Application Of Dermoscopy In Slow Mohs Micrographic Surgery For The Surgical Margin Of Basal Cell Carcinoma

Basal cell carcinoma is the most common non-melanocytic malignant tumor in dermatology.which is mostly seen in the elderly.The internationally recommended treatment method is Mohs microscopic surgery.Slow Mohs microscopy surgery is an improvement on the classic MMS.which is a technique of fixing with formalin solution and embedding sections in paraffin,orienting tissues in a way similar to MMS,and performing complete edge analysis.However,its high surgical cost and long operation time limit further development in the country,which requires us to further explore new methods to assist in defining the boundary of BCC surgery.Objective:To evaluate the clinical application value of dermoscopy in the determination of surgical margins of BCC with s MMS,and to explore whether the use of dermatoscopy to determine the surgical margins of BCC can reduce the number of final s MMS surgical resections and reduce tissue damage.Methods : A total of 102 cases of basal cell carcinoma diagnosed by pathology in the Department of Dermatology of the First Affiliated Hospital of Xinjiang Medical University from December 2018 to December 2020 were selected and divided into a case group and a control group.In the case group,dermoscopy was used to observe the boundary of BCC surgery before operation.Based on the boundary defined by dermoscopy,resection was performed with reference to the traditional surgical margin,and histopathological examination was performed respectively.In the control group,s MMS was used for resection,and the difference between the positive surgical margins determined between the two and the number of final surgical resections were compared,and statistical analysis was performed.Result:1.The study included 102 BCC patients.The average age of 102 patients was 64.5 years(30-88 years),the average age of onset was 56.3 years(0-84 years),and the average course of disease was 8.6 years(0.17years-68 years).There was no statistically significant difference between the groups.2.With multiple operations as the dependent variable(0=single,1=multiple),gender,age,age of onset,course of disease,tumor length,tumor width,and tumor type were independent variables,but logistic regression analysis was performed.Show: Tumor width(OR=1.565,P=0.031)is a possible risk factor for multiple operations.3.There was no significant difference in the number of final resections between the case group and the control group(P=0.803).Conclusion:Although our final research results did not confirm that dermoscopy can reduce the number of final surgical resections for slow MMS,this study provides practical suggestions for improving the slow MMS technique.With the popularization of dermatoscope in clinic,its simple operation makes it more acceptable to patients,and the detection of BCC boundary by dermoscopy is better than naked eye observation.Dermoscopy will have greater clinical value in defining BCC boundaries in the near future.Nevertheless,a larger population-based sample is still needed to confirm this view.