Mohs Surgery Medication: Antibiotics

Sections

Mohs Surgery

Medication

Medication Summary

The goals of pharmacotherapy are to reduce morbidity and prevent complications.

Class Summary

Prophylactic antibiotics are recommended when the surgical site is considered high risk for surgical infection, including the oral mucosa, genitalia, and lower extremities below the knee.

Dicloxacillin

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Dicloxacillin is used for the treatment of infections caused by penicillinase-producing staphylococci. It may be used to initiate therapy when staphylococcal infection is suspected.

Cephalexin is a first-generation cephalosporin that arrests bacterial growth by inhibiting bacterial cell wall synthesis. It has bactericidal activity against rapidly growing organisms. Its primary activity is against skin flora, and it is used for skin infections or prophylaxis in minor procedures.

Clindamycin (Cleocin)

Clindamycin is a lincosamide for the treatment of serious skin and soft-tissue staphylococcal infections. It is also effective against aerobic and anaerobic streptococci (except enterococci). Clindamycin inhibits bacterial growth, possibly by blocking dissociation of peptidyl transfer ribonucleic acid (tRNA) from ribosomes, causing RNA-dependent protein synthesis to arrest.

Doxycycline (Adoxa, Doryx, Vibramycin, Monodox)

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Doxycycline is a broad-spectrum, synthetically derived bacteriostatic antibiotic in the tetracycline class. It is almost completely absorbed, concentrates in bile, and is excreted in urine and feces as a biologically active metabolite in high concentrations.

It inhibits protein synthesis and, thus, bacterial growth by binding to 30S and possibly 50S ribosomal subunits of susceptible bacteria. It may block dissociation of peptidyl t-RNA from ribosomes, causing RNA-dependent protein synthesis to arrest. The adult dosage is 100 mg orally twice daily. Severe hepatic dysfunction is a contraindication.

Azithromycin (Zithromax, Zmax)

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Azithromycin t is used to treat mild-to-moderate microbial infections. In adults, it is given in a single dose of 1 g orally. Azithromycin acts by binding to 50S ribosomal subunit of susceptible microorganisms and blocks dissociation of peptidyl tRNA from ribosomes, causing RNA-dependent protein synthesis to arrest. Nucleic acid synthesis is not affected. It concentrates in phagocytes and fibroblasts, as demonstrated by in vitro incubation techniques. In vivo studies suggest that concentration in phagocytes may contribute to drug distribution to inflamed tissues.

Trimethoprim and sulfamethoxazole (Bactrim, Bactrim DS, Septra DS)

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Trimethoprim/sulfamethoxazole inhibits bacterial growth by inhibiting the synthesis of dihydrofolic acid. The antibacterial activity of trimethoprim/sulfamethoxazole includes common urinary tract pathogens, except Pseudomonas aeruginosa.

Ciprofloxacin (Cipro)

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Ciprofloxacin is a fluoroquinolone with activity against most gram-negative organisms but no activity against anaerobes. It inhibits bacterial DNA synthesis and consequently growth.

