Surgical Dermatology
Mohs Micrographic Surgery
Mohs Micrographic Surgery
There are numerous surgical approaches and expert techniques that Dr. Carroll utilizes to prevent skin cancers from spreading to other parts of the body. During your consultation and examination, Dr. Carroll can determine the safest and most effective option for you.
What is Different About Mohs Surgery?
Dr. Carroll specializes in Mohs micrographic surgery which is a highly effective technique for the removal of skin cancer. Developed in the 1930s by Dr. Frederic Mohs at the University of Wisconsin, Mohs surgery has is recognized as the skin cancer treatment with the highest cure rate (more than 90%). It differs from other skin cancer treatments as it permits immediate and complete microscopic examination of the removed cancerous tissue. All extensions and “roots” of the cancer can be eliminated. This extremely precise and methodical method requires a highly experienced specialist with the proper training exemplified in Dr. Carroll.
During Mohs surgery, the affected tissue is removed one layer at a time. Once the tissue is removed, the sample is reviewed closely so that any microscopic roots of the cancer can be immediately and accurately identified. If cancer cells are seen, an additional tissue layer is removed only in areas where the cancer is still present, leaving normal skin intact. When compared to other skin cancer treatments, Mohs micrographic surgery has the lowest chance of regrowth, minimizes the potential for scarring and is the most precise means of removing skin cancer.
Will Mohs Surgery be Right for Me?
During your consultation with Dr. Carroll, the best treatment plan for you will be determined. Mohs surgery is not appropriate for the treatment of all skin cancers. It is typically reserved for those skin cancers that have recurred following previous treatment or for cancers that pose a high risk for recurrence. Mohs surgery is also a preferred method for cancers located in areas where maximal tissue preservation is needed whether for cosmetic or functional reasons such as the nose, ears, eyelids, lips, hairline, hands, feet, and genitals.
Regular skin exams are essential to skin cancer detection.
Benign, Premalignant & Malignant Skin Lesions
A skin lesion may be classified as benign, premalignant or malignant. Classifying a lesion as such is vital to your health. Dr. Carroll provides an accurate diagnosis based on the appearance of the lesion and the patient’s clinical history. Based on the diagnosis, a biopsy may be required.
Most common skin lesions such as moles and tags are benign. A premalignant or precancerous skin lesion carries carries an increased risk of cancer. Malignant skin lesions must be treated immediately. Knowing the similarities and differences between these lesions allows Dr. Carroll to make a proper diagnosis.
Any changing growths on the skin, including change in color, shape or size, should be seen by a Dermatologist as soon as possible. If a lesion is new, starts bleeding or is painful, it can be a sign of a cancerous or pre-cancerous lesion, and it must be evaluated immediately.
When addressing the removal of lipoma, cysts, dysplastic nevi, and pilar cysts, a common approach involves the use of a general incision method.
Benign, Premalignant & Malignant Skin Lesions
A skin lesion may be classified as benign, premalignant or malignant. Classifying a lesion as such is vital to your health. Dr. Carroll provides an accurate diagnosis based on the appearance of the lesion and the patient’s clinical history. Based on the diagnosis, a biopsy may be required.
Most common skin lesions such as moles and tags are benign. A premalignant or precancerous skin lesion carries an increased risk of cancer. Malignant skin lesions must be treated immediately. Knowing the similarities and differences between these lesions allows Dr. Carroll to make a proper diagnosis.
Any changing growths on the skin, including changes in color, shape, or size, should be seen by a Dermatologist as soon as possible. If a lesion is new, starts bleeding, or is painful, it can be a sign of a cancerous or pre-cancerous lesion, and it must be evaluated immediately.
When addressing the removal of lipoma, cysts, dysplastic nevi, and pilar cysts, a common approach involves the use of a general incision method.
Common Skin Cancer Types
Actinic Keratosis (AK)
- Dry, scaly patches or spots that are precancerous growths.
- Common with people who have fair skin.
- Usually forms on areas of the skin that receive more sun exposure, such as the head, neck, hands, and forearms.
- Important to treat as AK can progress to squamous cell carcinoma (SCC).
Basal Cell Carcinoma (BCC)
- Most common type of skin cancer.
- Flesh-colored, pearl-like bump or pinkish patch.
- Common in people who have fair skin, yet they can occur in people with darker skin.
- Usually form on the skin after years of sun exposure or indoor tanning.
- Common on the head, neck, and arms, yet can form anywhere on the body, including the chest, abdomen, and legs.
- Important to treat as BCC can invade surrounding tissue and grow into nerves and bones.
Squamous Cell Carcinoma (SCC)
- Second most common type of skin cancer.
- Red, firm bump, scaly patch, or sore that heals and reopens.
- Common in people who have light skin, yet SCC can develop in darker-skinned people.
