Mohs micrographic surgery (MMS) for atypical fibroxanthoma (AFX)—a fibrohistiocytic tumor with relatively high local recurrence rates, but low metastatic potential—is associated with a lower recurrence rate than wide local excision (WLE), a recent study found. Researchers sought to systematically review evidence of AFX recurrence and metastatic rates following different surgical modalities. They conducted a comprehensive literature search from 1946, or database inception, to March 20, 2017. 23 studies were selected (907 patients and 914 tumors). 175 cases were treated with MMS (recurrence rate, 2.0%; metastatic rate, 1.9%). 732 were treated with WLE (recurrence rate, 8.7; metastasis rate, 1%). Researchers found that among immunocompromised patients, no recurrence or metastases developed in the MMS subgroup, whereas 4 out of 10 recurred and 1 out of 10 metastasized in the WLE subgroup.
Tolkachjov SN, Kelley BF, Alahdab F, Erwin PJ, Brewer JD. Atypical fibroxanthoma: Systematic review and meta-analysis of treatment with Mohs micrographic surgery or excision. [Published online ahead of print July 5, 2018]. J Am Acad Dermatol. doi:10.1016/j.jaad.2018.06.048.
This Week's Must Reads
ALT-70 Gets High Marks for Diagnosing Cellulitis, J Am Acad Dermatol; ePub 2018 Jul 9; Li, et al
MMS/MART-1 Immunostaining for Atypical Melanocytes, J Am Acad Dermatol; ePub 2018 Jul 9; Etzkorn, et al
Economic Analysis of Noninvasive Pathologic Assay, JAMA Dermatology; ePub 2018 Jul 11; Hornberger, et al
Use of Advanced Practice Professionals on the Rise, JAMA Dermatology; ePub 2018 Jul 11; Zhang, et al
Folate and Risk of Cutaneous Melanoma in Women, Cancer Epidemiol; 2018 Aug; Dhana, Ten, Li, et al
Must Reads in Dermatologic Surgery
Safety of Dermatologic Surgery in an Office Setting, Dermatolog Surg; ePub 2018 Jun 27; Schmitt, et al
Mohs Surgery Effective for Atypical Fibroxanthoma, J Am Acad Dermatol; ePub 2018 Jul 5; Tolkachjov, et al
Surgical Management of Hidradenitis Suppurativa, J Surg Res; 2018 Sep; Ruan, Chen, Singhal, et al
Primary Closure Lengths in MMS Based on Cancer Type, Dermatolog Surg; ePub 2018 Jun 8; Theroux, et al
Acne Successfully Treated with Laser Combination, Dermatolog Surg; ePub 2018 Jun 5; Bakus, et al