Do you give neoadjuvant intralesional 5FU/MTX prior to Mohs for CSCC purely to reduce scar size and improve cosmetic outcome?

No. With Mohs surgery, we know we can get high cure rates and good cosmetic outcomes.

I have never given intralesional chemotherapy before Mohs. The idea of shrinking the tumor before Mohs is interesting but I would be concerned with the amount of inflammation this could produce. It could make the interpretation of the Mohs slides more difficult.