Vulvar Dermatofibrosarcoma Protuberans: Surgical Planning and Management Considerations for the Dermatologic Surgeon.

Background: Dermatofibrosarcoma protuberans (DFSP) arising in the vulvar and perivulvar region poses unique challenges to the dermatologic surgeon. The potential for broad subclinical extension and involvement of deeper and high-risk functional structures requires a strong knowledge of relevant anatomy. Careful considerations are required for preoperative arrangements, surgical day preparations, and postoperative surveillance to improve treatment outcomes and patient experiences.

Assessment of a Deep Learning Model Trained on Permanent Pathology for the Classification of Squamous Cell Carcinoma in Mohs Frozen Sections: Lessons Learned.

Background: There is a scarcity of artificial intelligence models trained on frozen pathology. One way to expand the clinical utility of models trained on permanent pathology is by applying them to frozen sections and fine-tune based on weaknesses.

Objective: To qualitatively evaluate a deep learning model trained on permanent pathology to classify squamous cell carcinoma on Mohs surgery frozen sections to learn model shortcomings and inform retraining and fine-tuning.

Immunohistochemistry-Assisted Mohs Surgery for Invasive Eyelid and Periorbital Cutaneous Melanoma.

Background: Prior studies describe wide local excision and "slow Mohs" outcomes for periocular melanoma. Mohs micrographic surgery (MMS) with immunohistochemistry maximizes tissue preservation and offers same-day comprehensive margin evaluation, which facilitates expedited repair, and coordination of oculoplastic reconstruction when necessary.

Objective: To describe oncologic and reconstructive outcomes of invasive periocular cutaneous melanoma treated with immunohistochemistry-assisted MMS.

Mohs Micrographic Surgery for Invasive Melanoma Allows for Tissue Preservation Compared With Wide Local Excision: A Retrospective Cohort Study.

Background: While increasing evidence supports the safety and effectiveness of immunohistochemistry-assisted Mohs micrographic surgery (MMS) for superficially invasive melanoma, there is a paucity of the literature investigating its effect on final defect size.

Objective: To evaluate the tissue sparing effect of MMS for melanoma.

Materials And Methods: Three hundred and twenty-eight patients with early-stage (T1a/T1b) cutaneous melanomas treated with MMS from January 2008 to December 2018 were evaluated.

Risk factors associated with tumor upstaging in melanomas treated with Mohs micrographic surgery with melanocytic immunohistochemistry.

Background: Mohs micrographic surgery with melanocytic immunohistochemistry (MMS-I) is increasingly utilized for special site melanoma treatment. Yet, frequency and risk factors associated with upstaging of all-stage cutaneous melanomas treated with MMS-I remain undefined.

Objective: Determine upstaging frequency and factors associated with tumor upstaging for all-stage melanomas treated with MMS-I.

ChatGPT offers an editorial on the opportunities for chatbots in dermatologic research and patient care.

ChatGPT is a chatbot developed by OpenAI, an artificial intelligence research laboratory, that is trained on massive-scale internet text data to understand a broad range of language styles and topics. As a mature, conversational chatbot, ChatGPT can respond to follow-up questions and produce coherent primary texts based on the user's request. We explore the opportunities and risks of integrating chatbots into dermatologic patient care and research while presenting ChatGPT's response to the same question.

Cost-effectiveness analysis of margin-controlled surgery for vulvar Paget's disease.

Objectives: To determine the cost of two surgical treatment approaches for vulvar Paget's disease and model the cost-effectiveness considering differences in recurrence and reoperation over time.

Methods: We assessed cost-effectiveness between excision guided by Mohs micrographic surgery (MMS-E) and traditional wide local excision (WLE). We examined billing data from patients with vulvar Paget's disease who underwent MMS-E (cases, n = 24, 2018-2022) or WLE (controls, n = 64, 1990-2020).

Dermatologic surgeons' approaches to acral lentiginous melanoma: a survey of the American College of Mohs Surgery.

Acral lentiginous melanoma (ALM) is a subtype of melanoma that primarily affects ethnic minorities and is associated with poor outcomes. Racial inequalities in melanoma survival, particularly between Blacks and Whites, have been well documented in the literature. There are limited data on the role of surgical approach to ALM and its contribution to the existing disparities in ALM survival.