Mohs Micrographic Surgery for skin cancer.

Mohs Micrographic Surgery is a technique offering superior treatment for skin cancer with cure rates of 99% for primary and 94.4% for recurrent BCC, greater than 94% for SCC. As developed by Dr Frederic Mohs, the technique originally involved application of a chemical fixative. Mohs' fresh tissue technique is now usual, with immediate horizontal frozen sectioning of the entire margins of excised tissue, mapping and microscopic identification of remaining tumour, then repeat excisions, mapping and examination until a tumour-free plane is demonstrated throughout. This provides maximal conservation of uninvolved tissue structures, and allows more confident repair of a cancer-free surgical defect. Mohs Micrographic Surgery is becoming more widely available in Australasia; concurrently, indications for the technique are widening, as are the research interests, training opportunities, and professional organization of Mohs Practitioners. Very high, and increasing, incidence and prevalence of skin cancer in Australasia, and factors tending to contribute to this, suggest that Mohs Micrographic Surgery has an expanding role to play in Australasia.