Advertisement

Melanoma in Situ

  • Katherine T. Steele
  • Christopher J. MillerEmail author
Chapter

Abstract

Melanoma in situ, defined as melanoma entirely restricted to the epidermis and its accompanying epithelial adnexal structures, is increasing in incidence. Detection and treatment of MIS is important, due to the risk of occult invasion or progression to invasive melanoma. There is a lack of high-quality evidence regarding the optimal treatments for MIS. The majority of MIS in the United States are treated with surgical modalities including conventional wide local excision, staged excision, and Mohs micrographic surgery (MMS). Conventional wide local excision effectively treats most well-defined primary melanomas on the trunk and extremities, but the technique has greater than a 10% risk of positive margins and local recurrence for MIS on the head, neck, hands, feet, and pretibial leg. Staged excision with microscopic margin evaluation via formalin-fixed paraffin-embedded sections and MMS achieve local clearance rates of > 98% for in situ and invasive melanomas arising in chronically sun-damaged skin. Anatomic location and history of previous treatment identify melanomas that may benefit from staged excision or MMS to detect subclinical spread of tumor prior to reconstruction.

Keywords

Local Excision Head Neck Staged excision Surgery 

References

  1. 1.
    Siegel RL, Miller KD, Jemal A. Cancer statistics, 2017. CA Cancer J Clin. 2017;67(1):7–30.CrossRefGoogle Scholar
  2. 2.
    Wei EX, Qureshi AA, Han J, Li TY, Cho E, Lin JY, et al. Trends in the diagnosis and clinical features of melanoma in situ (MIS) in US men and women: a prospective, observational study. J Am Acad Dermatol. 2016;75(4):698–705.CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Bax MJ, Johnson TM, Harms PW, Schwartz JL, Zhao L, Fullen DR, et al. Detection of occult invasion in melanoma in situ. JAMA Dermatol. 2016;152(11):1201–8.CrossRefPubMedGoogle Scholar
  4. 4.
    Gardner KH, Hill DE, Wright AC, Brewer JD, Arpey CJ, Otley CC, et al. Upstaging from melanoma in situ to invasive melanoma on the head and neck after complete surgical resection. Dermatol Surg Off Publ Am Soc Dermatol Surg Al. 2015;41(10):1122–5.Google Scholar
  5. 5.
    Shain AH, Yeh I, Kovalyshyn I, Sriharan A, Talevich E, Gagnon A, et al. The genetic evolution of melanoma from precursor lesions. N Engl J Med. 2015;373(20):1926–36.CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Weinstock MA, Sober AJ. The risk of progression of lentigo maligna to lentigo maligna melanoma. Br J Dermatol. 1987;116(3):303–10.CrossRefPubMedGoogle Scholar
  7. 7.
    Landow SM, Gjelsvik A, Weinstock MA. Mortality burden and prognosis of thin melanomas overall and by subcategory of thickness, SEER registry data, 1992–2013. J Am Acad Dermatol. 2017;76(2):258–63.CrossRefPubMedGoogle Scholar
  8. 8.
    Pomerantz H, Huang D, Weinstock MA. Risk of subsequent melanoma after melanoma in situ and invasive melanoma: a population-based study from 1973 to 2011. J Am Acad Dermatol. 2015;72(5):794–800.CrossRefPubMedGoogle Scholar
  9. 9.
    Watts CG, Madronio C, Morton RL, Goumas C, Armstrong BK, Curtin A, et al. Clinical features associated with individuals at higher risk of melanoma: a population-based study. JAMA Dermatol. 2017;153(1):23–9.CrossRefPubMedGoogle Scholar
  10. 10.
    NCCN Clinical Practice Guidelines in Oncology: Melanoma [Internet]. [cited 2017 Mar 25]. Available from: https://www.nccn.org/professionals/physician_gls/pdf/melanoma.pdf
  11. 11.
    Viola KV, Rezzadeh KS, Gonsalves L, Patel P, Gross CP, Yoo J, et al. National utilization patterns of Mohs micrographic surgery for invasive melanoma and melanoma in situ. J Am Acad Dermatol. 2015;72(6):1060–5.CrossRefPubMedGoogle Scholar
  12. 12.
