Arizona Mohs Surgery & Dermatology Anir Dhir MD, FACMS, & Shelby Coplen, PA-C

Comprehensive Skin Cancer & Dermatology Care

Quality, Experience, and Compassion

 

Mohs micrographic surgery specialist Mohs micrographic surgery specialist

Who We Are

Arizona Mohs Surgery & Dermatology, PLLC, is a dermatology practice dedicated to the comprehensive evaluation and treatment of skin cancer, psoriasis, rosacea, acne, rashes, and other dermatologic conditions.

Dr. Anir Dhir specializes in Mohs micrographic surgery and the most advanced and elegant reconstructive techniques. He treats biopsy-proven skin cancers and also performs skin cancer screenings, biopsies, and non-surgical treatments. Shelby Coplen, PA-C, has practiced medical dermatology in Tucson since 2018. She is an expert in skin cancer screenings, non-surgical treatment of skin cancer, and treatment of rashes, psoriasis, rosacea, and acne.

The Arizona Mohs Surgery team is committed to providing the highest quality care in a modern, compassionate, and comfortable environment. Our experienced staff looks forward to taking great care of you.

 

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What Is Mohs Surgery?

The most advanced treatment for skin cancer

Are your providers available to perform skin cancer screening, biopsies, and non-surgical treatment?

Of course.  We would be honored to assist you with evaluation and biopsy of suspicious lesions if not already done by your dermatologist or primary care physician.  We are also happy to perform excisions and prescribe non-surgical treatments when Mohs surgery is not needed.

On October 1, 2024, we are delighted to have Shelby Coplen, PA-C, join our experienced team. Shelby has practiced medical dermatology in Tucson since 2017.  She is an expert in skin cancer screenings, non-surgical treatment of skin cancer, and treatment of rashes, psoriasis, rosacea, and acne. 

What types of skin cancers are treated with Mohs surgery?

Mohs surgery is the gold standard for skin cancers occurring in more cosmetically and functionally critical areas such as the face, ears, scalp, neck, hands, feet, and shins. Larger and more aggressive cancers in non-facial locations, as well as some “recurrent’ tumors (those that have failed other therapies), are also appropriate candidates for Mohs surgery. Mohs surgery is also the best approach for skin cancers that are poorly defined, arise in a scar, grow rapidly, or occur in a patient with a compromised immune system in most locations. Mohs surgery is generally not needed for thin, small cancers in non-critical locations because these can be successfully managed with simpler techniques.  Dr. Dhir is happy to assist patients with cancers qualifying for Mohs surgery, simpler excision, or non-surgical therapies.

What is the difference between Mohs surgery and other frozen sections?

In Mohs surgery, one physician functions as both surgeon and pathologist. If a physician removes a skin cancer and sends the specimen to another lab or pathologist for analysis, he or she is not performing Mohs surgery for two reasons:

  1. a single physician is not correlating the clinical and microscopic pictures for maximum accuracy, and
  2. only a small portion of the margins is examined instead of 100% of the true 3-D circumferential margin as with Mohs surgery.
Am I in good hands?

Absolutely.  Unlike many physicians performing Mohs surgery in Tucson, Dr. Dhir completed a dedicated and prestigious American College of Mohs Surgery (ACMS) accredited fellowship prior to entering private practice.  He was then the single busiest Mohs surgeon in Kentucky for many years prior to opening Arizona Mohs Surgery. He has performed nearly 42,000 Mohs procedures with a cure rate over 99.5% and an infection rate of only 0.2%.

Dr. Dhir is a nationally recognized expert in both Mohs surgery and facial reconstruction. Since 2003, his colleagues have repeatedly elected him to both Best Doctors in America and Castle Connolly's Top Doctors - recognitions that place Dr. Dhir in the top 4 to 7% of all U.S. board-certified physicians, respectively.

How long will it take?

Most patients spend 2.5 to 4 hours with us. Much of that is “downtime” where you rest comfortably while waiting on our team to prepare frozen Mohs sections and read the slides to ensure clear surgical margins. We encourage patients to bring reading materials to pass the time, and we also provide Wi-Fi access so that you may watch a movie or surf the internet on your own laptop computer, phone, or iPad. Please note that surgeries for larger, neglected, aggressive, recurrent, or mid-facial cancers may take longer, particularly if multiple stages are needed to clear the tumor and/or more advanced reconstruction is needed.

