MOHS MICROGRAPHIC SURGERY DERMATOPATHOLOGY CONCORDANCE
It would be advisable that other MMS centers in the United Kingdom and in other European countries perform similar quality assurance audits to ensure that the same high quality of training and expertise is being offered in dermatologic centers across Europe.
Acknowledgments The authors would like to thank Nisith Sheth and Catherine Gleeson for their assistance in collecting part of the data.
5. Grabski WJ, Salasche SJ, McCollough ML, Berkland ME, et al. Mohs micrographic frozen sections: a peer review comparison study. J Am Acad Dermatol 1989;20:670–4. 6. Mariwalla K, Aasi SZ, Glusac EJ, Leffell DJ. Mohs micrographic surgery histopathology concordance. J Am Acad Dermatol 2009;60:94–8. 7. Tan E, Elliott T, Yu L, Litterick K. Mohs surgery histopathology concordance in Australia. Australas J Dermatol 2011;52:245–7. 8. Hurwitz RM, Buckel LJ. Actinic keratosis on a continuum with squamous cell carcinoma. Arch Dermatol 2010;146:923–4. 9. Ko CJ. Actinic keratosis: facts and controversies. Clin Dermatol 2010;28:249–53. 10. Silapunt S, Peterson SR, Alcalay J, Goldberg LH. Mohs tissue mapping and processing: a survey study. Dermatol Surg 2003;29:1109–12.
References 1. Wood LD, Ammirati CT. An overview of Mohs micrographic surgery for the treatment of basal cell carcinoma. Dermatol Clin 2011;29:153–60. 2. Belkin D, Carucci JA. Mohs surgery for squamous cell carcinoma. Dermatol Clin 2011;29:161–74. 3. Telfer NR, Colver GB, Morton CA. Guidelines for the management of basal cell carcinoma. Br J Dermatol 2008;159:35–48. 4. Motley RJ, Preston PW, Lawrence CM. Multi-professional Guidelines for the Management of the Patient with Primary Cutaneous Squamous Cell Carcinoma; 2009. Available from: http://www.bad.org.uk Accessed April 30, 2012.
11. Miller CJ, Sobanko JF, Zhu X, Nunnciato T, et al. Special stains in Mohs surgery. Dermatol Clin 2011;29:273–86. 12. Lane JE, Chiller KG, Baucom MF, Kent DE. Mohs micrographic surgery histopathology concordance in fellowship-trained surgeons. J Am Acad Dermatol 2010;62:148.
Address correspondence and reprint requests to: Ioulios Palamaras, MD, PhD, Dermatological Surgery and Laser Care Unit, St John’s Institute of Dermatology, St Thomas’ Hospital, Westminster Bridge Road, London SE1 7EH, UK, or e-mail: [email protected]
COMMENTARY
Commentary: Mohs Micrographic Surgery Concordance Between Mohs Surgeons and Dermatopathologists GARY D. MONHEIT, MD*
The authors have indicated no significant interest with commercial supporters.
T
his report further documents the expertise of the Mohs surgeon in evaluating cancer slides and interpreting the results. For the last 10 years, our Mohs surgery practice has sent slides to our
referral pathologist for review to further back up and credential our work. Every tenth slide is sent to our referral pathologist as an unknown and examined as an unknown for a histologic diagnosis. The
*Total Skin and Beauty Dermatology Center, PC, Departments of Dermatology and Ophthalmology, University of Alabama at Birmingham, Birmingham, Alabama © 2013 by the American Society for Dermatologic Surgery, Inc. Published by Wiley Periodicals, Inc. ISSN: 1076-0512 Dermatol Surg 2013;39:1652–1653 DOI: 10.1111/dsu.12331 1652
SEMKOVA ET AL
diagnosis of the Mohs micrographic surgeon is then compared for concordance with that of the referral pathologist. An evaluation is also made concerning the quality of the slide. This has been performed monthly, with a final concordance of 99.1%. I encourage all Mohs micrographic surgical practices to use the same slide quality control.
Address correspondence and reprint requests to: Ioulios Palamaras, MD, PhD, Dermatological Surgery and Laser Care Unit, St John’s Institute of Dermatology, St Thomas’ Hospital, Westminster Bridge Road, London SE1 7EH, UK, or e-mail: [email protected]
39:11:NOVEMBER 2013
1653
It would be advisable that other MMS centers in the United Kingdom and in other European countries perform similar quality assurance audits to ensure that the same high quality of training and expertise is being offered in dermatologic centers across Europe.
