Mohs Surgery for Lentigo Maligna

1-cm margin.6Occasionally, however, melanomas will extend more than 1 cm beyond the clinical margin, as in the case reported by Dhawan et al. These are the cases that recur after "conservative" treatments with narrow margins. Excision of melanoma by Mohs surgery identifies the cases with wide subclinical extension and limits the creation of large wounds to a select few patients. If all melanomas are excised with narrow margins, the local recurrence rate is higher than excision by wider margins. Mohs surgery reduces the chance of local recurrence while still offering narrow margins to most patients.4,5 De Berker also refers to a dermatopathologist's list excluding melanoma as appropriate for Mohs surgery. Although some Mohs surgeons and pathologists are uncomfortable reading frozen sections for melanoma, it should be emphasized that examination of the margins by frozen section has been documented to be effective and reliable.7Frozen section techniques