How would you approach an ulcerative non-melanomatous skin cancer of the lower extremity s/p Mohs surgery with gross disease left behind?

If there is gross disease, then the wound is less likely to heal. Need to explore surgery with flap or RT as definitive management.

The key is to understand why there is gross disease left behind. If the patient is not a surgical candidate, then one must explore alternative therapies depending on the diagnosis. The ulceration will not resolve if the cancer is not addressed.

I want to answer the million-dollar question on why Mohs surgery left remaining residual disease and provide further insight into this case. In addition, I want to thank everyone for their expertise. This is an elderly patient with a pretibial basal cell carcinoma for several years, first treated wi...

Surgery, if possible to avoid RT (unlikely). Otherwise, definitive RT with the understanding that an amputation may be in the cards. Electively treat inguinal nodes.