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      Comparison between examination with naked eye, curretage and dermoscopy in determining tumor extension before Mohs micrographic surgery

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          Abstract

          Mohs micrographic surgery (MMS) is a technique for the treatment of cutaneous malignancies. Subtle determination of tumor margin would end to fewer stages of surgery. Our aim was to compare these three ways for determining tumor extension before initiation of MMS, examination with the naked eye, dermoscopy and curettage. Sixty patients who had basal cell carcinoma (BCC) in head and neck area were randomized in three groups (curettage, dermoscopy and examination with the naked eye). Each group encompassed twenty patients. The total number of resection stages in MMS was recorded for each patient. Demographic data of the patients and the total number of resection stages in MMS were statistically analyzed. Based on analysis of variance (ANOVA) test results, there was no significant difference for total number of stages in statistical point of view between three groups ( P value = 0.1). In this research, the Pearson correlation coefficient showed that there is a direct relation between the age and resection stages ( r = 0.19, P value = 0.04). The Chi-square test showed no differences between three groups in age, residence and radiotherapy history.

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          Dermoscopy of pigmented skin lesions.

          Dermoscopy is an in vivo method for the early diagnosis of malignant melanoma and the differential diagnosis of pigmented lesions of the skin. It has been shown to increase diagnostic accuracy over clinical visual inspection in the hands of experienced physicians. This article is a review of the principles of dermoscopy as well as recent technological developments.
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            Dermatoscopy: alternative uses in daily clinical practice.

            Dermatoscopy, also known as dermoscopy, epiluminescence microscopy, or surface microscopy, is a noninvasive technique allowing rapid and magnified (× 10) in vivo observation of the skin with the visualization of morphologic features often imperceptible to the naked eye. Videodermatoscopy (VD) represents the evolution of dermatoscopy and is performed with a video camera equipped with lenses providing higher magnification (× 10 to × 1000). Over the past few years, both dermatoscopy and VD have been demonstrated to be useful in a wide variety of cutaneous disorders, including ectoparasitic infestations, cutaneous/mucosal infections, hair and nail abnormalities, psoriasis, and other dermatologic as well as cosmetologic conditions. Depending on the skin disorder, both dermatoscopy and VD may be useful for differential diagnosis, prognostic evaluation, and monitoring response to treatment. Nowadays, it represents an important and relatively simple aid in daily clinical practice. Copyright © 2010 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.
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              Optical Coherence Tomography Used as a Modality to Delineate Basal Cell Carcinoma prior to Mohs Micrographic Surgery

              Optical coherence tomography (OCT) has potential as a modality for in vivo imaging of non-melanoma skin cancer (NMSC). By allowing identification of sub-surface margins of NMSC lesions, the use of OCT could improve the rate of complete excision and reduce the average number of stages during Mohs micrographic surgery (MMS). The objective of this study was to use OCT to delineate the apparent sub-surface margins of NMSC lesions prior to their excision by MMS. Lesions were scanned with reference to a physical marker on the skin, and the apparent margins were then identified from the OCT images and marked on the skin. Photographs of these margins and the Mohs defect were correlated and compared. OCT appears capable of visualizing the transition from lesional to normal tissue. In this case study, margins marked by use of the OCT system before surgery exhibit excellent correlation with the MMS defect. OCT offers the promise of better outcomes by enabling accurate margin mapping of NMSC in advance of MMS. Priorities now are to demonstrate this capability in a larger study, and to understand clearly indications and contraindications for use.
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                Author and article information

                Journal
                Adv Biomed Res
                Adv Biomed Res
                ABR
                Advanced Biomedical Research
                Medknow Publications & Media Pvt Ltd (India )
                2277-9175
                2013
                06 March 2013
                : 2
                : 2
                Affiliations
                [1]Department of Dermatology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
                Author notes
                Address for correspondence: Dr. Iman Momeni, Department of Dermatology, Isfahan, Sofe Blvd. Alzahra Hospital, Iran. E-mail: momeni_i@ 123456yahoo.com
                Article
                ABR-2-2
                10.4103/2277-9175.107961
                3732882
                23930247
                d98dcadf-699c-4c2b-b326-f29aabfa62cb
                Copyright: © 2013 Asilian

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 16 April 2012
                : 25 July 2012
                Categories
                Original Article

                Molecular medicine
                curettage,basal cell carcinoma,dermoscopy,mohs micrographic surgery
                Molecular medicine
                curettage, basal cell carcinoma, dermoscopy, mohs micrographic surgery

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