We read with interest the paper by Hamada et al,¹ which draws a number of conclusions from a 5 year follow up study of 69 periocular basal cell carcinomas (BCCs) treated by conventional surgery and, in particular, suggests that there is no place for Mohs micrographic surgery (MMS) in patients with periocular BCCs. MMS is the serial saucerisation excision with mapped horizontal tissue sections examining 100% of the surgical margins to produce histological evidence of tumour negative margins. Unfortunately, the data included in the paper are incomplete and if such conclusions are to be considered, then further clarification is required.

Risk of BCC recurrence relates directly to the nature of the tumours treated.² The principal risk factors for recurrence include previous treatment, large tumour size, and …