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In standard wide excision, skin cancer is removed with margins and the wound is closed immediately after. The tissue sample is then sent across for routine histological processing. The processing takes a number of days during which cross sections (or vertical sections) are created at various distances through the sample and are microscopically assessed by a pathologist.

The pathologist looks for skin cancer at the margins of each section, but these are actually only a fraction of the actual excision margin when compared to Mohs Micrographic Surgery. It may, however, be adequate for certain tumours especially in locations over the trunk and limbs where it is less cosmetically sensitive.

A complete assessment from a dermatologist and Mohs micrographic surgeon is imperative to discuss both options and select a plan of management based on tumour characteristics and patient preferences.

Dr Angeline Yong is a dermatologist and dermatological surgeon whose clinical interests are in skin cancers, Mohs Micrographic Surgery and cutaneous reconstruction. An integral member of both the skin cancer division and Mohs Micrographic Surgery service at the National Skin Centre, Dr Yong has completed a year-long fellowship at St John’s Institute of Dermatology, Guy’s and St Thomas’ NHS Trust, which is the leading, as well as largest dermatology centre in the United Kingdom.

She is also the first and currently the only Singaporean to qualify to be admitted as a member of the American College of Mohs Surgery, the leading body that accredits Mohs Micrographic Surgeons in the United States. In addition, she is also an international fellow of the American Society of Mohs Surgery, member of the American Society of Dermatologic Surgery, and member of the British Society of Dermatologic Surgery.

Specialized range of treatments