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Basal Cell Carcinoma — SCE Dermatology MCQ

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HardDermatological SurgeryBasal Cell CarcinomaSCE Dermatology

A 55-year-old woman with morphoeic BCC on her temple undergoes Mohs micrographic surgery. How does Mohs surgery differ from standard excision in terms of margin assessment?

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Correct answer: E — Mohs examines 100% of the surgical margin using en face frozen sections

The best answer is “Mohs examines 100% of the surgical margin using en face frozen sections”. BAD guidance stratifies BCC by site, subtype, border and margin status; high-risk or incompletely excised disease requires specialist discussion, while treatment should balance clearance, function and tissue preservation. The alternatives “Standard excision examines 100% of margins, within an appropriate UK pathway”, “Mohs uses wider clinical margins, after clinicopathological correlation, after specialist assessment”, “Mohs uses vertical bread-loaf sections like standard histology, after specialist assessment”, “Both techniques examine identical amounts of margin tissue, when the full phenotype supports it” are clinically adjacent possibilities, but they do not fit the defining morphology, distribution, histopathology, risk signal or management sequence in this stem.

Reference: BAD basal cell carcinoma guideline 2021: https://academic.oup.com/bjd/article/185/5/899/6599942