[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-341281-105":59,"doc-detail-341281-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","mohs-micrographic-surgery-comes-to-dermatology-practice-in-india-lessons-learnt-over-2-years","Mohs Micrographic Surgery Comes to Dermatology Practice in India - Lessons Learnt Over 2 Years","","Mohs micrographic surgery (MMS) is presented as a specialized technique for skin cancer surgery that enables complete histopathologic assessment of peripheral and deep margins, with the surgeon also acting as the pathologist for same-day evaluation and reconstruction. The editorial summarizes the delayed adoption of MMS in India, describing a two-year center experience focused on basal cell carcinoma and well-differentiated squamous cell carcinoma, training needs, pathology workflow solutions, resource constraints, and technique adjustments in darker Fitzpatrick skin types.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/mohs-micrographic-surgery-comes-to-dermatology-practice-in-india-lessons-learnt-over-2-years/341281/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/mohs-micrographic-surgery-comes-to-dermatology-practice-in-india-lessons-learnt-over-2-years/341281.png","ImageObject",300,407,{"name":92,"@type":93},"Violet","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-23","2026-09-22",true,{"@type":102,"interactionType":103,"userInteractionCount":39},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"Why is MMS considered effective for non-melanoma skin cancers?","Question",{"text":112,"@type":113},"MMS enables complete histopathologic analysis of resected peripheral and deep margins, allowing precise margin control. Reported recurrence rates for basal cell carcinoma and squamous cell carcinoma can be very low.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"What limits the widespread adoption of MMS in India?",{"text":117,"@type":113},"Key barriers include limited availability of cryostat facilities and trained histopathology technicians for processing samples in resource-limited settings. Implementation also depends on procedural expertise and trained dermatosurgeons.",{"name":119,"@type":110,"acceptedAnswer":120},"How should MMS technique be modified for darker Fitzpatrick skin types?",{"text":121,"@type":113},"The editorial notes subtle modifications because tumor behavior in skin of color affects delineation. Pigmented nodular basal cell carcinoma may allow clearer clinical and dermoscopic peripheral extent, enabling a smaller initial margin in some cases.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},341281,1790619017,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":39,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":19,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":52},4398048950312,"https://ap-avatar.wpscdn.com/avatar/400002538284de19e3c?_k=1778320343897328908","Guest Editorial  \nMohs Micrographic Surgery Comes to Dermatology Practice in India: Lessons Learnt Over 2 Years  \nMohs micrographic surgery (MMS) is a specialized form of skin cancer surgery which has the potential to offer highest cure rates and negligible recurrence rates for a plethora of cutaneous tumors owing to complete histopathologic analysis of resected peripheral and deep margins offered by the procedure.[1] MMS also allows the operating surgeon to be the pathologist, which allows precise examination of the resected specimen by surgeon and reconstruction of defect on the same day. Currently, MMS has become the gold standard for treatment of non-melanoma skin cancers (NMSCs), with 5-year recurrence rates as low as 1% for basal cell carcinoma (BCC) and 3%–5% for squamous cell carcinoma (SCC) .[2,3] There is also growing popularity of MMS for melanoma in situ, invasive melanoma, and lesscommon cutaneous neoplasms.[1]  \nDespite its inception and widespread practice since the 1990s in various parts of the world, the introduction of this technique and practice in India has been significantly delayed and sparse. Although many dermatologists perform standard excision for skin cancers in India, MMSis seldom offered. Our center has been performing MMS for skin cancers, especially BCC and well-differentiated SCC, for the past 2 years. MMS offers several advantages over standard excision, such as detection of microscopic extension of tumor, precise examination of peripheral and deep margins, and better preservation of uninvolved tissue. With increasing life expectancy and rise in patient population with immunosuppression and organ transplants, the incidence of skin cancers, especially NMSC, has been increasing in India, with BCC accounting for about 70% of all skin cancers. This underlines the scope of expert workforce in dermatology to cater to this patient load in India.  \nKnowledge regarding the local anatomy, technique of MMS, and reconstruction including grafts and flaps is also a prerequisite for performing MMS. As highlighted in a review article,[4] there is an unmet need for procedural dermatology and trained dermatosurgeons in India, which would also be a limiting factor for implementation of MMS. Certified training and mentorship programs are provided by the American College of Mohs Surgery, American Society of Dermatologic Surgery, Brazilian Society of Dermatology, and European Society for Mohs Surgery, which could be utilized to obtain formal training and expertise in MMS.[1] To begin with, small tumors like BCCs less than 2 cm, which do not involve free margins like the eyelids, nose, or lips, could be treated with MMS. Good rapport needs to be established with colleagues from plastic surgery, anesthesiology, ENT, and oculoplasty  \nbefore operating larger tumors or tumors over high-risk areas. The use of MMS for treatment of locally aggressive tumors like SCCs entailing more complex reconstruction procedures would require multidisciplinary care from the departments mentioned above.  \nA significant deterrent in widespread practice of MMSis the availability of cryostat and trained histopathology technicians for processing samples in resource-limited settings like India. Although it is recommended that tissue processing should be performed preferably in the operation theater where MMS is undertaken, this is always not essential. In our practice, we have been working in liaison with pathology department, which is located in close vicinity to our operating room, thereby providing prompt processing and reporting of the samples. This could potentially be implemented in other institutes of the country, as infrastructure required is available in most pathology departments where staff can be trained in appropriate sample processing. The reporting of samples could be initially performed with the support from pathologists, who are trained in reporting skin cancers.  \nAlthough cost can be a limiting factor, especially in resourc","cbCaifGzZtVx96TP","https://ap.wps.com/l/cbCaifGzZtVx96TP","pdf",2304166,"English","# Guest Editorial\n## MMS benefits and current role in skin cancer care\n## Delayed adoption and two-year center experience in India\n## Training, reconstruction, and multidisciplinary collaboration\n## Sample processing and pathology support in resource-limited settings\n## Practical considerations: cost, cryostat limitations, and skin of color technique","[{\"question\":\"Why is MMS considered effective for non-melanoma skin cancers?\",\"answer\":\"MMS enables complete histopathologic analysis of resected peripheral and deep margins, allowing precise margin control. Reported recurrence rates for basal cell carcinoma and squamous cell carcinoma can be very low.\"},{\"question\":\"What limits the widespread adoption of MMS in India?\",\"answer\":\"Key barriers include limited availability of cryostat facilities and trained histopathology technicians for processing samples in resource-limited settings. Implementation also depends on procedural expertise and trained dermatosurgeons.\"},{\"question\":\"How should MMS technique be modified for darker Fitzpatrick skin types?\",\"answer\":\"The editorial notes subtle modifications because tumor behavior in skin of color affects delineation. Pigmented nodular basal cell carcinoma may allow clearer clinical and dermoscopic peripheral extent, enabling a smaller initial margin in some cases.\"}]","Mohs Micrographic Surgery Comes to Dermatology Practice in India - Lessons Learnt Over 2 Years | PDF",1790041344]