Few data exist to guide the application of Mohs micrographic surgery (MMS) in the pediatric population.
To summarize the clinical characteristics of children undergoing MMS, identify challenges that limit the use of MMS in this population, and examine how these challenges can be overcome.
A systematic review of PubMed and EMBASE, from inception of databases to November 2, 2019, identified all cases of pediatric skin lesions treated with MMS.
A total of 111 patients were included. The median patient age was 11 years (range 6 weeks to 17 years). The most commonly treated tumor was DFSP (n=62), followed by BCC (n=30). The most common location was the head and neck (n=34), followed by trunk (n=28) and extremities (n=23).The most commonly cited challenges in the application of MMS in children included: patient cooperation, concerns for safety of prolonged general anesthesia, availability of a Mohs surgery service in the pediatric setting, and access to a histopathology lab experienced in MMS sectioning.
Many articles did not report specific patient characteristics.
Multiple obstacles limit the application of MMS in pediatrics. This review describes practical methods to circumvent these obstacles in order to facilitate the appropriate use of MMS in children.

Copyright © 2020. Published by Elsevier Inc.