title: Usefulness of the staged excision for lentigo maligna and lentigo maligna melanoma: the "square" procedure.
abstract: BACKGROUND
  Management of lentigo maligna (LM) and lentigo maligna melanoma (LMM) may present problems because of the characteristic, yet unpredictable, subclinical peripheral and periadnexal extension of atypical junctional melanocytic hyperplasia beyond the visible margins.
  
  
  OBJECTIVE
  We used paraffin-embedded (permanent) peripheral vertical section margin control in a staged fashion in the management of LM and LMM.
  
  
  METHODS
  We used a modification of surgical excision in a staged fashion by means of a two-bladed knife with permanent peripheral vertical section margin control.
  
  
  RESULTS
  This method is technically easy and results in complete histologic evaluation of the peripheral margins without compromising the measurement of tumor thickness of the primary melanoma.
  
  
  CONCLUSIONS
  The use of the "square" procedure, a staged excision with permanent peripheral vertical section margin control, is useful in the management of LM and LMM.
authors.affiliation: University of Michigan Medical Center, Ann Arbor, USA.
authors.forename: T M
authors.initials: TM
authors.lastname: Johnson
authors.forename: J T
authors.initials: JT
authors.lastname: Headington
authors.forename: S R
authors.initials: SR
authors.lastname: Baker
authors.forename: L
authors.initials: L
authors.lastname: Lowe
mesh_terms: D001706:Biopsy; D006801:Humans; D018327:Hutchinson's Melanotic Freckle / Q000473:pathology / Q000601:surgery*; D015580:Mohs Surgery; D019651:Plastic Surgery Procedures / Q000379:methods*; D012878:Skin Neoplasms / Q000473:pathology / Q000601:surgery*; D013524:Surgical Flaps