title: Inherited bleeding disorders in dermatologic surgery.
abstract: BACKGROUND
  A patient referred for Mohs micrographic surgery of a basal cell carcinoma had a history of a congenital clotting factor IX deficiency requiring recombinant factor IX replacement.
  
  
  OBJECTIVE
  To examine the management and problems associated with cutaneous surgery in patients with inherited clotting factor deficiencies.
  
  
  METHODS
  Case report and review of the medical literature.
  
  
  RESULTS
  Reconstructive options must be carefully chosen to minimize bleeding in patients with clotting factor deficiencies. Preoperative consultation with a hematologist and coagulation factor replacement both before and after cutaneous surgery prevent excessive hemorrhage.
  
  
  CONCLUSIONS
  Meticulous attention to hemostasis, careful preoperative assessment, and postoperative follow-up minimize complications in patients with known coagulation deficiencies who require cutaneous surgery.
authors.affiliation: Department of Dermatology, University of Texas Health Science Center at Houston, 77030, USA. sraypeterson@hotmail.com
authors.forename: S R
authors.initials: SR
authors.lastname: Peterson
authors.forename: A K
authors.initials: AK
authors.lastname: Joseph
mesh_terms: D000368:Aged; D002280:Basal Cell Carcinoma / Q000150:complications* / Q000601:surgery; D005164:Factor IX / Q000008:administration & dosage; D002836:Hemophilia B / Q000150:complications* / Q000628:therapy; D006470:Hemorrhage / Q000209:etiology / Q000517:prevention & control; D006488:Hemostasis, Surgical; D006801:Humans; D008297:Male; D015580:Mohs Surgery; D009669:Nose Neoplasms / Q000150:complications* / Q000601:surgery; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control; D016038:Skin Transplantation
chemical_list: D005164:Factor IX