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The technique is based on staged excision of the tumor with systematic horizontal sectioning and real-time examination of the entire peripheral and deep surgical margins, allowing further tissue removal only in areas where residual tumor is identified. Its unique strength lies in the ability to detect subclinical tumor extensions that may be missed by conventional excision and standard vertical sectioning, thereby improving local control while minimizing unnecessary tissue sacrifice. Since its introduction in the 1930s by Frederic E. Mohs, the technique has evolved into a cornerstone of modern dermato-oncology, particularly for tumors arising in anatomically critical areas, recurrent neoplasms, and histologically aggressive malignancies. MMS is now widely regarded as the treatment of choice for high-risk basal cell carcinoma and cutaneous squamous cell carcinoma because of its superior cure rates and tissue-sparing approach. Beyond its oncologic advantages, MMS allows precise clinicopathologic correlation and immediate reconstruction tailored to the final defect, contributing to favorable functional and cosmetic outcomes. As experience with the technique has expanded, so too has interest in adjunctive tools for preoperative tumor delineation and margin control, further refining patient selection and surgical accuracy. Overall, MMS represents an essential advance over conventional excision for selected cutaneous malignancies, offering an optimal balance between radical tumor clearance and preservation of normal tissue.<\/jats:p>","DOI":"10.3390\/jcm15124754","type":"journal-article","created":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T13:04:04Z","timestamp":1781874244000},"page":"4754","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Current and Future Perspectives in Mohs Micrographic Surgery for Non-Melanoma Skin Cancers: A Narrative Review"],"prefix":"10.3390","volume":"15","author":[{"given":"A.","family":"Paradisi","sequence":"first","affiliation":[{"name":"Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"},{"name":"UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. 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Surg."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1320","DOI":"10.1097\/DSS.0000000000000907","article-title":"Safety of Local Intracutaneous Lidocaine Anesthesia Used by Dermatologic Surgeons for Skin Cancer Excision and Postcancer Reconstruction: Quantification of Standard Injection Volumes and Adverse Event Rates","volume":"42","author":"Alam","year":"2016","journal-title":"Dermatol. Surg."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"e2021120","DOI":"10.5826\/dpc.1104a120","article-title":"Toxicity of Infiltrative Lidocaine in Dermatologic Surgery: Are Current Limits Valid?","volume":"11","author":"Wang","year":"2021","journal-title":"Dermatol. Pract. 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Dermatol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1001\/jamadermatol.2019.0152","article-title":"Use of Antibiotics for Dermatologic Procedures From 2008 to 2016","volume":"155","author":"Barbieri","year":"2019","journal-title":"JAMA Dermatol."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Campbell, E., Virk, A., Lessard, S., Lohman, M.E., and Otley, C. (2026). Antibiotic Prophylaxis in Dermatologic Surgery: Advisory Statement 2025 (APDSAS 2025). Dermatol. Surg.","DOI":"10.1097\/DSS.0000000000005056"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"749","DOI":"10.1097\/DSS.0000000000004652","article-title":"Retrospective Review of the Infection Rate of Lower Extremities Treated with Mohs Micrographic Surgery with and Without Prophylactic Antibiotics","volume":"51","author":"Patel","year":"2025","journal-title":"Dermatol. Surg."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1684\/ejd.2020.3771","article-title":"Safety margins for dermatofibrosarcoma protuberans: A comparison between wide local excision and Mohs Tubingen technique","volume":"30","author":"Cammarata","year":"2020","journal-title":"Eur. J. Dermatol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"728","DOI":"10.1016\/j.ctrv.2008.06.002","article-title":"Dermatofibrosarcoma protuberans: Wide local excision vs. Mohs micrographic surgery","volume":"34","author":"Paradisi","year":"2008","journal-title":"Cancer Treat. Rev."