Seattle Mohs Surgery doctors
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Daniel Berg, MD
Seattle Dermatologic Surgeon
4225 Roosevelt Way NE Roosevelt 1, Fourth Floor , Seattle |
14 answers | |
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Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
1135 116th Ave. NE Suite 630, Bellevue |
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11 answers |
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Laurie Jacobson, MD
Seattle Dermatologist
11011 Meridian Ave North 102, Seattle |
3 answers | |
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James M. Ridgway, MD
Seattle Facial Plastic Surgeon
600 Broadway Suite 280, Seattle |
2 answers | |
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Nobuyoshi Kageyama, MD
Seattle Dermatologist
1200 112th Ave NE Suite C-187, Bellevue |
2 answers |
Recent Answers
I am having Mohs on my left cheek 1.5 cm and want to try and heal naturally is this ok?
The original healing of Moh's surgery when it was first described was to heal on its own. This requires dressing changes and time and will leave some sort of a scar. Normally, patients want some plastic surgical closure but you can always heal it on your own and do a scar revision if needed.
A derm diagnosed BCC on my nasal ala via biopsy. I asked for a copy of the pathology report because I prefer to see a Mohs-certified doc to do the procedure. The original derm reads his own slides. The report I received says nothing other than "Basal cell carcinoma." There is no physical description of size, appearance, subtype etc. Should the report be more detailed? Would my surgeon need that info (eg how much of margins in sections are cancer-free) to best proceed with the surgery?
The Mohs surgeon whom you see will rely on the pathology report to a) confirm the diagnosis - in this case BCC and b) add information such as type of Basal Cell Carcinoma (BCC) that may influence the outcome.
With regards to a) confirming the diagnosis. In Seattle, as in other parts of the country, skin biopsies are read by both dermatologists and dermatopathologists. To some degree it depends on the comfort/preference of the dermatologist. Pathology is an important piece of training for dermatologists. BCC in most cases is considered a fairly straightforward pathologic diagnosis and most dermatologists who read their own pathology would be comfortable with this diagnosis most of the time. It is not impossible for there to be a diagnostic error (ie something other than BCC) but I'd guess relatively unlikely in the hands of a good dermatologist. With regards to b), the subtype of BCC does influence both the decision to do Mohs and the anticipated extent of the surgery. In cases where the lesion is in difficult anatomic location like the nasal ala, the subtype of BCC will not be as important as an indication. In other words, on the nasal ala, the anatomic location alone is reason enough to consider Mohs surgery for tissue sparing. Some subtypes of BCC, e.g. infiltrative, would be expected to need a more extensive resection but again, given the location, this doesn't necessarily change the management and the Mohs surgeon may not feel that information will change what he/she does.
If you prefer a further comment on the pathology, your options would be:
1) Ask the dermatologist who did and read the biopsy for more detail
2) Ask the dermatologist who did the biopsy or the Mohs surgeon who sees you to request that the biopsy specimen be reviewed by a dermatopathologist (who will issue a report).
3) Ask if the Mohs surgeon wishes to review the slides from the biopsy themselves prior to doing the procedure.
Given the location on the ala, I'd recommend considering a consultation with the Mohs surgeon prior to any surgery at which visit you can raise these questions.
Hope that helps.
I was curious to whether or not a RN could perform MOHS surgery if the physician was on site?
I would think it would be inappropriate for any non-MD to be doing a Moh's procedure. I would expect the doctor to be doing it if it were my skin cancer being removed.