    Mora AN, Karia PS, Nguyen BM. A quantitative systematic review of the efficacy of imiquimod monotherapy for lentigo maligna and an analysis of factors that affect tumor clearance. J Am Acad Dermatol. 2015;73(2):205–12.CrossRefPubMedGoogle Scholar
  13. 13.
    Rosko AJ, Vankoevering KK, McLean SA, Johnson TM, Moyer JS. Contemporary management of early-stage melanoma: a systematic review. JAMA Facial Plast Surg. 2017;19:232–8.CrossRefPubMedGoogle Scholar
  14. 14.
    Diagnosis and treatment of early melanoma. NIH Consensus Development Conference. January 27–29, 1992. Consens Statement Natl Inst Health Consens Dev Conf. 1992;10(1):1–25.Google Scholar
  15. 15.
    Agarwal-Antal N, Bowen GM, Gerwels JW. Histologic evaluation of lentigo maligna with permanent sections: implications regarding current guidelines. J Am Acad Dermatol. 2002;47(5):743–8.CrossRefPubMedGoogle Scholar
  16. 16.
    Zalla MJ, Lim KK, Dicaudo DJ, Gagnot MM. Mohs micrographic excision of melanoma using immunostains. Dermatol Surg Off Publ Am Soc Dermatol Surg Al. 2000;26(8):771–84.Google Scholar
  17. 17.
    Albertini JG, Elston DM, Libow LF, Smith SB, Farley MF. Mohs micrographic surgery for melanoma: a case series, a comparative study of immunostains, an informative case report, and a unique mapping technique. Dermatol Surg Off Publ Am Soc Dermatol Surg Al. 2002;28(8):656–65.Google Scholar
  18. 18.
    Clayton BD, Leshin B, Hitchcock MG, Marks M, White WL. Utility of rush paraffin-embedded tangential sections in the management of cutaneous neoplasms. Dermatol Surg Off Publ Am Soc Dermatol Surg Al. 2000;26(7):671–8.Google Scholar
  19. 19.
    Bienert TN, Trotter MJ, Arlette JP. Treatment of cutaneous melanoma of the face by Mohs micrographic surgery. J Cutan Med Surg. 2003;7(1):25–30.CrossRefPubMedGoogle Scholar
  20. 20.
    Kunishige JH, Brodland DG, Zitelli JA. Surgical margins for melanoma in situ. J Am Acad Dermatol. 2012;66(3):438–44.CrossRefPubMedGoogle Scholar
  21. 21.
    Bichakjian CK, Halpern AC, Johnson TM, Foote Hood A, Grichnik JM, Swetter SM, et al. Guidelines of care for the management of primary cutaneous melanoma. American Academy of Dermatology J Am Acad Dermatol. 2011;65(5):1032–47.CrossRefPubMedGoogle Scholar
  22. 22.
    Clausen SP, Brady MS. Surgical margins in patients with cutaneous melanoma--assessing the adequacy of excision. Melanoma Res. 2005;15(6):539–42.CrossRefPubMedGoogle Scholar
  23. 23.
    Grotz TE, Markovic SN, Erickson LA, Harmsen WS, Huebner M, Farley DR, et al. Mayo clinic consensus recommendations for the depth of excision in primary cutaneous melanoma. Mayo Clin Proc. 2011;86(6):522–8.CrossRefPubMedPubMedCentralGoogle Scholar
  24. 24.
    Grotz TE, Glorioso JM, Pockaj BA, Harmsen WS, Jakub JW. Preservation of the deep muscular fascia and locoregional control in melanoma. Surgery. 2013;153(4):535–41.CrossRefPubMedGoogle Scholar
  25. 25.
    DeFazio JL, Marghoob AA, Pan Y, Dusza SW, Khokhar A, Halpern A. Variation in the depth of excision of melanoma: a survey of US physicians. Arch Dermatol. 2010;146(9):995–9.CrossRefPubMedGoogle Scholar
  26. 26.
    Abide JM, Nahai F, Bennett RG. The meaning of surgical margins. Plast Reconstr Surg. 1984;73(3):492–7.CrossRefPubMedGoogle Scholar
  27. 27.
    Kimyai-Asadi A, Katz T, Goldberg LH, Ayala GB, Wang SQ, Vujevich JJ, et al. Margin involvement after the excision of melanoma in situ: the need for complete en face examination of the surgical margins. Dermatol Surg Off Publ Am Soc Dermatol Surg Al. 2007;33(12):1434–1439–1441.Google Scholar
  28. 28.