Acknowledgments The authors would like to thank Nisith Sheth and Catherine Gleeson for their assistance in collecting part of the data.
5. Grabski WJ, Salasche SJ, McCollough ML, Berkland ME, et al. Mohs micrographic frozen sections: a peer review comparison study. J Am Acad Dermatol 1989;20:670–4. 6. Mariwalla K, Aasi SZ, Glusac EJ, Leffell DJ. Mohs micrographic surgery histopathology concordance. J Am Acad Dermatol 2009;60:94–8. 7. Tan E, Elliott T, Yu L, Litterick K. Mohs surgery histopathology concordance in Australia. Australas J Dermatol 2011;52:245–7. 8. Hurwitz RM, Buckel LJ. Actinic keratosis on a continuum with squamous cell carcinoma. Arch Dermatol 2010;146:923–4. 9. Ko CJ. Actinic keratosis: facts and controversies. Clin Dermatol 2010;28:249–53. 10. Silapunt S, Peterson SR, Alcalay J, Goldberg LH. Mohs tissue mapping and processing: a survey study. Dermatol Surg 2003;29:1109–12.
References 1. Wood LD, Ammirati CT. An overview of Mohs micrographic surgery for the treatment of basal cell carcinoma. Dermatol Clin 2011;29:153–60. 2. Belkin D, Carucci JA. Mohs surgery for squamous cell carcinoma. Dermatol Clin 2011;29:161–74. 3. Telfer NR, Colver GB, Morton CA. Guidelines for the management of basal cell carcinoma. Br J Dermatol 2008;159:35–48. 4. Motley RJ, Preston PW, Lawrence CM. Multi-professional Guidelines for the Management of the Patient with Primary Cutaneous Squamous Cell Carcinoma; 2009. Available from: http://www.bad.org.uk Accessed April 30, 2012.
11. Miller CJ, Sobanko JF, Zhu X, Nunnciato T, et al. Special stains in Mohs surgery. Dermatol Clin 2011;29:273–86. 12. Lane JE, Chiller KG, Baucom MF, Kent DE. Mohs micrographic surgery histopathology concordance in fellowship-trained surgeons. J Am Acad Dermatol 2010;62:148.
Address correspondence and reprint requests to: Ioulios Palamaras, MD, PhD, Dermatological Surgery and Laser Care Unit, St John’s Institute of Dermatology, St Thomas’ Hospital, Westminster Bridge Road, London SE1 7EH, UK, or e-mail: [email protected]
COMMENTARY
Commentary: Mohs Micrographic Surgery Concordance Between Mohs Surgeons and Dermatopathologists GARY D. MONHEIT, MD*
The authors have indicated no significant interest with commercial supporters.
T
his report further documents the expertise of the Mohs surgeon in evaluating cancer slides and interpreting the results. For the last 10 years, our Mohs surgery practice has sent slides to our
referral pathologist for review to further back up and credential our work. Every tenth slide is sent to our referral pathologist as an unknown and examined as an unknown for a histologic diagnosis. The
*Total Skin and Beauty Dermatology Center, PC, Departments of Dermatology and Ophthalmology, University of Alabama at Birmingham, Birmingham, Alabama © 2013 by the American Society for Dermatologic Surgery, Inc. Published by Wiley Periodicals, Inc. ISSN: 1076-0512 Dermatol Surg 2013;39:1652–1653 DOI: 10.1111/dsu.12331 1652
SEMKOVA ET AL
diagnosis of the Mohs micrographic surgeon is then compared for concordance with that of the referral pathologist. An evaluation is also made concerning the quality of the slide. This has been performed monthly, with a final concordance of 99.1%. I encourage all Mohs micrographic surgical practices to use the same slide quality control.
Address correspondence and reprint requests to: Ioulios Palamaras, MD, PhD, Dermatological Surgery and Laser Care Unit, St John’s Institute of Dermatology, St Thomas’ Hospital, Westminster Bridge Road, London SE1 7EH, UK, or e-mail: [email protected]
39:11:NOVEMBER 2013
1653