Reeder VJ, Gustafson CJ, Mireku K, Davis SA, Feldman SR, Pearce DJ. Trends in Mohs surgery from 1995 to 2010: an analysis of nationally representative data. Dermatol Surg. 2015 Mar. 41 (3):397-403. [Medline].
Beal BT, White EK, Behera AK, et al. Patients' Body Image Improves After Mohs Micrographic Surgery for Nonmelanoma Head and Neck Skin Cancer. Dermatol Surg. 2018 May 24. [Medline].
Micrographic Surgery and Dermatologic Oncology. American Board of Dermatology. Available at https://www.abderm.org/residents-and-fellows/fellowship-training/micrographic-surgery-and-dermatologic-oncology.aspx. Accessed: 2018 Dec 27.
Connolly SM, Baker DR, Coldiron BM, et al. AAD/ACMS/ASDSA/ASMS 2012 appropriate use criteria for Mohs micrographic surgery: a report of the American Academy of Dermatology, American College of Mohs Surgery, American Society for Dermatologic Surgery Association, and the American Society for Mohs Surgery. J Am Acad Dermatol. 2012 Oct. 67(4):531-50. [Medline].
Jeon SY, Kim KH, Song KH. Efficacy of photodynamic diagnosis-guided Mohs micrographic surgery in primary squamous cell carcinoma. Dermatol Surg. 2013 Dec. 39(12):1774-83. [Medline].
Chin-Lenn L, Murynka T, McKinnon JG, Arlette JP. Comparison of outcomes for malignant melanoma of the face treated using mohs micrographic surgery and wide local excision. Dermatol Surg. 2013 Nov. 39(11):1637-45. [Medline].
Rowe DE, Carroll RJ, Day CL Jr. Prognostic factors for local recurrence, metastasis, and survival rates in squamous cell carcinoma of the skin, ear, and lip. Implications for treatment modality selection. J Am Acad Dermatol. 1992 Jun. 26(6):976-90. [Medline].
Padilla RS, Bailin PL, Howard WR, Dinner MI. Verrucous carcinoma of the skin and its management by Mohs' surgery. Plast Reconstr Surg. 1984 Mar. 73(3):442-7. [Medline].
Swanson NA, Taylor WB. Plantar verrucous carcinoma. Literature review and treatment by the Mohs' chemosurgery technique. Arch Dermatol. 1980 Jul. 116(7):794-7. [Medline].
Cheville JC, Bromley C, Argenyi ZB. Trisomy 7 in keratoacanthoma and squamous cell carcinoma detected by fluorescence in-situ hybridization. J Cutan Pathol. 1995 Dec. 22(6):546-50. [Medline].
Goldenhersh MA, Olsen TG. Invasive squamous cell carcinoma initially diagnosed as a giant keratoacanthoma. J Am Acad Dermatol. 1984 Feb. 10(2 Pt 2):372-8. [Medline].
Hodak E, Jones RE, Ackerman AB. Solitary keratoacanthoma is a squamous-cell carcinoma: three examples with metastases. Am J Dermatopathol. 1993 Aug. 15(4):332-42; discussion 343-52. [Medline].
Kingman J, Callen JP. Keratoacanthoma. A clinical study. Arch Dermatol. 1984 Jun. 120(6):736-40. [Medline].
Mikhail GR. Squamous cell carcinoma diagnosed as keratoacanthoma. Cutis. 1974. 13:378-84.
Schwartz RA. Keratoacanthoma. J Am Acad Dermatol. 1994 Jan. 30(1):1-19; quiz 20-2. [Medline].
Archer CB, Louback JB, MacDonald DM. Spontaneous regression of perianal extramammary Paget's disease after partial surgical excision. Arch Dermatol. 1987 Mar. 123(3):379-82. [Medline].
Chanda JJ. Extramammary Paget's disease: prognosis and relationship to internal malignancy. J Am Acad Dermatol. 1985 Dec. 13(6):1009-14. [Medline].
Coldiron BM, Goldsmith BA, Robinson JK. Surgical treatment of extramammary Paget's disease. A report of six cases and a reexamination of Mohs micrographic surgery compared with conventional surgical excision. Cancer. 1991 Feb 15. 67(4):933-8. [Medline].
Hurt MA, Hardarson S, Stadecker MJ, Santa Cruz DJ. Fibroepithelioma-like changes associated with anogenital epidermotropic mucinous carcinoma. Fibroepitheliomatous Paget phenomenon. J Cutan Pathol. 1992 Apr. 19(2):134-41. [Medline].