    Johnson TM, Headington JT, Baker SR, Lowe L. Usefulness of the staged excision for lentigo maligna and lentigo maligna melanoma: the “square” procedure. J Am Acad Dermatol. 1997;37(5 Pt 1):758–64.CrossRefPubMedGoogle Scholar
  29. 29.
    Möller MG, Pappas-Politis E, Zager JS, Santiago LA, Yu D, Prakash A, et al. Surgical management of melanoma-in-situ using a staged marginal and central excision technique. Ann Surg Oncol. 2009;16(6):1526–36.CrossRefPubMedGoogle Scholar
  30. 30.
    Dhawan SS, Wolf DJ, Rabinovitz HS, Poulos E. Lentigo maligna. The use of rush permanent sections in therapy. Arch Dermatol. 1990;126(7):928–30.CrossRefPubMedGoogle Scholar
  31. 31.
    Bub JL, Berg D, Slee A, Odland PB. Management of lentigo maligna and lentigo maligna melanoma with staged excision: a 5-year follow-up. Arch Dermatol. 2004;140(5):552–8.CrossRefPubMedGoogle Scholar
  32. 32.
    Hill DC, Gramp AA. Surgical treatment of lentigo maligna and lentigo maligna melanoma. Australas J Dermatol. 1999;40(1):25–30.CrossRefPubMedGoogle Scholar
  33. 33.
    Chang KH, Dufresne R, Cruz A, Rogers GS. The operative management of melanoma: where does Mohs surgery fit in? Dermatol Surg Off Publ Am Soc Dermatol Surg Al. 2011;37(8):1069–79.Google Scholar
  34. 34.
    Higgins HW, Lee KC, Galan A, Leffell DJ. Melanoma in situ: part II. Histopathology, treatment, and clinical management. J Am Acad Dermatol. 2015;73(2):193. –203–204.CrossRefPubMedGoogle Scholar
  35. 35.
    Read T, Noonan C, David M, Wagels M, Foote M, Schaider H, et al. A systematic review of non-surgical treatments for lentigo maligna. J Eur Acad Dermatol Venereol. 2016;30(5):748–53.CrossRefPubMedGoogle Scholar
  36. 36.
    Swetter SM, Chen FW, Kim DD, Egbert BM. Imiquimod 5% cream as primary or adjuvant therapy for melanoma in situ, lentigo maligna type. J Am Acad Dermatol. 2015;72(6):1047–53.CrossRefPubMedGoogle Scholar
  37. 37.
    Etzkorn JR, Sobanko JF, Shin TM, Elenitsas R, Chu EY, Gelfand JM, et al. Correlation between appropriate use criteria and the frequency of subclinical spread or reconstruction with a flap or graft for melanomas treated with Mohs surgery with melanoma antigen recognized by T cells 1 immunostaining. Dermatol Surg Off Publ Am Soc Dermatol Surg Al. 2016;42(4):471–6.Google Scholar
  38. 38.
    Mangold AR, Skinner R, Dueck AC, Sekulic A, Pockaj BA. Risk factors predicting positive margins at primary wide local excision of cutaneous melanoma. Dermatol Surg Off Publ Am Soc Dermatol Surg Al. 2016;42(5):646–52.Google Scholar
  39. 39.
    Miller CJ, Shin TM, Etzkorn JR, Sobanko JF. Rate of positive margins after conventional wide local excision. J Am Acad Dermatol. 2017;77:333–40.Google Scholar
  40. 40.
    Berdahl JP, Pockaj BA, Gray RJ, Casey WJ, Woog JJ. Optimal management and challenges in treatment of upper facial melanoma. Ann Plast Surg. 2006;57(6):616–20.CrossRefPubMedGoogle Scholar
  41. 41.
    Christophel JJ, Johnson AK, McMurry TL, Park SS, Levine PA. Predicting positive margins in resection of cutaneous melanoma of the head and neck. Laryngoscope. 2013;123(3):683–8.CrossRefPubMedGoogle Scholar
  42. 42.
