A 58-year-old man has a recurrent basal cell carcinoma on the nasal ala after two prior simple excisions. Which treatment modality offers the lowest recurrence rate for this lesion?

• A Repeat wide local excision with 4 mm margins
• B Curettage and electrodesiccation
• C Mohs micrographic surgery ✓
• D Topical 5-fluorouracil cream

Explanation

Mohs micrographic surgery allows complete margin examination via frozen sections while sparing tissue, giving five-year cure rates above 95 percent for recurrent and morphoeic facial basal cell carcinoma. Recurrent tumours send invisible finger-like projections along embryonic fusion planes of the nose, which simple excision misses. Curettage and topical therapy are unsuitable for recurrent disease, and repeat excision carries a higher recurrence rate than Mohs.

Reference: Rook's Textbook of Dermatology, 9th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.