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A method for distinguishing the intended margins for a melanoma from the tissue cones after surgical excision
Author(s) -
Kriegel David,
Marmur Ellen,
Shan Hui Yi,
Mercer Stephen E.,
Birge Miriam B.,
Lee Arnold
Publication year - 2011
Publication title -
international journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.677
H-Index - 93
eISSN - 1365-4632
pISSN - 0011-9059
DOI - 10.1111/j.1365-4632.2011.05048.x
Subject(s) - medicine , melanoma , surgical excision , lesion , wide local excision , cheek , surgery , nodular melanoma , nevus , dermatology , cancer research
Background Surgical excision of severely dysplastic nevi and thin cutaneous melanomas (<1 mm in depth) remains the most effective treatment to date. However, sometimes a severely dysplastic nevus may be upstaged to a melanoma in situ , or a melanoma in situ may be upgraded to an invasive melanoma once the completely excised specimen is reviewed microscopically. This then requires a re‐excision around the entire scar at follow‐up as the dermatological surgeon can be perplexed as to where the precise locations of the pigmented lesion and the tissue cones are, thereby generating a longer scar. Objective We want to introduce a simple, cost‐effective and easy‐to‐implement approach that permits the dermatological surgeon to distinguish from a linear scar the site of the original pigmented lesion and the lengths of the tissue cones. Therefore, if a re‐excision is necessary, instead of surgical removal around the entire scar, only a focal directed excision of the pigmented lesion is necessary and this will result in a shorter scar; this will be useful for cosmetically sensitive areas on the face. A case is included to illustrate our objective. Results and Discussion Using our surgical method on a patient’s left cheek pigmented lesion originally diagnosed as melanoma in situ with a subsequent revised diagnosis of invasive melanoma generated a shorter scar and a favorable cosmetic outcome.