title: Efficacy of photodynamic diagnosis-guided Mohs micrographic surgery in primary squamous cell carcinoma.
abstract: BACKGROUND
  Cutaneous squamous cell carcinoma (cSCC) usually has ill-defined margins because of its irregular invasive patterns.
  
  
  OBJECTIVE
  To evaluate the surgical efficacy of photodynamic diagnosis (PDD) in primary cSCC treated using Mohs micrographic surgery (MMS).
  
  
  METHODS
  We examined 67 cases of biopsy-proven primary facial cSCC treated with MMS. The 67 SCC were divided into the two groups depending on PDD application: PDD group (n = 38, 56.7%) and non-PDD group (n = 29, 43.3%). We analyzed the differences in surgical features between the PDD and non-PDD groups.
  
  
  RESULTS
  The PDD group required fewer Mohs stages (1.37 vs 1.83, p = .02) and smaller surgical margins (8.03 vs 11.24 mm, p = .03). PDD showed additional benefits in terms of surgical margin and Mohs stage, especially in low-risk SCC, including thin (≤4 mm), small (≤20 mm), well-differentiated, and nonulcerative tumors (p < .05) but did not show beneficial effects in high-risk SCC (p > .05) during MMS.
  
  
  CONCLUSIONS
  PDD can increase surgical efficacy of primary cSCC during MMS. These benefits are more pronounced in low-risk SCC. We recommend PDD as a simple and useful technique for delineating the margins of low-risk SCC before MMS.
authors.affiliation: Department of Dermatology, Skin Cancer Center, College of Medicine, Dong-A University, Busan, Korea.
authors.forename: Su-Young
authors.initials: SY
authors.lastname: Jeon
authors.forename: Ki-Ho
authors.initials: KH
authors.lastname: Kim
authors.forename: Ki-Hoon
authors.initials: KH
authors.lastname: Song
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000622:Aminolevulinic Acid; D001706:Biopsy; D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000601:surgery*; D005153:Facial Neoplasms / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015580:Mohs Surgery / Q000379:methods*; D060787:Neoplasm Grading; D017319:Photosensitizing Agents; D012878:Skin Neoplasms / Q000473:pathology* / Q000601:surgery*; D016896:Treatment Outcome
chemical_list: D017319:Photosensitizing Agents; D000622:Aminolevulinic Acid