

            Nonmelanoma skin cancers (NMSCs) represent the most common cancer in the United States, accounting for more than 2 million cases per year. Despite the magnitude of health burden on the US population, there remain many questions regarding the epidemiology, health outcomes, and treatments of NMSCs. This article highlights these areas of clinical and research need. The article focuses on the recent epidemiologic trends as well as health outcomes of NMSCs in the United States. In addition, current national guidelines, available treatments and care pathways, and clinical trials are discussed. Published by Elsevier Inc.
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              High and sustained efficacy after two sessions of topical 5-aminolaevulinic acid photodynamic therapy for basal cell carcinoma: a prospective, clinical and histological 10-year follow-up study.

              Prolonged follow-up data on topical photodynamic therapy (PDT) in basal cell carcinoma (BCC) are necessary for a full evaluation of its effect and for comparison with conventional treatment methods. To assess 10-year long-term PDT efficacy in primary and recurrent BCC and to evaluate clinical and histopathological factors which may be associated with treatment failure. We performed a longitudinal study on 60 histologically verified BCCs in 44 patients treated with curettage and one or two sessions of dimethylsulphoxide (DMSO)-supported topical 5-aminolaevulinic acid (ALA)-based PDT. Treated lesions were investigated by clinical and histopathological examination at regular intervals. The main outcomes were 10-year lesion complete response rate using a time-to-event analysis, histological treatment failure and cosmesis. Overall complete response rate for all lesions was 75% (95% confidence interval 64-87%); 60% after one and 87% after two treatment sessions. The response rate was 78% for primary lesions; 63% after one and 90% after two sessions. The cosmetic outcome was rated as good or excellent in 91-100% of evaluated cases. Treatment failure was documented in 15 (25%) of 60 lesions; clinical investigation identified 14 of them. All failures were noted within 3 years of treatment. Male gender, recurrent tumour and one treatment session were factors significantly associated with treatment failure. The only lesion larger than 2·0 cm relapsed. Two sessions of DMSO-supported topical ALA-PDT and curettage can provide long-term effective treatment results with favourable cosmetic outcome in primary, small BCC. © 2012 The Authors. BJD © 2012 British Association of Dermatologists.
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                Author and article information

                Journal
                ISRN Dermatol
                ISRN Dermatol
                ISRN.DERMATOLOGY
                ISRN Dermatology
                International Scholarly Research Network
                2090-4592
                2090-4606
                2012
                19 December 2012
                : 2012
                : 617314
                Affiliations
                1Center of R&D in Plastic Surgery, Soroka University Medical Center, Ben-Gurion University of the Negev, P.O. Box 151, 84101 Beer-Sheva, Israel
                2Division of Plastic and Reconstructive Surgery, Soroka University Medical Center, Ben-Gurion University of the Negev, P.O. Box 151, 84101 Beer-Sheva, Israel
                Author notes
                *Eldad Silberstein: eldads@ 123456bgu.ac.il

                Academic Editors: C. Ferrándiz, C.-C. Lan, and A. Zalewska

                Article
                10.5402/2012/617314
                3535742
                23316382
                759cec88-27af-45a4-ac6f-4a04030aa214
                Copyright © 2012 Ofer Arnon et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 14 October 2012
                : 6 December 2012
                Categories
                Clinical Study

                Dermatology
                Dermatology

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