The use of Mohs is appropriate for the specific indication and is generally considered acceptable.
This indication requires additional clinival/patient information and physical judgement for a final determination of the appropriateness of Mohs surgery.
The use of Mohs is inappropriate for the specific indication and is generally not considered acceptable.
Face (central face, eyelids [including inner/outer canthi], eyebrows, nose, lips [cutaneous/mucosal/vermillion], chin, ear and periauricular skin/sulci, temple)
Genitalia (includingperineal and perianal), Nipples/areola, Hans, Feet, Ankles, Nail units.
Cheeks, forehead, scalp, neck, jawline.
Pretibial surface.
Trunk, Extremities (excluding pretibial surface, hands, feet, nail, units and ankles)
Aggressive. Aggressive BCC features (eg. high-risk for recurrence): Morpheaform , fibrosing , sclerosing , infiltrating , perineural, metatypical/keratotic, micronodular.
Aggressive. Aggressive SCC features (eg, high-risk for recurrence): Sclerosing, Basosquamous (excluding keratotic BCC), Small cell, Poorly or undifferentiated (characterized by a high degree of nuclear polymorphism, high mitotic rate, or low degree of keratinization) Perineural/perivascular, Spindle cell, Pagetoid, Infiltrating, Keratoacanthoma (KA) type: central facial, Single cell, Clear cell, Lymphoepithelial, Sarcomatoid, Breslow depth 2 mm or greater, Clark level IV or greater.
AK with focal SCC in situ. Also called: Bowenoid AK, SCC in situ-AK type
Without aggressive histologic features. No aggressive SCC features, <2mm depth without other definig features, Clark level <III
Genetic Syndromes. Basal Cell nevus syndrome, xeroderma pigmentosum, or other syndromes at high risk for skin cancer.
Healthy. No immunosuppression, prior radiation therapy, chronic infections or genetic syndromes.
Immunocompromised. Patient with HIV, organ transplant, hematologic malignancy or pharmacologic immunosuppression.