Assessment by our Mohs surgeons found that images, videos, and video mosaics exhibited overall clinically acceptable quality with regard to resolution and contrast. Identification of the epidermal, peripheral, and deep dermal margins was feasible due to the immediate recognition of relevant features specific to each region. Furthermore, the presence of artifacts was duly noted, without detracting from any of the image and video assessments of each margin. The images, videos, and video mosaics that were not acceptable were blurred, saturated, and/or contained an abundance of artifact, all of which compromised quality. Saturation in the images and videos appeared to be due to the concentration of the contrast agent, aluminum chloride, which was topically applied prior to imaging. Although 35% was proven optimal for visibility in shave biopsy wounds,17,21 the tissue conditions in Mohs stage 1 surgical wounds may be more variable. (Such variability is being investigated in the newly initiated larger study.) Nonetheless, despite the compromised quality, recognition of the epidermal, peripheral, and deep dermal margins was still possible. Similarly, the recognition of residual BCC tumor was still feasible despite relatively poor imaging quality in four nodular BCC lesions. This suggests that there may be some leeway for recognition of more amorphous features such as bright tumor islands. However, in two lesions (1 superficial BCC and 1 invasive SCC), when compared to pathology, detailed features such as round inflammatory cells or elongated basal cells, and length of blood vessels were not easily demarcated in the confocal images and videos. In such situations, we may anticipate difficulty in distinguishing challenging cases of BCC or SCC.