Cleveland Mohs Surgery doctors
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Margaret Mann, MD
Cleveland Dermatologic Surgeon
11100 Euclid Ave. , Cleveland |
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Richard Gentile, MD
Cleveland Facial Plastic Surgeon
6505 Market St Suite A103, Boardman |
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Renuka Diwan, MD
Cleveland Dermatologist
29101 Health Campus Drive Suite 300 , Cleveland |
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Renuka Diwan
Cleveland Dermatologic Surgeon
29101 Health Campus Dr Ste 300, Westlake |
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Paul Vanek, MD
Cleveland Plastic Surgeon
9485 Mentor Ave. Suite 100, Mentor |
Recent Answers
I have Basal Cell Carcinona (BCC) in the face (upper maxilla ), and it was removed on November 22, 2008. However, the surgeon did an incomplete primary excision and the biopsy showed positive margins for BCC. I did some research, and the Mohs Micrographic Surgery (MMS) is a good option for the recurrent BCC. Do I need to have a clinical recurrence to undergo MMS?
First of all, you should be commended for your research. And rest assure that Mohs surgery is the best option for you, it will leave you with the smallest scar possible and ensure that all the tumor is removed. Mohs surgery is perfectly indicated in your case-- having a skin cancer on the face that was incompletely removed the first time. You do not need to wait for clinically visible recurrence of the cancer before your proceed with Mohs surgery.
I would advise you to consult with a fellowship-trained Mohs surgeon. These are dermatologist like myself who have taken an additional year of fellowship training specifically to treat skin cancers. In addition, fellowship trained Mohs Surgeons are well versed in advanced facial reconstruction techniques. You should check to see if your physician is a part of the American College of Mohs Surgery.
Best,
Dr. Mann
I may have another small bcc on my scalp (seeing a doc hopefully soon)....I would rather not have mohs again if baldness is the result. Is freezing or burning off an alternative?
If you are concerned about a potential skin cancer on the scalp, you should definitely see a dermatologist to determine what it is first. A biopsy of the area will tell you if this is indeed a basal cell or a precancerous growth.
While freezing with liquid nitrogen and burning (electrodessication and curettage) are both options for skin cancers, I generally do not recommend them for basal cells on the scalp. Using liquid nitrogen to treat a bcc requires significant amount of "freeze time" and recurrence rate is high. Similarly electrodessication and curettage will likely leave you with a bald patch as well.
Mohs surgery is the most appropriate option in this area. It is tissue sparing-- meaning only the minimium amount of tissue will be removed. If the hair follicles are spared, the hair will likely grow back even if left to heal on its own. If the hair follicles are removed with the surgery, then I would recommend closing the wound with stitches. Most patients have very nice cosmetic results with minimal to no hair loss.
As in the case of any skin cancer, the top priorities are to ensure the cancer removal and to provide the bet cosmetic outcome. Mohs is the ideal choice since it accomplishes both.
Best,
Dr. Mann
the Dr had to take 2 cuts to get it all, it went to the skull. I have a 2" hole in my forehead. The last bolster was taken out 2 weeks ago, it was to big to sew and a skin graft would have looked terrible. I am keeping the hole filled with polysporin and bandaged. The itching around the hole is unbearable, he said it would be bandaged for at least 2 more months. How can I rid the itching, I don't want to irritate the healing as the hole is getting smaller. Any advise on healing? Thank you
Minor itching is a part of the natural healing process, especially for a wound as large as yours. But you describe "unbearable" itch, and this makes me concern that you may be allergic to something in the wound care. Many patients can develop an allergy to polysporin, even if they have used it without problems before. That is why, in my cliinic, I usually recommend using just vaseline. Several dermatologic studies have shown that infection rate is no different when patients use vaseline or polysporin after surgery. The other concern is perhaps a sensitivity to the bandage or tape. You may want to consider changing to paper tape as some patients can be sensitive to certain types of bandages. Lastly, you should definitely see your doctor again and bring up your concerns about itching. If you have a severe allergic reaction, topical steroids for a few days may help.
Best,
Dr. Mann