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Surmanowicz, P., Sivanand, A., Du, A.X., Mahmood, M.N., and Gniadecki, R. (2021). Muffin Technique Micrographic Surgery for Non-melanoma Skin Cancer. Front. 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Dermatol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1001\/jama.2025.18749","article-title":"Keratinocyte Carcinoma: A Review","volume":"335","author":"Wehner","year":"2026","journal-title":"JAMA"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1016\/j.jaad.2018.03.060","article-title":"Basal cell carcinoma","volume":"80","author":"Cameron","year":"2019","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"540","DOI":"10.1016\/j.jaad.2017.10.006","article-title":"Guidelines of care for the management of basal cell carcinoma","volume":"78","author":"Bichakjian","year":"2018","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1016\/j.jaad.2012.06.009","article-title":"AAD\/ACMS\/ASDSA\/ASMS 2012 appropriate use criteria for Mohs micrographic surgery: A report of the American Academy of Dermatology, American College of Mohs Surgery, American Society for Dermatologic Surgery Association, and the American Society for Mohs Surgery","volume":"67","author":"Connolly","year":"2012","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1111\/ijd.17496","article-title":"Novel imaging techniques for tumor margin detection in basal cell carcinoma: A systematic scoping review of FDA and EMA-approved imaging modalities","volume":"64","author":"Boostani","year":"2025","journal-title":"Int. J. Dermatol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"e136","DOI":"10.1111\/ijd.13501","article-title":"Effectiveness of dermoscopy in Mohs micrographic surgery (MMS) for nonmelanoma skin cancer (NMSC)","volume":"56","author":"Yeom","year":"2017","journal-title":"Int. J. Dermatol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"e14196","DOI":"10.1111\/dth.14196","article-title":"Effectiveness of dermoscopy in the demarcation of surgical margins in slow Mohs surgery","volume":"33","author":"Litaiem","year":"2020","journal-title":"Dermatol. Ther."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1411","DOI":"10.1097\/DSS.0000000000001247","article-title":"Videodermoscopy and Curettage: The Value of Simple Procedures During Mohs Surgery","volume":"43","author":"Dika","year":"2017","journal-title":"Dermatol. Surg."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1590\/abd1806-4841.20142400","article-title":"Utility of dermoscopy for demarcation of surgical margins in Mohs micrographic surgery","volume":"89","author":"Suzuki","year":"2014","journal-title":"An. Bras. Dermatol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"565","DOI":"10.1111\/bjd.15903","article-title":"Dermoscopy prior to Mohs micrographic surgery does not improve tumour margin assessment and leads to fewer Mohs stages","volume":"178","author":"Jayasekera","year":"2018","journal-title":"Br. J. Dermatol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"2","DOI":"10.4103\/2277-9175.107961","article-title":"Comparison between examination with naked eye, curretage and dermoscopy in determining tumor extension before Mohs micrographic surgery","volume":"2","author":"Asilian","year":"2013","journal-title":"Adv. Biomed. Res."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1945","DOI":"10.1111\/j.1524-4725.2012.02587.x","article-title":"In Vivo Reflectance Confocal Microscopy of Basal Cell Carcinoma: Feasibility of Preoperative Mapping of Cancer Margins","volume":"38","author":"Pan","year":"2012","journal-title":"Dermatol. Surg."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"380","DOI":"10.1111\/bjd.14244","article-title":"A new approach for presurgical margin assessment by reflectance confocal microscopy of basal cell carcinoma","volume":"174","author":"Venturini","year":"2016","journal-title":"Br. J. Dermatol."},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Lupu, M., Voiculescu, V.M., Caruntu, A., Tebeica, T., and Caruntu, C. (2021). Preoperative Evaluation through Dermoscopy and Reflectance Confocal Microscopy of the Lateral Excision Margins for Primary Basal Cell Carcinoma. Diagnostics, 11.","DOI":"10.3390\/diagnostics11010120"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1111\/exd.12196","article-title":"Optical coherence tomography for presurgical margin assessment of non-melanoma skin cancer\u2014A practical approach","volume":"22","author":"Alawi","year":"2013","journal-title":"Exp. Dermatol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"627","DOI":"10.1111\/dsu.12093","article-title":"Optical Coherence Tomography\u2013Based Optimization of Mohs Micrographic Surgery of Basal Cell Carcinoma: A Pilot Study","volume":"39","author":"Wang","year":"2013","journal-title":"Dermatol. Surg."