Jones RE Jr, Austin C, Ackerman AB. Extramammary Paget's disease. A critical reexamination. Am J Dermatopathol. 1979 Summer. 1(2):101-32. [Medline].
Mazoujian G, Pinkus GS, Haagensen DE Jr. Extramammary Paget's disease--evidence for an apocrine origin. An immunoperoxidase study of gross cystic disease fluid protein-15, carcinoembryonic antigen, and keratin proteins. Am J Surg Pathol. 1984 Jan. 8(1):43-50. [Medline].
Misago N, Toda S, Hikichi Y, Iyadomi M, Kohda H. A unique case of extramammary Paget's disease. Derivation from eccrine porocarcinoma?. Am J Dermatopathol. 1992 Dec. 14(6):553-9. [Medline].
Piura B, Zirkin HJ. Vulvar Paget's disease with an underlying sweat gland adenocarcinoma. J Dermatol Surg Oncol. 1988 May. 14(5):533-7. [Medline].
Burns MK, Chen SP, Goldberg LH. Microcystic adnexal carcinoma. Ten cases treated by Mohs micrographic surgery. J Dermatol Surg Oncol. 1994 Jul. 20(7):429-34. [Medline].
Chiller K, Passaro D, Scheuller M, Singer M, McCalmont T, Grekin RC. Microcystic adnexal carcinoma: forty-eight cases, their treatment, and their outcome. Arch Dermatol. 2000 Nov. 136(11):1355-9. [Medline].
Cooper PH. Sclerosing carcinomas of sweat ducts (microcystic adnexal carcinoma). Arch Dermatol. 1986 Mar. 122(3):261-4. [Medline].
Friedman PM, Friedman RH, Jiang SB, Nouri K, Amonette R, Robins P. Microcystic adnexal carcinoma: collaborative series review and update. J Am Acad Dermatol. 1999 Aug. 41(2 Pt 1):225-31. [Medline].
Goldstein DJ, Barr RJ, Santa Cruz DJ. Microcystic adnexal carcinoma: a distinct clinicopathologic entity. Cancer. 1982 Aug 1. 50(3):566-72. [Medline].
Wallace RD, Bernstein PE. Microcystic adnexal carcinoma. Ear Nose Throat J. 1991 Nov. 70(11):789-93. [Medline].
ADAMS JT, SALTZSTEIN SL. METASTASIZING DERMATOFIBROSARCOMA PROTUBERANS: REPORT OF TWO CASES. Am Surg. 1963 Dec. 29:878-86. [Medline].
Barnes L, Coleman JA Jr, Johnson JT. Dermatofibrosarcoma protuberans of the head and neck. Arch Otolaryngol. 1984 Jun. 110(6):398-404. [Medline].
Bendix-Hansen K, Myhre-Jensen O, Kaae S. Dermatofibrosarcoma protuberans. A clinico-pathological study of nineteen cases and review of world literature. Scand J Plast Reconstr Surg. 1983. 17(3):247-52. [Medline].
Bonnabeau RC Jr, Stoughton WB, Armanious AW, Cuono CB, Mossburg WL, Lancaster JR. Dermatofibrosarcoma protuberans. Report of a case with pulmonary metastasis and multiple intrathoracic recurrences. Oncology. 1974. 29(1):1-12. [Medline].
Garcia C, Clark RE, Buchanan M. Dermatofibrosarcoma protuberans. Int J Dermatol. 1996 Dec. 35(12):867-71. [Medline].
Gloster HM Jr, Harris KR, Roenigk RK. A comparison between Mohs micrographic surgery and wide surgical excision for the treatment of dermatofibrosarcoma protuberans. J Am Acad Dermatol. 1996 Jul. 35(1):82-7. [Medline].
Hess KA, Hanke CW, Estes NC, Shideler SJ. Chemosurgical reports: myxoid dermatofibrosarcoma protuberans. J Dermatol Surg Oncol. 1985 Mar. 11(3):268-71. [Medline].
Jimenez FJ, Grichnik JM, Buchanan MD, Clark RE. Immunohistochemical margin control applied to Mohs micrographic surgical excision of dermatofibrosarcoma protuberans. J Dermatol Surg Oncol. 1994 Oct. 20(10):687-9. [Medline].
Kahn LB, Saxe N, Gordon W. Dermatofibrosarcoma protuberans with lymph node and pulmonary metastases. Arch Dermatol. 1978 Apr. 114(4):599-601. [Medline].
McPeak CJ, Cruz T, Nicastri AD. Dermatofibrosarcoma protuberans: an analysis of 86 cases--five with metastasis. Ann Surg. 1967 Nov. 166(5):803-16. [Medline]. [Full Text].
