Dense inflammation does not mask residual primary basal cell carcinoma during Mohs micrographic surgery

Background: Areas of dense inflammation are commonly removed during Mohs micrographic surgery for basal cell carcinoma because of the concern that they may mask areas of tumor. Objective: Our purpose was to determine whether inflammation masks tumor during Mohs surgery for primary basal cell carcinoma. Methods: Twenty-five consecutive cases of primary basal cell carcinoma with areas of dense inflammation encountered during Mohs surgery were sectioned and stained with hematoxylin and eosin and Ber-EP4. Results: In no cases did the dense inflammation mask residual tumor. Conclusion: Dense inflammation does not mask primary basal cell carcinoma during Mohs surgery and should be carefully evaluated before additional surgery is performed. (J Am Acad Dermatol 2001;45:231-8.)