Vitaly Terushkin, MD, FACMS

Fellowship-trained Mohs surgeon and board-certified Dermatologist and Dermatopathologist, specializing in Mohs surgery for melanoma and non-melanoma skin cancer

[Vitaly Terushkin, MD, FACMS @drvitalyt]

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

[Vitaly Terushkin, MD, FACMS @drvitalyt]

Mohs surgery frozen section of the week - collision of a basal cell carcinoma with a lymphangioma.

[Vitaly Terushkin, MD, FACMS @drvitalyt]

Mohs surgery (with MART-1) frozen section of the day - Melanoma in situ with adnexal extension.

[Vitaly Terushkin, MD, FACMS @drvitalyt]

Mohs surgery frozen section of the day - Melanoma in situ

Note the proliferation of atypical melanocytes arranged as single units and nests at the dermal epidermal junction and as single cells above it.

[Vitaly Terushkin, MD, FACMS @drvitalyt]

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

Immunostains for skin cancers such as AE1/AE3 for squamous cell carcinoma allow for superior interpretation of Mohs frozen sections compared to H&E alone.

[Vitaly Terushkin, MD, FACMS @drvitalyt]

Mohs surgery frozen section of the day -

Melanoma in situ stained with both H & E and MART-1.

Note the proliferation of melanocytes arranged as single units and nests at the dermal-epidermal junction and as single cells above it.

[Vitaly Terushkin, MD, FACMS @drvitalyt]

Today marks 11,000 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.

[Vitaly Terushkin, MD, FACMS @drvitalyt]

Mohs surgery frozen section of the day -

This basal cell carcinoma (BCC) was found incidentally while performing Mohs surgery for melanoma in situ with the MART-1 immunostain. Note how the melanocytes populate the BCC.

[Vitaly Terushkin, MD, FACMS @drvitalyt]

Mohs surgery frozen section of the day - Fibroepithelioma of Pinkus (FeP)

A FeP is a rare type of basal cell carcinoma that is characterized by thin basaloid strands of epithelium that interconnect.

[Vitaly Terushkin, MD, FACMS @drvitalyt]

Mohs surgery frozen section of the day - Intradermal nevus.

This benign lesion was found incidentally during Mohs surgery for a basal cell carcinoma.

The multinucleaned melanocytes may look abnormal but they are benign.

[Vitaly Terushkin, MD, FACMS @drvitalyt]

Mohs surgery frozen section of the day - Gelfoam.

Gelfoam is an absorbable gelatin sponge that is used to stop bleeding from skin wounds. Dermatologists sometimes use gelfoam after skin biopsies.

[Vitaly Terushkin, MD, FACMS @drvitalyt]

Last Mohs surgery day of 2021! It has been a productive year in more ways than one.

Grateful to have performed over 2000 Mohs surgeries with amazing coworkers.

And personally, @vicsorina and I welcomed our son Max.

Wishing everyone a happy and healthy new year!

[Vitaly Terushkin, MD, FACMS @drvitalyt]

Mohs surgery frozen section of the day - here we have a splinter with a surrounding foreign body giant cell reaction.

[Vitaly Terushkin, MD, FACMS @drvitalyt]

5 years in a row!

[Vitaly Terushkin, MD, FACMS @drvitalyt]

https://t.co/nyHoSFK7UR

[Vitaly Terushkin, MD, FACMS @drvitalyt]

Mohs surgery frozen section of the day - Infiltrative basal cell carcinoma with perineural invasion on the nose. Note the basaloid cells arranged in spiky tumor islands within the dermis and around nerves. Mohs surgery is the gold standard in treatment.

[Vitaly Terushkin, MD, FACMS @drvitalyt]

There will likely be a scar after Mohs surgery but the goal is to repair the defect so that the scar is nearly imperceptible.

[Vitaly Terushkin, MD, FACMS @drvitalyt]

This is an example of a clonal seborrheic keratosis that was seen on frozens during Mohs for melanoma. In a clonal SK, there are populations of keratinocytes that appear nested. On MART-1, it looks like there is pagetosis of melanocytes but they are simply populating these nests.

[Vitaly Terushkin, MD, FACMS @drvitalyt]

The cells that create hair color are called melanocytes. In this Mohs section of a hair follicle, these cells appear black. Melanocytes make pigment that is responsible for skin color.

[Vitaly Terushkin, MD, FACMS @drvitalyt]

Grateful to make the Castle Connolly Top Doctor list for 2021!