J Am Acad Dermatol. 2020 Oct 01;:
Authors: Zargham H, Khachemoune A
Abstract
BACKGROUND: Few data exist to guide the application of Mohs micrographic surgery (MMS) in the pediatric population.
OBJECTIVE: To summarize the clinical characteristics of children undergoing MMS, identify challenges that limit the use of MMS in this population, and examine how these challenges can be overcome.
METHODS: A systematic review of PubMed and EMBASE, from inception of databases to November 2nd, 2019, identified all cases of pediatric skin lesions treated with MMS.
RESULTS: A total of 111 patients were included. The median patient age was 11 years (range 6 weeks to 17 years). The most commonly treated tumor was DFSP (n=62), followed by BCC (n=30). The most common location was the head and neck (n=34), followed by trunk (n=28) and extremities (n=23).The most commonly cited challenges in the application of MMS in children included: patient cooperation, concerns for safety of prolonged general anesthesia, availability of a Mohs surgery service in the pediatric setting, and access to a histopathology lab experienced in MMS sectioning.
LIMITATIONS: Many articles did not report specific patient characteristics.
CONCLUSION: Multiple obstacles limit the application of MMS in pediatrics. This review describes practical methods to circumvent these obstacles in order to facilitate the appropriate use of MMS in children.
PMID: 33011324 [PubMed - as supplied by publisher]
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