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"100015","DOI":"10.1016\/j.ejcskn.2023.100015","article-title":"Preoperative evaluation of high-risk basal cell carcinoma with line-field confocal optical coherence tomography (LC-OCT) reduces Mohs micrographic surgery stage number: A case-control study","volume":"2","author":"Paradisi","year":"2024","journal-title":"EJC Skin Cancer"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"799","DOI":"10.1097\/DSS.0000000000004297","article-title":"Artificial Intelligence for Mohs and Dermatologic Surgery: A Systematic Review and Meta-Analysis","volume":"50","author":"Mirza","year":"2024","journal-title":"Dermatol. Surg."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"2105","DOI":"10.1016\/j.jid.2023.05.018","article-title":"ChatGPT and Generative Artificial Intelligence in Mohs Surgery: A New Frontier of Innovation","volume":"143","author":"Jeha","year":"2023","journal-title":"J. Investig. Dermatol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"930","DOI":"10.1097\/DSS.0000000000004690","article-title":"Applications, Ethical Considerations, and Patient Perspectives on Artificial Intelligence in Dermatologic Surgery: Focus on Mohs Surgery","volume":"51","author":"Fardos","year":"2025","journal-title":"Dermatol. Surg."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1058","DOI":"10.1111\/jdv.19743","article-title":"Efficacy of micrographic surgery versus conventional excision in reducing recurrence for basal cell carcinoma and squamous cell carcinoma: A systematic review and meta-analysis","volume":"38","author":"Lacerda","year":"2024","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"1149","DOI":"10.1016\/S1470-2045(08)70260-2","article-title":"Surgical excision versus Mohs\u2019 micrographic surgery for primary and recurrent basal-cell carcinoma of the face: A prospective randomised controlled trial with 5-years\u2019 follow-up","volume":"9","author":"Mosterd","year":"2008","journal-title":"Lancet Oncol."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1111\/ajd.70000","article-title":"Ten Years of Scalp Keratinocyte Carcinomas (Basal Cell Carcinomas and Squamous Cell Carcinomas) Treated by Mohs Micrographic Surgery at a Large Australian Centre, a Descriptive Study","volume":"67","author":"Islam","year":"2025","journal-title":"Australas. J. Dermatol."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"adv41118","DOI":"10.2340\/actadv.v105.41118","article-title":"10 Years of Mohs Micrographic Surgery in Denmark: Results from a Nationwide Cohort","volume":"105","author":"Andersen","year":"2025","journal-title":"Acta Derm. Venereol."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"1766","DOI":"10.1016\/S0140-6736(04)17399-6","article-title":"Surgical excision vs Mohs\u2019 micrographic surgery for basal-cell carcinoma of the face: Randomised controlled trial","volume":"364","author":"Smeets","year":"2004","journal-title":"Lancet"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"13688","DOI":"10.1038\/s41598-025-93104-3","article-title":"Long-term outcomes of reduced-dose bleomycin in electrochemotherapy for basal cell carcinoma in elderly patients","volume":"15","author":"Omerzel","year":"2025","journal-title":"Sci. Rep."},{"key":"ref_56","first-page":"209","article-title":"Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries","volume":"71","author":"Sung","year":"2021","journal-title":"CA Cancer J. Clin."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1007\/s13555-016-0165-y","article-title":"Skin Cancer: Epidemiology, Disease Burden, Pathophysiology, Diagnosis, and Therapeutic Approaches","volume":"7","author":"Apalla","year":"2017","journal-title":"Dermatol. Ther."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1016\/j.cpt.2024.08.002","article-title":"Overview of skin cancer types and prevalence rates across continents","volume":"3","author":"Roky","year":"2025","journal-title":"Cancer Pathog. Ther."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1007\/s40487-022-00201-8","article-title":"Basal Cell Carcinoma: A Narrative Review on Contemporary Diagnosis and Management","volume":"10","author":"Naik","year":"2022","journal-title":"Oncol. Ther."