Usefulness of the staged excision for lentigo maligna and lentigo maligna melanoma: the "square" procedure.
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.
Johnson
T M
TM
University of Michigan Medical Center, Ann Arbor, USA.
Headington
J T
JT
Baker
S R
SR
Lowe
L
L
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