Mikhail GR, Lynn BH. Dermatofibrosarcoma protuberans. J Dermatol Surg Oncol. 1978 Jan. 4(1):81-4. [Medline].
Peters CW, Hanke CW, Pasarell HA, Bennett JE. Chemosurgical reports. Dermatofibrosarcoma protuberans of the face. J Dermatol Surg Oncol. 1982 Oct. 8(10):823-6. [Medline].
Ratner D, Thomas CO, Johnson TM, Sondak VK, Hamilton TA, Nelson BR, et al. Mohs micrographic surgery for the treatment of dermatofibrosarcoma protuberans. Results of a multiinstitutional series with an analysis of the extent of microscopic spread. J Am Acad Dermatol. 1997 Oct. 37(4):600-13. [Medline].
Robinson JK. Dermatofibrosarcoma protuberans resected by Mohs' surgery (chemosurgery). A 5-year prospective study. J Am Acad Dermatol. 1985 Jun. 12(6):1093-8. [Medline].
Sagi A, Ben-Yakar Y, Mahler D. A ten-year-old boy with dermatofibrosarcoma protuberans of the face. J Dermatol Surg Oncol. 1987 Jan. 13(1):82-3. [Medline].
Altman DA, Nickoloff BJ, Fivenson DP. Differential expression of factor XIIIa and CD34 in cutaneous mesenchymal tumors. J Cutan Pathol. 1993 Apr. 20(2):154-8. [Medline].
Kutzner H. Expression of the human progenitor cell antigen CD34 (HPCA-1) distinguishes dermatofibrosarcoma protuberans from fibrous histiocytoma in formalin-fixed, paraffin-embedded tissue. J Am Acad Dermatol. 1993 Apr. 28(4):613-7. [Medline].
Dzubow LM. Sebaceous carcinoma of the eyelid: treatment with Mohs surgery. J Dermatol Surg Oncol. 1985 Jan. 11(1):40-4. [Medline].
Nelson BR, Hamlet KR, Gillard M, Railan D, Johnson TM. Sebaceous carcinoma. J Am Acad Dermatol. 1995 Jul. 33(1):1-15; quiz 16-8. [Medline].
Yount AB, Bylund D, Pratt SG, Greenway HT. Mohs micrographic excision of sebaceous carcinoma of the eyelids. J Dermatol Surg Oncol. 1994 Aug. 20(8):523-9. [Medline].
Zalla MJ, Randle HW, Brodland DG, Davis JL, Roenigk RK. Mohs surgery vs wide excision for atypical fibroxanthoma: follow-up. Dermatol Surg. 1997 Dec. 23(12):1223-4. [Medline].
Kimyai-Asadi A, Ayala GB, Goldberg LH, Vujevich J, Jih MH. The 20-minute rapid MART-1 immunostain for malignant melanoma frozen sections. Dermatol Surg. 2008 Apr. 34(4):498-500. [Medline].
Albertini JG, Elston DM, Libow LF, Smith SB, Farley MF. Mohs micrographic surgery for melanoma: a case series, a comparative study of immunostains, an informative case report, and a unique mapping technique. Dermatol Surg. 2002 Aug. 28(8):656-65. [Medline].
Snow SN, Mohs FE, Oriba HA, Dudley CM, Leverson G, Hetzer M. Cutaneous malignant melanoma treated by Mohs surgery. Review of the treatment results of 179 cases from the Mohs Melanoma Registry. Dermatol Surg. 1997 Nov. 23(11):1055-60. [Medline].
Sharma AN, Foulad DP, Doan L, Lee PK, Atanaskova Mesinkovska N. Mohs surgery for the treatment of lentigo maligna and lentigo maligna melanoma - a systematic review. J Dermatolog Treat. 2019 Nov 20. 1-7. [Medline].
Chesser RS, Bertler DE, Fitzpatrick JE, Mellette JR. Primary cutaneous adenoid cystic carcinoma treated with Mohs micrographic surgery toluidine blue technique. J Dermatol Surg Oncol. 1992 Mar. 18(3):175-6. [Medline].
Bullen R, Larson PO, Landeck AE, Nychay S, Snow SN, Hazen P, et al. Angiosarcoma of the head and neck managed by a combination of multiple biopsies to determine tumor margin and radiation therapy. Report of three cases and review of the literature. Dermatol Surg. 1998 Oct. 24(10):1105-10. [Medline].
Afshar M, Lee RA, Jiang SI. Desmoplastic trichilemmoma--a report of successful treatment with Mohs micrographic surgery and a review and update of the literature. Dermatol Surg. 2012 Nov. 38(11):1867-71. [Medline].