    Hou JL, Reed KB, Knudson RM, Mirzoyev SA, Lohse CM, Frohm ML, et al. Five-year outcomes of wide excision and Mohs micrographic surgery for primary lentigo maligna in an academic practice cohort. Dermatol Surg Off Publ Am Soc Dermatol Surg Al. 2015;41(2):211–8.Google Scholar
  43. 43.
    Parrett BM, Kashani-Sabet M, Leong SPL, Buncke N, Singer MI. The safety of and indications for immediate reconstruction of head and neck melanoma defects: our early experience. Ann Plast Surg. 2014;72(Suppl 1):S35–7.CrossRefPubMedGoogle Scholar
  44. 44.
    Sullivan SR, Scott JR, Cole JK, Chi Y, Anaya DA, Byrd DR, et al. Head and neck malignant melanoma: margin status and immediate reconstruction. Ann Plast Surg. 2009;62(2):144–8.CrossRefPubMedGoogle Scholar
  45. 45.
    Rawlani R, Rawlani V, Qureshi HA, Kim JY, Wayne JD. Reducing margins of wide local excision in head and neck melanoma for function and cosmesis: 5-year local recurrence-free survival. J Surg Oncol. 2015;111(7):795–9.CrossRefPubMedGoogle Scholar
  46. 46.
    Hudson LE, Maithel SK, Carlson GW, Rizzo M, Murray DR, Hestley AC, et al. 1 or 2 cm margins of excision for T2 melanomas: do they impact recurrence or survival? Ann Surg Oncol. 2013;20(1):346–51.CrossRefPubMedGoogle Scholar
  47. 47.
    Moehrle M, Kraemer A, Schippert W, Garbe C, Rassner G, Breuninger H. Clinical risk factors and prognostic significance of local recurrence in cutaneous melanoma. Br J Dermatol. 2004;151(2):397–406.CrossRefPubMedGoogle Scholar
  48. 48.
    Wildemore JK, Schuchter L, Mick R, Synnestvedt M, Elenitsas R, Bedrosian I, et al. Locally recurrent malignant melanoma characteristics and outcomes: a single-institution study. Ann Plast Surg. 2001;46(5):488–94.CrossRefPubMedGoogle Scholar
  49. 49.
    Etzkorn JR, Sobanko JF, Elenitsas R, Newman JG, Goldbach H, Shin TM, et al. Low recurrence rates for in situ and invasive melanomas using Mohs micrographic surgery with melanoma antigen recognized by T cells 1 (MART-1) immunostaining: tissue processing methodology to optimize pathologic staging and margin assessment. J Am Acad Dermatol. 2015;72(5):840–50.CrossRefPubMedGoogle Scholar
  50. 50.
    Dawn ME, Dawn AG, Miller SJ. Mohs surgery for the treatment of melanoma in situ: a review. Dermatol Surg Off Publ Am Soc Dermatol Surg Al. 2007;33(4):395–402.Google Scholar
  51. 51.
    Heaton KM, Sussman JJ, Gershenwald JE, Lee JE, Reintgen DS, Mansfield PF, et al. Surgical margins and prognostic factors in patients with thick (>4mm) primary melanoma. Ann Surg Oncol. 1998;5(4):322–8.CrossRefPubMedGoogle Scholar
  52. 52.
    Agnese DM, Maupin R, Tillman B, Pozderac RD, Magro C, Walker MJ. Head and neck melanoma in the sentinel lymph node era. Arch Otolaryngol Head Neck Surg. 2007;133(11):1121–4.CrossRefPubMedGoogle Scholar
  53. 53.
    Balch CM, Soong SJ, Smith T, Ross MI, Urist MM, Karakousis CP, et al. Long-term results of a prospective surgical trial comparing 2 cm vs. 4 cm excision margins for 740 patients with 1–4 mm melanomas. Ann Surg Oncol. 2001;8(2):101–8.PubMedGoogle Scholar
  54. 54.
    Neades GT, Orr DJ, Hughes LE, Horgan K. Safe margins in the excision of primary cutaneous melanoma. Br J Surg. 1993;80(6):731–3.CrossRefPubMedGoogle Scholar
  55. 55.
    Cohn-Cedermark G, Månsson-Brahme E, Rutqvist LE, Larsson O, Singnomklao T, Ringborg U. Outcomes of patients with local recurrence of cutaneous malignant melanoma: a population-based study. Cancer. 1997;80(8):1418–25.CrossRefPubMedGoogle Scholar
  56. 56.
