title: Clinical usefulness of Mohs' chemosurgery for palliative purposes in patients with cutaneous squamous cell carcinoma with risk factors or without indication for surgery: three case reports.
abstract: Mohs' chemosurgery is a technique of chemical fixation of a cutaneous tumor using 20% zinc chloride, and the surgeon performs a sequential series of excisions until no residual tumor can be found in the bottom layer of the specimen by microscopic examination. This technique has also been gradually accepted as one of the palliative treatment options in patients with cutaneous tumors with risk factors for surgery. We report three cases of cutaneous squamous cell carcinoma that were treated with Mohs' chemosurgery for palliative purposes. In case 1, Mohs' chemosurgery could prevent rapid tumor growth and control the bleeding, exudation and offensive odor from ulcerated tumors. The patient was able to live enjoyably at home with her family before she was transferred to a palliative care hospital. In case 2, Mohs' chemosurgery followed by debridement of residual tumor and a full-thickness skin graft contributed to an early hospital discharge, which prevented the progression of cognitive decline. In case 3, remission of the tumor was achieved by concurrent treatment with local radiotherapy and Mohs' chemosurgery. Mohs' chemosurgery for palliative purposes is not a radical treatment, but contributes to the patient's quality of life. It has the possibility of becoming a radical treatment if eligible patients and concurrent treatment are carefully selected. An increase in the number of skin cancer patients with risk factors for surgery has been predicted because of the progression of the aging society. Mohs' chemosurgery may become one of the treatment options for such patients.
authors.affiliation: Department of Dermatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors.forename: Noriaki
authors.initials: N
authors.lastname: Nakai
authors.forename: Yasutaro
authors.initials: Y
authors.lastname: Okuzawa
authors.forename: Norito
authors.initials: N
authors.lastname: Katoh
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery*; D002712:Chlorides / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008297:Male; D015580:Mohs Surgery; D010166:Palliative Care; D011788:Quality of Life; D012307:Risk Factors; D012878:Skin Neoplasms / Q000473:pathology / Q000601:surgery*; D017967:Zinc Compounds / Q000008:administration & dosage
chemical_list: D002712:Chlorides; C583017:Mohs' paste; D017967:Zinc Compounds
keywords: Mohs' chemosurgery; Mohs' paste; cutaneous squamous cell carcinoma; palliative treatment; quality of life