Mohs Micrographic Surgery

In certain situations, Dr. Eivins may recommend you for a specialized technique called Mohs micrographically controlled surgery. In this method, performed by specially trained dermatologic surgeons, the skin cancer is removed under local anesthesia in an office setting and microscopic sections are prepared on slides while you wait. Your Mohs surgeon examines the slides to determine if all the cancer cells have been removed. If not additional layers are taken until the cancer is completely excised. The advantage of this technique is that a minimum amount of tissue is removed and all the edges of the specimen are carefully studied. This method has a high cure rate, but is not required for all skin cancers. In general, most dermatologists agree that recurrent skin cancers (skin cancers that were previously treated and have come back, incompletely removed skin cancers, large skin cancers, and skin cancers in cosmetically important areas), may benefit from the Mohs technique. After the skin cancer has been removed using this method, it maybe allowed to heal naturally or reconstructive surgery using a skin flap or skin graft may be performed. The Dermatology center has a CLIA certified lab to perform Mohs Surgery.

Photodynamic Therapy (PDT)

Photodynamic therapy (PDT) using a topical medication called aminolevulinic acid has been approved by the Food and Drug Administration (FDA) to treat actinic keratosis (AKs), an early potential sign of skin cancer. Unfortunately, initial treatment using this medication overnight, combined with laser therapy, was found to be both difficult and uncomfortable for the patient. However, recent developments using aminolevulinic acid with lasers and light sources for shorter treatment periods (i.e. one hour), called "short contact" photodynamic therapy, have yielded much more positive results.

A typical short contact photodynamic therapy treatment begins with a light microdermabrasion. This technique is used to remove any dead skin cells on the surface of the face, which allows for better penetration of the aminolevulinic acid. The microdermabrasion is followed by a topical application of aminolevulinic acid, which is left in place for approximately 30 to 60 minutes. The medication is then removed using an alcohol swab, soap and water. Finally, the patient is treated with a laser or light source.

According to Dr. Eivins, "While initial results may be seen as early as the first session, some patients require a series of three to five sessions to see significant results. Recent studies show PDT to have excellent cosmetic results in addition to prevent formation of squamous cell carcinoma."