New research outlines Appropriate Use Criteria (AUC) for Mohs surgery.

The findings, which are co-published in the Journal of the American Academy of Dermatology and Dermatologic Surgery, mark the first AUC for any test or treatment within dermatology.

The Mohs AUC represents a collaborative initiative by the American Academy of Dermatology (AAD), American College of Mohs Surgery, the American Society for Dermatologic Surgery Association and the American Society for Mohs Surgery.

“These Appropriate Use Criteria for Mohs surgery embody a unique effort to develop criteria to support the efficient use of medical resources while providing the highest quality care for the patients who will benefit the most,” says dermatologist Suzanne M. Connolly, MD, chair of the Ad Hoc Task Force on the Development of Appropriate Use Criteria for Mohs Surgery, in a press release. “The goal of the AUC is to provide evidence-based guidance on which types of skin cancer cases are most appropriate for this specialized surgery.”

Nearly 80 dermatologists including both Mohs surgeons and non-Mohs dermatologists contributed to this AUC. They developed AUC for 270 scenarios for which Mohs surgery is frequently considered based on tumor and patient characteristics. The Mohs AUC outline highly specific skin cancer patient scenarios that dermatologists encounter in practice and classify the use of Mohs into one of three categories: appropriate, uncertain, or inappropriate.

Consensus was reached for all 270 scenarios with 200 (74.07 percent) deemed as appropriate, 24 (8.89 percent) as uncertain and 46 (17.04 percent) as inappropriate. (An appropriate rating means that Mohs is an acceptable approach for that clinical scenario and patient; other approaches also may be considered based on physician assessment.) The majority of scenarios involving the head, neck, hands, feet and genitalia were rated appropriate.

“As the incidence of skin cancer continues to climb and the practice of Mohs surgery advances in the future, Mohs surgeons, dermatologists, primary care providers and the health care community in general will need to understand how to best utilize Mohs surgery in the treatment of skin cancer – and the AUC we initiated is an important first step in that direction,” says Connolly.

For more information on the AUC for Mohs Surgery, visit the AAD.