In your practice or during fellowship training, do you perform curettage of cutaneous carcinomas to define subclinical borders prior to Mohs?

RCT trial done by Huang et al., PMID 15389195 many years ago showed that curettage decreases layers and increases the size of defect but does not increase the number of flaps/grafts (this is all off memory, someone may want to check). So I curettage if I don't think a larger initial layer will chang...

No matter the debulking method - curettage vs. sharp - the end result is fewer Mohs stages and decreased likelihood of the Mohs specimen “chunking“ from OCT media on a chuck. Thin skin, such as eyelids and helical rim, may not allow for even slight debulking. Sharp clinical eye will be a better guid...

I agree 100% with Dr. @Dr. First Last. I also remember from training (I haven't looked up any primary literature) that curettage decreases the likelihood of floaters. There are also advantages with thicker tumors, like dome-shaped SCCs, to debulking with curettage so that you don't get false positiv...

I'm quite late to the party on this thread, but just feel that the other side should be represented. During my fellowship, we "debulked" most tumors prior to Mohs, usually by curette, and I did this when I started practicing 27 years ago. After a year or so, I stopped debulking except for some large...