Retrospective Study of Punch Scoring Versus Freehand Approach for First Stage Mohs Micrographic Surgery.

The objective was to observe whether there is a difference in the number of subjects requiring more than one stage of Mohs micrographic surgery for small lesion nonmelanoma skin cancers using the punch scoring method versus freehand approach. Retrospective review. Outpatient Mohs Clinic. Thirty patients with small lesion (<5mm) basal cell and squamous cell carcinoma who had Mohs micrographic surgery using either the punch scoring method (15) for scoring the first layer or the freehand method (15). Differences between the two groups were evaluated by the number of subjects requiring more than one stage and the reason for any additional stages. There was no observed difference in the number of subjects requiring more than one Mohs stage between the punch scoring group and the freehand group. Dermatologic surgeons can use the punch scoring method or the freehand approach for scoring small lesion Mohs based on provider preference.