Vitaly Terushkin, MD

Mohs surgery frozen section of the week - Melanoma in situ on H & E. This is a beautiful and classic example showing nesting and confluence of atypical melanocytes at the dermal-epidermal junction.

Mohs surgery frozen section of the day - Squamous cell carcinoma with perineural invasion.

Mohs surgery frozen section of the day.

Calcium hydroxylapetite cosmetic filler was found incidentally during Mohs surgery for squamous cell carcinoma of the dorsal hand. Note the round refractile granules in the dermis.

Thanks so much for the kind words from our patient on !

We can still enjoy the sun, but it's important to be safe (hat, sunglasses, and sunscreen). 😎

Thanks so much to the .college for the opportunity to work on an important project for our specialty.

Mohs surgery frozen section of the week - Squamous cell carcinoma with single cell spread stained with H&E and AE1/AE3.

Immunohistochemistry has not only revolutionized the way Mohs surgeons treat melanoma (with the use of the MART-1 antibody) but is particularly helpful when treating aggressive keratinocytic neoplasms like squamous cell carcinoma and basal cell carcinoma.

Squamous cell carcinoma with single cell spread can be challenging to treat because these single cells can blend in with inflammation and surrounding stroma. The use of the pancytokeratin marker AE1/AE3 makes it much easier to track this tumor, remove it when seen, and improve cure rates.

Our high complexity in-house laboratory is the only Mohs lab in NYC that routinely performs real-time immunostaining during surgery for complex and high-risk cancers.

Thanks so much to this patient for her kind words on Google Reviews! We will gladly take 10 stars!

Thanks so much for the kind words from our patient on !

Today marks 15,000 Mohs surgeries completed since finishing fellowship!

When seeing a Mohs surgeon for your skin cancer, make sure to see someone with experience. Also, make sure they have graduated from an ACGME-accredited Mohs surgery fellowship.

The background image is a Mohs surgery frozen section of dermatofibrosarcoma protuberans.

Thanks so much to this patient for their kind words on !

Dr. Shane Meehan, my former dermatopathology fellowship director, visiting the office. We had an eventful and educational morning!

Mohs surgery frozen section of the week - Warty dyskeratoma.

On histopathology, this benign growth usually has a cup-shaped architecture filled with keratin. The acanthotic epidermis is comprised of acantholytic dyskeratotic cells.

It is important for Mohs surgeons to recognize this benign growth and not confuse it with an acantholytic squamous cell carcinoma. This confusion will lead to additional morbidity to the patient as additional tissue will be removed to clear this benign growth.

Mohs surgery case of the week -

This patient underwent Mohs surgery for melanoma with the MART-1 immunostain. The defect was repaired with a medially based bilobed flap. Note how the flap restored the collapsed ala and recreated symmetry.

Mohs surgery frozen section of the week-

Basal cell carcinoma with perineural invasion.

While basal cell carcinoma is considered to be a slow growing skin cancer, left untreated for many years, it can grow quite large, deep, and even wrap itself around nerves.

Mohs surgery frozen section of the week - Squamous cell carcinoma with perineural invasion stained with H&E and AE1/AE3.

The use of immunohistochemistry has not only revolutionized the way Mohs surgeons treat melanoma (with the use of the MART-1 antibody) but is particularly helpful when treating aggressive keratinocytic neoplasms like squamous cell carcinoma and basal cell carcinoma. Squamous cell carcinoma with perineural invasion has a high rerecurrence rate partially due to the difficulty in seeing the tumor cells with standard H&E. The use of the pancytokeratin marker AE1/AE3 makes it much easier to track this tumor, remove it when seen, and improve cure rates.

Our high complexity in-house laboratory is the only Mohs lab in NYC that routinely performs real-time immunostaining during surgery for complex and high-risk cancers.

Mohs surgery frozen section of the day - Squamous cell carcinoma with perineural invasion stained with H&E and AE1/AE3.

The use of immunohistochemistry has not only revolutionized the way Mohs surgeons treat melanoma (with the use of the MART-1 antibody) but is particularly helpful when treating aggressive keratinocytic neoplasms like squamous cell carcinoma and basal cell carcinoma. Squamous cell carcinoma with perineural invasion has a high rerecurrence rate partially due to the difficulty in seeing the tumor cells with standard H&E. The use of the pancytokeratin marker AE1/AE3 makes it much easier to track this tumor, remove it when seen, and improve cure rates.

Our high complexity in-house laboratory is the only Mohs lab in NYC that routinely performs real-time immunostaining during surgery for complex and high-risk cancers.

Four years in a row!

Closed out the year with over 250 melanomas treated with Mohs surgery and the MART-1 stain.

I am grateful for our patients and referring dermatologists for trusting us and for an excellent Mohs surgery team.

This is a textbook image of melanoma in situ. There is confluence, pagetosis, and nesting.

Happy New Year!

Mohs surgery case of the day - Squamous cell carcinoma with moderate differentiation.

This squamous cell carcinoma grew so deep that clearing the wound required removing all of the soft tissue and exposing the bone. On histopathology, there are sheets of atypical keratinocytes intermixed with keratin pearls.

Mohs surgery frozen section of the day - Melanoma stained with H&E and MART-1.

Note the prominent extension of atypical melanocytes along the adnexal structures.

Mohs surgery frozen section of the week - Basal cell carcinoma within a sea of Chronic Lymphocytic Leukemia (CLL).

On frozen section pathology, there are basaloid tumor islands surrounded by nodules of lymphocytes.

Notably, this patient was aware of his condition prior to surgery. However, two other times in my career, the diagnosis of CLL was made incidentally, and the patient was referred to appropriate specialists for evaluation.

Did you know that when melanoma is detected early, the 5-year survival rate soars to 99%? Regular skin checks and sun safety habits are key to catching warning signs early on. Let's spread the word and prioritize our skin health.

Thanks so much to this patient for their kind words.

We truly care about giving patients the best outcome from Mohs surgery.

Mohs frozen section of the week - Basal cell carcinoma invading muscle (on the chin).

Mohs surgery reconstruction of the week.

This patient underwent Mohs surgery with the MART-1 immunostain for a melanoma in situ of the left cheek. The defect was repaired with a bilobed flap. The patient tolerated the procedure well under local anesthesia.

Mohs surgery frozen section of the day - Cutaneous leiomyosarcoma of the scalp.

Cutaneous leiomyosarcoma is a rare neoplasm arising from smooth muscle. On histopathology, there are sheets of spindled cells with atypia. Mohs surgery provides excellent outcomes.

Great way to start the week! Thanks to our patient for the kind words. Happy Monday!

Thanks so much to our patient for the kind words. Our team is grateful and appreciative of the opportunity to care for our patients.

Mohs surgery frozen section of the day -
Primary cutaneous mucinous carcinoma (PCMC).

PCMC is a very rare, slow growing adnexal neoplasm. In these frozen sections, note the well-demarcated nodule within the dermis. It is comprised of collections of epithelial cells that appear to float within mucin.