},{"key":"ref_60","doi-asserted-by":"crossref","unstructured":"Leiter, U., Eigentler, T., and Garbe, C. (2014). Epidemiology of Skin Cancer. Sunlight, Vitamin D and Skin Cancer, Springer.","DOI":"10.1007\/978-1-4939-0437-2_7"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1111\/ijd.16164","article-title":"The risk of metastases from squamous cell carcinoma of the skin","volume":"62","author":"Caudill","year":"2023","journal-title":"Int. J. Dermatol."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1016\/j.jaad.2025.09.042","article-title":"Impact of immunosuppression on cutaneous squamous cell carcinoma outcomes","volume":"94","author":"Klein","year":"2025","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"852","DOI":"10.1097\/DSS.0000000000004680","article-title":"Immunosuppression as an Independent Risk Factor for Poor Outcomes in Cutaneous Squamous Cell Carcinoma: A Prospective Study","volume":"51","author":"Rosenthal","year":"2025","journal-title":"Dermatol. Surg."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"419","DOI":"10.1001\/jamadermatol.2015.4994","article-title":"Risk Factors for Cutaneous Squamous Cell Carcinoma Recurrence, Metastasis, and Disease-Specific Death","volume":"152","author":"Thompson","year":"2016","journal-title":"JAMA Dermatol."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"adv40990","DOI":"10.2340\/actadv.v104.40990","article-title":"Clinical Risk Factors for Cutaneous Squamous Cell Carcinoma in Patients with Actinic Keratosis or Cutaneous Squamous Cell Carcinoma in Situ: A Retrospective Double-cohort Study","volume":"104","author":"Knuutila","year":"2024","journal-title":"Acta Derm. Venereol."},{"key":"ref_66","doi-asserted-by":"crossref","unstructured":"Sandoval-Clavijo, A., Mart\u00ed-Mart\u00ed, I., Ferr\u00e1ndiz-Pulido, C., Verdaguer-Faja, J., Jaka, A., and Toll, A. (2025). Human Papillomavirus-Related Cutaneous Squamous Cell Carcinoma. Cancers, 17.","DOI":"10.3390\/cancers17050897"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"e086488","DOI":"10.1136\/bmjopen-2024-086488","article-title":"Prediction of relative survival trends in patients with cutaneous squamous cell carcinoma using a model-based period analysis: A retrospective analysis of the surveillance, epidemiology, and end results database","volume":"14","author":"Zheng","year":"2024","journal-title":"BMJ Open"},{"key":"ref_68","doi-asserted-by":"crossref","unstructured":"Tan, B., Seth, I., Fischer, O., Hewitt, L., Melville, G., Bulloch, G., and Ashford, B. (2022). Sex Disparity for Patients with Cutaneous Squamous Cell Carcinoma of the Head and Neck: A Systematic Review. Cancers, 14.","DOI":"10.3390\/cancers14235830"},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"763","DOI":"10.1586\/era.11.36","article-title":"Management of high-risk squamous cell carcinoma of the skin","volume":"11","author":"Samarasinghe","year":"2011","journal-title":"Expert. Rev. Anticancer. Ther."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"633","DOI":"10.1016\/j.jaad.2018.09.015","article-title":"Clinical outcomes in high-risk squamous cell carcinoma patients treated with Mohs micrographic surgery alone","volume":"80","author":"Marrazzo","year":"2019","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1016\/j.jaad.2015.02.1131","article-title":"Squamous cell carcinoma with aggressive subclinical extension: 5-year retrospective review of diagnostic predictors","volume":"73","author":"Goldenberg","year":"2015","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"819","DOI":"10.1001\/jamadermatol.2019.0032","article-title":"Performance of the American Joint Committee on Cancer Staging Manual, 8th Edition vs the Brigham and Women\u2019s Hospital Tumor Classification System for Cutaneous Squamous Cell Carcinoma","volume":"155","author":"Ruiz","year":"2019","journal-title":"JAMA Dermatol."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"3385","DOI":"10.1002\/hed.28259","article-title":"Validation of Current Staging Systems in HNCSCC: A Multinational Cohort Study","volume":"47","author":"Girardi","year":"2025","journal-title":"Head. Neck"},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1001\/jamadermatol.2017.3960","article-title":"Comparison of Tumor Classifications for Cutaneous Squamous Cell Carcinoma of the Head and Neck in the 7th vs 8th Edition of the AJCC Cancer Staging Manual","volume":"154","author":"Karia","year":"2018","journal-title":"JAMA Dermatol."