- Usually form on skin that gets frequent sun exposure (rim of ear, face, neck, arms, chest, and back).
- Can grow deep in the skin and cause damage and disfigurement.
- Early treatment can prevent damage and stop SCC from spreading to other areas of the body.
Melanoma
- Deadliest form of skin cancer.
- Appears in a mole or suddenly appears as a new dark spot on skin.
- Early treatment is crucial.
- Knowing the melanoma ABCDE warning signs to detect melanoma early.
Early Detection of Melanoma
Use the A B C D E guide to detect moles or lesions; however, it should not replace regular skin cancer screening or physician’s examination.
Atypical Mole Removal
Atypical moles are also called dysplastic moles, and they are very common. In fact, an estimated one out of every 10 Americans has at least one atypical mole.
Atypical moles are larger than common moles with borders that are irregular and poorly defined. Atypical moles vary in color, ranging from tan to dark brown shades on a pink background. Their irregular borders may include notches, or they may fade into surrounding skin and include a flat portion that is level with the skin.
Atypical Moles and Melanoma Risk
While atypical moles are considered more likely to develop into melanoma than regular moles, not everyone who has atypical moles gets melanoma. With a higher melanoma risk involved, it is important to have any atypical moles evaluated particularly when there’s any family history of melanoma. Dr. Carroll “grades” or categorizes atypical moles based on the cellular features she observes microscopically. She visually categorizes the degree of disorganization seen within the cells that make up the mole to determine whether the atypia is mild, moderate or severe.
Each patient is different, and Dr. Carroll takes into account a variety of factors before recommending whether an atypical mole should be removed or more aggressively watched for any change. Dr Carroll utilizes Dermoscopy to help determine if a particular lesion is atypical and needs to be biopsied or excised. Dermoscopy is the examination of the skin using skin surface microscopy mainly to evaluate pigmented skin lesions. Dermoscopy allows Dr. Carroll to properly diagnosis possible melanoma.
What are Moles?
Moles are common to most people. While most are not a medical concern, some can indicate a serious medical problem such as skin cancer.
At Carroll Dermatology Surgery and Laser Institute in West Palm Beach, we evaluate moles and determine if removal or treatment is necessary. Some patients choose to have benign, non-cancerous moles removed for appearance reasons.
The Formation of Moles on the Body
Moles can appear anywhere on the body and are usually round or oval shaped. Their color is normally shades of brown or black, and their texture can be smooth, rough, flat or raised. They form when the skin pigmentation cells grow together instead of their normal spacing on the skin. In addition to a full body screening each year, we recommend you personally check your moles for any changes in color, shape, size, or texture.
Moles can be removed for a variety of reasons:
- Cosmetic discomfort
- Physical discomfort
- Cancerous or precursor of cancer
Mole Removal
Dr. Carroll closely examines your moles to see if they need removal using one of these specialized dermatology procedures.
- Surgical excision in which an entire mole can be removed using stitches
- Surgical shave in which a surgical blade is used to remove the mole
Your mole should not return after mole removal; however, you should contact Dr. Carroll immediately if a removed mole returns as it may be a sign of melanoma skin cancer. It is important to remember that only a trained doctor should perform mole removal. Improperly removing a mole can cause scarring, infection, or potential spread of cancer if the mole in fact is cancerous.
Non-Melanoma Skin Cancer
Non-melanoma skin cancer (NMSC) refers to a group of skin cancers that develop from the cells in the skin other than melanocytes, which are responsible for melanoma.
The two most common types of NMSC are Basal Cell Carcinoma (BCC) and Squamous Cell Carcinoma (SCC). Although they are less aggressive than melanoma, NMSC can still cause significant damage if left untreated.
How Does General Incisions Work?
Basal Cell Carcinoma (BCC)
The standard treatment for Basal Cell Carcinoma is surgical excision, which involves a general incision. After administering local anesthesia to numb the area, the surgeon carefully cuts into the skin to remove the tumor along with a margin of healthy tissue to ensure complete eradication. In some cases, a specialized technique called Mohs Micrographic Surgery may be used to remove the tumor layer by layer, examining each layer under a microscope until no cancer cells are detected, resulting in minimal damage to surrounding healthy tissue.
Squamous Cell Carcinoma (SCC)
Similar to BCC, the primary treatment for Squamous Cell Carcinoma involves surgical excision with a general incision under local anesthesia. The surgeon removes the tumor along with a margin of healthy tissue to ensure complete removal. Depending on the size, location, and aggressiveness of the SCC, additional treatments such as radiation therapy or topical chemotherapy creams may be recommended to eliminate any remaining cancer cells and reduce the risk of recurrence.
Embark on Your Skincare Journey Today
At Carroll Dermatology, we are dedicated to providing high-quality medical and aesthetic services to our patients.
