History of Mohs Micrographic Surgery

Mohs Micrographic Surgery (MMS) is the current gold standardStandards for surgically excising complex skin cancers in anatomically sensitive locations under comprehensive frozen section margin control. The history of Mohs surgery dates back to the 1930s. At the time, skin cancer treatment lacked formal guidelines for surgical margins, and the method for removal was not consistent nor refined. Dr. Frederic Mohs, a research assistant in the Department of Zoology at the University of Wisconsin, originally worked alongside Professor Michael F. Guyer in his lab studying intralesional tumor injections. Dr. Mohs’s serendipitous finding, that Zinc Chloride pasteZinc Chloride paste fixes tissue with preservation of histologic features, paved the way for the eventual use of the paste in vivo, with subsequent removal of the treated cancerous tissue and histologic evaluation of the resected margin, a novel idea at the time. Horizontal sectioning with precise tissue mapping was an innovative way to remove skin cancers, allowing more targeted removal and margin assessment. Due to the application of Zinc Chloride pasteZinc Chloride paste, MMS was initially called “chemosurgeryChemosurgery”. As the technique has evolved with time, so has the histologic processing, which distinguishes MMS from other skin cancer surgical approaches.