Jessica Krant, MD

There are different approaches to surgically treating an SCC of the scalp. Mohs surgery performed by a very skilled and officially-trained Mohs surgeon is one of the best options, and proper Mohs training does include complex repairs such as flaps if necessary.

Direct excision by a plastic surgeon is also a fine option. The downside of this technique is that with traditional pathology readings, the "permanent section" pathology slides are read AFTER the wound is closed, and as is often the case with scalp SCC's. If the margins are surprisingly wide and the lesion is not cleared, a complex area has to be reopened and operated on.

Any technique with pathologic confirmation of clear margins before closure is a valid one, whether the removal be done by a Mohs fellowship-trained dermatologic surgeon, or a conscientious plastic surgeon.

Fellowship trained Mohs surgeons can be found at www.MohsCollege.org.