Van Mierlo PL, Geelen GM, Neumann HA. Mohs micrographic surgery for an erosive adenomatosis of the nipple. Dermatol Surg. 1998 Jun. 24(6):681-3. [Medline].
Bernstein SC, Roenigk RK. Leiomyosarcoma of the skin. Treatment of 34 cases. Dermatol Surg. 1996 Jul. 22(7):631-5. [Medline].
Davidson LL, Frost ML, Hanke CW, Epinette WW. Primary leiomyosarcoma of the skin. Case report and review of the literature. J Am Acad Dermatol. 1989 Nov. 21(5 Pt 2):1156-60. [Medline].
Iacobucci JJ, Stevenson TR, Swanson NA, Headington JT. Cutaneous leiomyosarcoma. Ann Plast Surg. 1987 Dec. 19(6):552-4. [Medline].
Brown MD, Swanson NA. Treatment of malignant fibrous histiocytoma and atypical fibrous xanthomas with micrographic surgery. J Dermatol Surg Oncol. 1989 Dec. 15(12):1287-92. [Medline].
Weimar VM, Ceilley RI. Chemosurgical reports. A myxoid variant of malignant fibrous histiocytoma: report of a case treated by Moh's technique with a slight modification. J Dermatol Surg Oncol. 1979 Jan. 5(1):16-8. [Medline].
Melancon JM, Tom WL, Lee RA, Jackson M, Jiang SI. Management of pilomatrix carcinoma: a case report of successful treatment with Mohs micrographic surgery and review of the literature. Dermatol Surg. 2011 Dec. 37(12):1798-805. [Medline].
American Heart Association. Infective endocarditis. Available at http://www.heart.org/HEARTORG/Conditions/CongenitalHeartDefects/TheImpactofCongenitalHeartDefects/Infective-Endocarditis_UCM_307108_Article.jsp. Accessed: January 23, 2014.
Wright TI, Baddour LM, Berbari EF, Roenigk RK, Phillips PK, Jacobs MA, et al. Antibiotic prophylaxis in dermatologic surgery: advisory statement 2008. J Am Acad Dermatol. 2008 Sep. 59(3):464-73. [Medline].
Matzke TJ, Christenson LJ, Christenson SD, Atanashova N, Otley CC. Pacemakers and implantable cardiac defibrillators in dermatologic surgery. Dermatol Surg. 2006 Sep. 32(9):1155-62; discussion 1162. [Medline].
El-Gamal HM, Dufresne RG, Saddler K. Electrosurgery, pacemakers and ICDs: a survey of precautions and complications experienced by cutaneous surgeons. Dermatol Surg. 2001 Apr. 27(4):385-90. [Medline].
Burg G, Hirsch RD, Konz B, Braun-Falco O. Histographic surgery: accuracy of visual assessment of the margins of basal-cell epithelioma. J Dermatol Surg. 1975 Oct. 1(3):21-4. [Medline].
Oganesyan G, Jarell AD, Srivastava M, Jiang SI. Efficacy and complication rates of full-thickness skin graft repair of lower extremity wounds after Mohs micrographic surgery. Dermatol Surg. 2013 Sep. 39(9):1334-9. [Medline].
Merritt BG, Lee NY, Brodland DG, Zitelli JA, Cook J. The safety of Mohs surgery: a prospective multicenter cohort study. J Am Acad Dermatol. 2012 Dec. 67(6):1302-9. [Medline].
Alam M, Ibrahim O, Nodzenski M, Strasswimmer JM, Jiang SI, Cohen JL, et al. Adverse events associated with mohs micrographic surgery: multicenter prospective cohort study of 20,821 cases at 23 centers. JAMA Dermatol. 2013 Dec. 149(12):1378-85. [Medline].
Cowan N, Goldenberg A, Basu P, Eilers R, Hau J, I Brian Jiang S. A Retrospective Analysis of Complication Rates in Mohs Micrographic Surgery Patients With Clinically Large Tumors and Tumors With Aggressive Subclinical Extension. J Drugs Dermatol. 2018 May 1. 17 (5):511-5. [Medline].
Bordeaux JS, Martires KJ, Goldberg D, Pattee SF, Fu P, Maloney ME. Prospective evaluation of dermatologic surgery complications including patients on multiple antiplatelet and anticoagulant medications. J Am Acad Dermatol. 2011 Sep. 65(3):576-83. [Medline].
Nasseri E. Prospective Study of Wound Infections in Mohs Micrographic Surgery Using a Single Set of Instruments. Dermatol Surg. 2015 Sep. 41 (9):1008-12. [Medline].