The majority of wound closures are performed in our office. Occasionally, we may need to utilize an outside surgical specialist to perform the post-Mohs reconstruction if the tumor turns out to be larger, deeper, or more complex than initially anticipated. If an outside surgical specialist is needed, the reconstruction may take place on the same day or on subsequent days. Please note that it is safe to delay the reconstruction, and that it’s possible that hospitalization may be needed for extensive reconstructions.

Are you able to treat very large or advanced skin cancers?

Mohs Surgery is a very accurate, office-based, outpatient procedure performed entirely under local anesthesia.  It is best suited to small- to medium-sized skin cancers that have not yet invaded into important underlying tissues such as muscle, cartilage, nerves, or bone.  Advanced tumors, those that have failed multiple previous procedures, or those at higher risk of deep invasion or metastasis are often most safely and effectively treated by a hospital-based head and neck surgical oncologist.  These advanced surgical cancer specialists have sophisticated training and expertise in larger surgeries and lymph node biopsies.  They also have access to anesthesiologists and other specialists like Medical Oncology and Radiation Oncology who are often needed for more advanced skin cancers.

Do you perform Mohs surgery for melanoma?

The majority of Mohs surgeons and dermatopathologists believe that permanent (formalin-fixed) tissue sections allow more accurate margin analysis for melanoma than Mohs frozen sections, even if additional MART-1 immunostaining is done. This is not an issue for basal and squamous cell carcinomas, where frozen sections are universally accepted and allow more efficient, same day analysis. Therefore, we follow current NCCN surgical margin guidelines which state "the gold standard for histologic assessment of excised melanoma is use of permanent sections". Our specimens are evaluated within 24 - 48 hours by a board-certified dermatopathologist. NCCN guidelines also suggest that the surgeon consider delaying closure of melanoma excisions until margin analysis has been completed if a flap or graft may be required. This means that some melanoma surgeries may require 2 or more visits to ensure maximum accuracy.

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Meet Doctor Dhir

Photo of Doctor Anir Dhir

Anir Dhir, MD, FACMS

Anir Dhir, M.D., is a fellowship-trained Mohs micrographic surgeon who is dedicated to excellence.  Since 1999, Dr. Dhir has performed nearly 42,000 Mohs surgeries with a cure rate of over 99.5%. He is a Life Member of the American College of Mohs Surgery and has been repeatedly elected by his colleagues over the past twenty one years to both Best Doctors in America and Castle Connolly's Top Doctors - honors given to only the top 4% and 7% of all U.S. Physicians, respectively.

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See What Our Clients Are Saying

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Three days have passed since your removal of the cancer from my face.  The pain from the surgery has been light and tolerable.  There has been no need for pills to relieve this pain.  There are no signs of bleeding or of swelling.  You mentioned the danger to a nerve which controls the mouth, had the cancer not been removed.  The body is wonderfully made!  It has never occurred to me that there is a mechanism which enables us to open our mouths.

—W
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Thank you for the excellent care I received on my visit from you and your staff…By the end of week two, you cannot tell where the surgery site was.

—RH
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Dr. Dhir, Wanted to show my appreciation for the excellent care I received last month!  Thank you so much!!!

—JS
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AT is doing fine. I just wanted to thank you for all your kindness. You were super in my eyes. We will never forget you all. God Bless you all.

—OT
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I am truly blessed to have you in my life. Thank you so much for your special attention.

—AS
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My contact with your office with questions about the procedure was greeted with full explanations and a courteous spirit.  Warmth without professionalism leaves one uncertain; professionalism without warmth leaves one uncomfortable. Gladly, you and your staff combined both warmth and professionalism.

—S
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Doctor, thank you for being so kind and so good at your work.

—BC
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Thank you all for being so kind, compassionate, and caring.

—PR
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I would like to thank you and your staff for the wonderful care I received in having my nose growth removed.  I appreciate how quickly you were able to see me and your expert care.

—MS
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Very professional, caring people. Will recommend to others.

—GR