Tiefenbrunn - American Society for Mohs Surgery

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Comments Not enough overlap to determine clear margin. This case can be reviewed and gets comments: Stain is too dark Tumor is near epidermis in stage II and therefore stage III needs to have skin edge, which it doesn’t • The slides will be scanned, and possibly photographed. • The map will be scanned. • A critique of the case, including the first reviewers comments will be created and sent to the presenter. • The case may become a teaching case. • Satisfactory means pass • Comments means fail • Loss of ASMS Fellowship is no longer associated with lack of satisfactory completion of peer review. • Participation is not only required for the first four years. However, if you get Comments, hide the case and meet your CLIA requirements by cross-reading with another lab. • One cause is lack of information.
• But until we get a map, we are not going to agonize over it. • It’s unreviewable. • Are these follicular structure or tumor? • The peer review committee split 6 to 6. • Map issues-ink legend, • Tumor not marked on map • Relationship not shown • Sections not labeled • Confusing slide labeling • Non-standard Mohs technique • Bubbles • Too complex a case – over 3 Stages. • No Identifiable Tumor Stage I • Other (Specify) • Fix the case and send it back—map the tumor, draw the relationships. • Sometimes this can be done by fax. • If it is unreviewable because of an unsolvable controversy, a new case must be picked and submitted. The first case does not count toward the limit of two free tries per year. • A Satisfactory outcome can be used as one of the two peer review episodes required by CLIA. • Comments are meant to steer the presenter into improving his Mohs. • Unreviewable is used when there is no map, or the map is not marked, or when the panel cannot agree if a structure is tumor or not. A second case should be sent for review. • Select your case carefully y y • Present it well • OR THIS COULD HAPPEN TO YOU
Page 1 and 2: Sharon F. Tiefenbrunn, M.D. Private
Page 3 and 4: •Cases using nonstandard techniqu
Page 5 and 6: II • If skin edge is missing in s
Page 7 and 8: Observed margin True margin/defect
Page 9 and 10: • 1mm of skin edge will give you
Page 11 and 12: B2 •Ideally B2 should be inked as
Page 13 and 14: The section is then teased from und
Page 15 and 16: • Circle the relevant sections--
Page 17: It will be classified into one of t

Tiefenbrunn - American Society for Mohs Surgery

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