Media Gallery

Mohs surgery is generally indicated for the treatment of tumors in areas where a high risk of recurrence exists and cosmetic results are critical.
The conventional bread-loaf technique for checking tissue margins by using vertical sections. Less than 1% of the margin is evaluated, as compared with almost 100% of the margin with the Mohs surgical technique. As illustrated here, residual tumor may not be found and may recur.
A Mohs surgery specimen is carefully separated into 4 quadrants.
Each quadrant of a specimen undergoing Mohs surgery is marked with 2 different colored dyes.
Marked tissue undergoing Mohs surgical technique is embedded into a chuck for the cryostat.
A Mohs surgery tissue specimen is cut into thin sections.
Mohs surgery sections are stained with hematoxylin and eosin and placed on slides.
Mohs surgery sections are stained with hematoxylin and eosin and placed on slides.
Residual tumors are marked on a map.
An illustrated example of the Mohs surgical technique.

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Feature of Tumor	Mohs Surgery	Excision, Electrodesiccation and Curettage, Cryosurgery, and Radiation Therapy
Primary or recurrent	Recurrent or incompletely excised	Primary
Location	High risk; on ear, digits, genitalia, or central part of face	Low risk; on trunk and extremities
Histologic finding	Aggressive growth pattern: morpheaform, infiltrating, keratotic, perineural or perivascular invasion	Nodular, superficial
Size	>0.6-1 cm on face, >2 cm elsewhere	< 0.6-1 cm on face, < 2 cm elsewhere
Clinical nature	Ill-defined borders, multicentric, radiation, genetic syndrome with multiple tumors	Well-defined borders

Treatment	Primary Tumor, %	Recurrent Tumor, %
Mohs surgery	1.0	5.6
Surgical excision	10.1	17.4
Radiotherapy	8.7	9.8
Cryosurgery	7.5	13.0^*
Electrodesiccation and curettage	7.7	40.0
^* Less than 5 years; no statistics for 5-year follow-up.

Author

Shang I Brian Jiang, MD Clinical Professor of Medicine and Dermatology, Director, Dermatologic and Mohs Micrographic Surgery, Program Director, UCSD Dermatologic and Mohs Surgery Fellowship, University of California School of Medicine, San Diego

Shang I Brian Jiang, MD is a member of the following medical societies: American Academy of Dermatology, American College of Mohs Surgery, American Society for Dermatologic Surgery, Association of Professors of Dermatology

Disclosure: Nothing to disclose.

Coauthor(s)

Silvia Soohyun Song University of California San Diego School of Medicine

Disclosure: Nothing to disclose.

Maureen A Mooney, MD, FAAD, FACMS Partner, Cascade Eye and Skin Centers; Clinical Instructor, Division of Dermatology, University of Washington School of Medicine; Clinical Instructor, Pacific Northwest University of Health Sciences

Maureen A Mooney, MD, FAAD, FACMS is a member of the following medical societies: American Academy of Dermatology, American College of Mohs Surgery, American Society for Dermatologic Surgery, Washington State Medical Association

Disclosure: Nothing to disclose.

Chief Editor

Arlen D Meyers, MD, MBA Professor of Otolaryngology, Dentistry, and Engineering, University of Colorado School of Medicine

Arlen D Meyers, MD, MBA is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, American Head and Neck Society

Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: Cerescan;RxRevu;Cliexa;The Physicians Edge;Sync-n-Scale;mCharts<br/>Received income in an amount equal to or greater than $250 from: The Physicians Edge, Cliexa;Proforma;Neosoma<br/> Received stock from RxRevu; Received ownership interest from Cerescan for consulting; .

