Surgical Dermatology

Mohs Surgery

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There are many situations in which Mohs surgery is the best option, including:

• Lesion in a delicate area
• Recurring lesion
• Scar tissue in or around the lesion
• Large cancerous lesion
• Lesion that lacks clear borders
• Rapid growing lesion

If a high cure rate is the top objective of skin cancer treatment, Mohs surgery is unquestionably the best option.

Mohs surgery includes many steps. Dr. Ravitskiy starts by examining your skin lesion and creating a treatment plan. She administers local anesthesia to numb your skin.

Next, Dr. Ravitskiy removes your skin lesion and one layer of skin beneath the lesion. She may remove multiple layers of tissue, one at a time, with lab exams between each removal to check for signs of cancer.

Through the immunohistochemistry process, Dr. Ravitskiy uses antibodies to look for specific antigens (markers), like MART1 and CK20, in tissue samples. This can help with differentiating cancers like basal cell carcinoma, squamous cell carcinoma, and melanoma.

The process of incremental tissue removal and lab testing continues until Dr. Ravitskiy finds no trace of cancerous cells. This process allows her to remove all the cancer without losing the healthy tissue around it.

A small wound might not require reconstruction because the skin can heal naturally. But many tumor removals leave behind larger wounds requiring skin reconstruction. Usually, Dr. Ravitskiy does so immediately after your procedure.

Depending on the depth and size of your wound, there are a few options:

• Bandage over wound
• Stitches to close the wound
• Skin graft (a skin transfer without its blood supply)
• Skin flap (a skin transfer with deeper tissues attached)

At your post-surgery appointment, Dr. Ravitskiy examines your wound and makes sure that you're healing well.

Because skin cancer has a high recurrence rate, it's extremely important to come into Ohio Dermatology Center for each of your regular checkups on time. Dr. Ravitskiy can identify skin cancer in its earliest stages so you can take action to prevent serious outcomes.

For Mohs surgery from a fellowship-trained ACMS fellow, contact Ohio Dermatology Center or click the online scheduling tool.

Skin Cancer Options

Skin cancer treatment varies considerably based on the type of cancer, the chance of recurrence, and your history of skin cancer.

For some skin cancers, particularly first-time occurrences, Dr. Ravitskiy may perform an excision to remove the growth and some of the tissue around it.

For actinic keratosis, a combination approach called LEVULAN® KERASTICK® with BLU-U® photodynamic therapy may be the best treatment. In this treatment, Dr. Ravitskiy applies a topical acid and then exposes your skin to a blue light that destroys the growth.

If you have advanced skin cancer, fast-growing cancer like melanoma, or are at risk for recurrence, you may need Mohs surgery. During this procedure, Dr. Ravitskiy removes cancer cells one layer at a time. After Mohs surgery, she does skin reconstruction to help you heal.

Rhinophyma Surgery

Rhinophyma is the most common clinical manifestation of phytamous rosacea. While conservative methods (e.g. topical or systemic antibiotics, retinoids) are effective for the treatment of acne rosacea, a surgical intervention is appropriate and required in established rhinophyma. A simple surgical excision using a scalpel to shave off the abnormal tissue with electrocauterization of the bleeding points can be performed.

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