Mohs surgery for lentigo maligna melanoma

Abstract

Melanomas with indistinct clinical margins are at increased risk for local recurrence or positive microscopic margins after conventional excision, particularly lentigo maligna melanoma (LMM). If reconstruction is performed immediately after conventional excision and before confirming clear margins, patients may require additional excisions and more complex reconstruction procedures. Mohs micrographic surgery (MMS) with melanocytic immunostains addresses these challenges with immediate microscopic examination of the entire peripheral and deep surgical margin to identify and remove subclinical LMM prior to reconstruction. This chapter explains MMS for LMM and how it can improve management compared to conventional excision.