Acknowledgements

Dominique Dorion, MD, MSc, FRCSC, FACS Deputy Dean and Associate Dean of Resources, Professor of Surgery, Division of Otolaryngology-Head and Neck Surgery, Faculty of Medicine, Université de Sherbrooke, Canada

Disclosure: Nothing to disclose.

Dirk M Elston, MD Director, Ackerman Academy of Dermatopathology, New York

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Mary Farley, MD Dermatologic Surgeon/Mohs Surgeon, Anne Arundel Surgery Center

Disclosure: Nothing to disclose.

Maureen Ann Mooney, MD Partner, Cascade Eye and Skin Centers; Clinical Staff, Division of Dermatology, University of Washington School of Medicine

Maureen Ann Mooney, MD is a member of the following medical societies: American Academy of Dermatology, American College of Mohs Micrographic Surgery and Cutaneous Oncology, American Medical Association, American Society for Dermatologic Surgery, International Society for Dermatologic Surgery, Washington State Medical Association, and Women's Dermatologic Society

Disclosure: Nothing to disclose.

Edward Parry, MD Fellowship Director, Clinical Professor, Department of Dermatology, Louisiana State University Medical School

Edward Parry, MD is a member of the following medical societies: American Academy of Dermatology and Association of Military Surgeons of the US

Disclosure: Nothing to disclose.

Désirée Ratner, MD Director, Comprehensive Skin Cancer Center, Continuum Cancer Centers of New York, Director of Dermatologic Surgery, Beth Israel Medical Center and St. Luke's and Roosevelt Hospitals, Professor of Clinical Dermatology, College of Physicians and Surgeons of Columbia University

Désirée Ratner, MD is a member of the following medical societies: American Academy of Dermatology, American College of Mohs Micrographic Surgery and Cutaneous Oncology, American Medical Association, American Society for Dermatologic Surgery, and Phi Beta Kappa

Disclosure: Nothing to disclose.

Clark A Rosen, MD Director, University of Pittsburgh Voice Center; Professor, Department of Otolaryngology and Communication Science and Disorders, University of Pittsburgh School of Medicine

Clark A Rosen, MD is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, American Medical Association, and Pennsylvania Medical Society

Disclosure: Merz Aesthetic Inc Consulting fee Consulting; Merz Aesthetic Inc Consulting fee Speaking and teaching

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Richard P Vinson, MD Assistant Clinical Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine; Consulting Staff, Mountain View Dermatology, PA

Richard P Vinson, MD is a member of the following medical societies: American Academy of Dermatology, Association of Military Dermatologists, Texas Dermatological Society, and Texas Medical Association

Disclosure: Nothing to disclose.

Mohs Surgery Medication

Medication Summary

Antibiotics

Class Summary

Dicloxacillin

Dicloxacillin

Cephalexin (Keflex)

Cephalexin (Keflex)

Clindamycin (Cleocin)

Doxycycline (Adoxa, Doryx, Vibramycin, Monodox)

Doxycycline (Adoxa, Doryx, Vibramycin, Monodox)

Azithromycin (Zithromax, Zmax)

Azithromycin (Zithromax, Zmax)

Trimethoprim and sulfamethoxazole (Bactrim, Bactrim DS, Septra DS)

Trimethoprim and sulfamethoxazole (Bactrim, Bactrim DS, Septra DS)

Ciprofloxacin (Cipro)

Ciprofloxacin (Cipro)

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Mohs Surgery Medication

Medication Summary

Antibiotics

Class Summary

Dicloxacillin

Dicloxacillin

Cephalexin (Keflex)

Cephalexin (Keflex)

Clindamycin (Cleocin)

Doxycycline (Adoxa, Doryx, Vibramycin, Monodox)

Doxycycline (Adoxa, Doryx, Vibramycin, Monodox)

Azithromycin (Zithromax, Zmax)

Azithromycin (Zithromax, Zmax)

Trimethoprim and sulfamethoxazole (Bactrim, Bactrim DS, Septra DS)

Trimethoprim and sulfamethoxazole (Bactrim, Bactrim DS, Septra DS)

Ciprofloxacin (Cipro)

Ciprofloxacin (Cipro)

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