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"1319","DOI":"10.1016\/j.jaad.2025.02.052","article-title":"Identifying the impact of minor risk factors in Brigham and Women\u2019s Hospital stage T1 cutaneous squamous cell carcinomas on risk of poor outcomes: A retrospective cohort study","volume":"92","author":"Shahwan","year":"2025","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"597","DOI":"10.1001\/jamadermatol.2025.0128","article-title":"Risk Factor Number and Recurrence, Metastasis, and Disease-Related Death in Cutaneous Squamous Cell Carcinoma","volume":"161","author":"Ran","year":"2025","journal-title":"JAMA Dermatol."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"1432","DOI":"10.1016\/j.jaad.2025.07.029","article-title":"Satellitosis or in-transit metastasis in cutaneous squamous cell carcinoma: Risk factors and the prognostic significance","volume":"93","author":"Pahalyants","year":"2025","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"368","DOI":"10.1016\/j.jaad.2025.04.029","article-title":"Lymphovascular invasion is an independent predictor of metastasis and disease-specific death in cutaneous squamous cell carcinoma: A multicenter retrospective study","volume":"93","author":"Hirotsu","year":"2025","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"2063","DOI":"10.1111\/odi.14723","article-title":"Long-term outcomes, quality of life, and costs of treatment modalities for T1\u2013T2 lip carcinomas","volume":"30","author":"Wakkee","year":"2024","journal-title":"Oral Dis."},{"key":"ref_80","doi-asserted-by":"crossref","unstructured":"Z\u00fcrcher, S., Martignoni, Z., Hunger, R.E., Benzaquen, M., and Seyed Jafari, S.M. (2024). Mohs Micrographic Surgery for Cutaneous Squamous Cell Carcinoma. Cancers, 16.","DOI":"10.3390\/cancers16132394"},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"664","DOI":"10.1111\/j.1524-4725.2010.01850.x","article-title":"Sclerosing Squamous Cell Carcinoma of the Skin, An Underemphasized Locally Aggressive Variant: A 20-Year Experience","volume":"37","author":"Salmon","year":"2011","journal-title":"Dermatol. Surg."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"426","DOI":"10.1111\/jdv.20103","article-title":"Mohs micrographic surgery in immunosuppressed vs immunocompetent patients: Results of a prospective nationwide cohort study (REGESMOHS, Spanish registry of Mohs surgery)","volume":"39","year":"2025","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"1286","DOI":"10.1002\/ohn.1129","article-title":"Mohs Micrographic Surgery Efficacy for Solid Organ Transplant Head and Neck Cutaneous Squamous Cell Carcinoma","volume":"172","author":"Li","year":"2025","journal-title":"Otolaryngol.\u2013Head Neck Surg."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1016\/j.jaad.2021.07.059","article-title":"Cost effectiveness of intermediate-risk squamous cell carcinoma treated with Mohs micrographic surgery compared with wide local excision","volume":"86","author":"Udkoff","year":"2022","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"338","DOI":"10.1111\/bjd.17188","article-title":"Recurrence rates of cutaneous squamous cell carcinoma of the head and neck after Mohs micrographic surgery vs. standard excision: A retrospective cohort study","volume":"181","author":"Lee","year":"2019","journal-title":"Br. J. Dermatol."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1097\/DSS.0000000000004088","article-title":"Disease-Specific Mortality of Dermatofibrosarcoma Protuberans After Mohs Surgery Versus Wide Local Excision: A Systematic Review and Meta-Analysis","volume":"50","author":"Crum","year":"2024","journal-title":"Dermatol. Surg."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"745","DOI":"10.1097\/DSS.0000000000000763","article-title":"Treatment of Porocarcinoma With Mohs Micrographic Surgery","volume":"42","author":"Tolkachjov","year":"2016","journal-title":"Dermatol. Surg."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"685","DOI":"10.1097\/DSS.0000000000000382","article-title":"Eccrine Porocarcinoma Treated by Mohs Micrographic Surgery","volume":"41","author":"Xu","year":"2015","journal-title":"Dermatol. Surg."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"1357","DOI":"10.1111\/ijd.17283","article-title":"Treatment of sebaceous carcinoma with Mohs micrographic surgery versus wide local excision: A systematic review","volume":"63","author":"Yadlapati","year":"2024","journal-title":"Int. J. 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