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King├ó┬?┬?s College London, UK
Posters & Accepted Abstracts: J Clin Exp Dermatol Res
Introduction: MMS is arguably the most revolutionary dermatosurgical technique of the last century and it is regarded as the gold standard for the treatment of NMSC, which has an increasing incidence and presents a huge financial challenge to the NHS. However, MMS is not always the most appropriate treatment option. Aim: This review article provides an opportunity to examine the appropriate use criteria (AUC) for MMS specifically looking at the cost and complexity of the lesion determined by the location, subtype and size of the lesion. Method: 25 relevant publications were identified on Medline, PubMed, AMED and CIAHL. These publications were analyzed for cost-effectiveness, selection criteria, patient experience and outcomes following MMS in NMSC patient cohort. Results: MMS is shown to be superior when compared to standard surgical excision (SSE) in terms of safety, recurrence rates and aesthetic outcomes. Although the immediate cost is much higher than SSE, it has been shown that given the reduced future costs incurred due to less subsequent procedures, MMS is the more cost effective technique, if used in complex and recurrent NMSC. SSE is however the most appropriate option for less complex cancers. Conclusion: Expanding the use of MMS for inappropriate indications raises the cost of medical expenses to the NHS. MMS should only be reserved for more complex and recurrent NMSC and when it is deemed inappropriate there are other evidence based medical treatment options that can be offered. Recent advances in molecular pathways may inevitably represent a paradigm shift towards medical management of NMSC.
Ali Ansaripour is a fourth year Medical student at King’s College London with a great interest in Dermatology and Dermatological Surgeries. He completed his Undergraduate Dermatology Training from St. John's Institute of Dermatology under the supervision of Dr. Raj Mallipeddi and Professor John McGrath. He recently won the Student Prize from the British Society of Dermatological Surgery (BSDS) for his article on Mohs’ micrographic surgery in non-melanoma cancer treatment in the UK.
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