Frederic E. Mohs, MD, and the history of zinc chloride

Charles Hewitt Moore, FRCS (1821-1870): Medical innovator

Charles Hewitt Moore, a Fellow of the Royal Society of Medicine, practiced at Middlesex and St. Luke's Hospitals and was administratively active in The Medical and Chirurgical Society. From 1851 to 1868, he demonstrated expertise in general surgery and the lymphatic system; on pelvic deformity and disease; on the vascular system and aneurisms; on the etiology of cancer; and on the neurophysiology of sleep. He subscribed to two principles of medical investigation: anomalies can reveal new information; and the propagation of untested theory inhibited medical learning and practice. Translator of the German edition of Rokitansky's Handbook (vol. 3, 1851), Moore wrote twelve papers, three chapters for Holmes' System of Surgery (1860-1862), and two treatises. Renowned in vascular and cancer surgery, he combined ablation with ZnCl₂ against cutaneous and breast cancer. Theorizing that ganglionic nerve tissue was involved in the sleep cycle, he anticipated modern investigations into the sleep-related activity of basal ganglia, the only nerve tissue of that kind in the brain.

Basal cell carcinoma with bone invasion: A systematic review and pooled survival analysis

BACKGROUND

Although basal cell carcinoma (BCC) tends to follow an indolent course, some tumors can exhibit locally aggressive behavior and invade into bone.

OBJECTIVE

To analyze all published demographic, clinical, and treatment data on recurrence patterns, disease progression, disease-specific death, and overall mortality of BCC with bone invasion.

METHODS

A systematic review and pooled-survival analysis was performed, including case reports and case series of BCC with bone invasion.

RESULTS

The study included 101 patients from 70 publications. BCC tumors invading into bone were most often large, neglected tumors located in high-risk face areas. At 5 years, patients had a 30% risk probability of disease recurrence (after negative margins), a 72.1% risk of disease progression or death (with ambiguous margin status), an 18.2% risk of BCC-related death, and a 20.7% overall probability of death.

LIMITATIONS

Limitations include the reliance on case reports and series for individual patient data, which has the potential to introduce selection bias.

CONCLUSION

The high rate of disease progression and suboptimal 5-year survival rate highlights the poor prognosis of BCC with bone invasion and further underscores the importance of early detection and treatment.

The Role of Mohs Surgery in Cutaneous Head and Neck Cancer

Mohs micrographic surgery (MMS) represents an excellent means to address basal cell carcinoma and some squamous cell carcinomas (cSCCs) of the head and neck region, achieving excellent outcomes with respect to local recurrence rates and disease-specific survival. MMS by virtue of its technique maximally preserves uninvolved tissues of the head and neck, thereby maintaining form, cosmesis, and function to the greatest extent as dictated by the disease. However, the application of MMS for managing high-risk cSCC and melanoma requires additional investigation. MMS may also prove beneficial in treating rare cutaneous diseases such as Merkel cell carcinoma and dermatofibrosarcoma protuberans.