Using Mohs surgery to delineate the true dimensions of a tumor, researchers identify a better standard for excision.
Excision of melanoma in situ remains more art than science. Those who use conventional excision are prepared for a high rate of local recurrence after standard 5-mm margins, and even after Mohs, some surgeons employ adjuvant therapies along the periphery (e.g., topical imiquimod) to further decrease the risk for recurrence. The 5-mm margin established by a 1992 consensus opinion is understood to be insufficient, but until now, little evidence has been available to set another specific benchmark.
These investigators reviewed 1120 Mohs surgeries performed in 1072 patients with melanoma in situ from 1982 to 2008 at a single center to estimate the appropriate clearance margin needed for conventional (non-Mohs) excision. In each case, the central…
Reviewing Author
DisclosuresConsultant / Advisory boardAmway
Editorial boards JAMA Dermatology; Dermatologic Surgery; Journal of Cosmetic Dermatology; Lasers in Medical Science; Skin Therapy Letter
Leadership positions in professional societies American Academy of Dermatology (Chair, Health Care Finance Committee); American College of Mohs Surgery (Board of Directors); American Society for Dermatologic Surgery (Board of Directors)
DisclosuresConsultant / Advisory boardAmway
Editorial boards JAMA Dermatology; Dermatologic Surgery; Journal of Cosmetic Dermatology; Lasers in Medical Science; Skin Therapy Letter
Leadership positions in professional societies American Academy of Dermatology (Chair, Health Care Finance Committee); American College of Mohs Surgery (Board of Directors); American Society for Dermatologic Surgery (Board of Directors)