    Fisher EB, Lewis VL, Griffith BH, Spies W. The role of cutaneous lymphoscintigraphy in determining regional lymph node drainage of truncal melanomas. Ann Plast Surg. 1992;28(6):506–10.CrossRefPubMedGoogle Scholar
  57. 57.
    Harish V, Bond JS, Scolyer RA, Haydu LE, Saw RPM, Quinn MJ, et al. Margins of excision and prognostic factors for cutaneous eyelid melanomas. J Plast Reconstr Aesthetic Surg JPRAS. 2013;66(8):1066–73.CrossRefGoogle Scholar
  58. 58.
    Osborne JE, Hutchinson PE. A follow-up study to investigate the efficacy of initial treatment of lentigo maligna with surgical excision. Br J Plast Surg. 2002;55(8):611–5.CrossRefPubMedGoogle Scholar
  59. 59.
    Jones TS, Jones EL, Gao D, Pearlman NW, Robinson WA, McCarter M. Management of external ear melanoma: the same or something different? Am J Surg. 2013;206(3):307–13.CrossRefPubMedPubMedCentralGoogle Scholar
  60. 60.
    M B, P K, J S, J F, GR E. The role of soft tissue reconstruction after melanoma resection in the head and neck. Head Neck. 2001;23(1):8–15.CrossRefGoogle Scholar
  61. 61.
    Ravin AG, Pickett N, Johnson JL, Fisher SR, Levin LS, Seigler HF. Melanoma of the ear: treatment and survival probabilities based on 199 patients. Ann Plast Surg. 2006;57(1):70–6.CrossRefPubMedGoogle Scholar
  62. 62.
    Pitman GH, Kopf AW, Bart RS, Casson PR. Treatment of lentigo maligna and lentigo maligna melanoma. J Dermatol Surg Oncol. 1979;5(9):727–37.CrossRefPubMedGoogle Scholar
  63. 63.
    Coleman WP, Davis RS, Reed RJ, Krementz ET. Treatment of lentigo maligna and lentigo maligna melanoma. J Dermatol Surg Oncol. 1980;6(6):476–9.CrossRefPubMedGoogle Scholar
  64. 64.
    Gibbs P, Robinson WA, Pearlman N, Raben D, Walsh P, Gonzalez R. Management of primary cutaneous melanoma of the head and neck: the University of Colorado experience and a review of the literature. J Surg Oncol. 2001;77(3):179–185–187.CrossRefPubMedGoogle Scholar
  65. 65.
    Tsang RW, Liu FF, Wells W, Payne DG. Lentigo maligna of the head and neck. Results of treatment by radiotherapy. Arch Dermatol. 1994;130(8):1008–12.CrossRefPubMedGoogle Scholar
  66. 66.
    Sullivan SR, Liu DZ, Mathes DW, Isik FF. Head and neck malignant melanoma: local recurrence rate following wide local excision and immediate reconstruction. Ann Plast Surg. 2012;68(1):33–6.CrossRefPubMedGoogle Scholar
  67. 67.
    Mayo K, Johnson TM, Harms KL. Staged excision techniques. In: Nehal KS, Busam KJ, editors. Lentigo maligna melanoma: challenges in diagnosis and management. Cham: Springer International Publishing; 2017.Google Scholar
  68. 68.
    Anderson KW, Baker SR, Lowe L, Su L, Johnson TM. Treatment of head and neck melanoma, lentigo maligna subtype: a practical surgical technique. Arch Facial Plast Surg. 2001;3(3):202–6.CrossRefPubMedGoogle Scholar
  69. 69.
    Mahoney M-H, Joseph M, Temple CLF. The perimeter technique for lentigo maligna: an alternative to Mohs micrographic surgery. J Surg Oncol. 2005;91(2):120–5.CrossRefPubMedGoogle Scholar
  70. 70.
    Jejurikar SS, Borschel GH, Johnson TM, Lowe L, Brown DL. Immediate, optimal reconstruction of facial lentigo maligna and melanoma following total peripheral margin control. Plast Reconstr Surg. 2007;120(5):1249–55.CrossRefPubMedGoogle Scholar
  71. 71.
    Demirci H, Johnson TM, Frueh BR, Musch DC, Fullen DR, Nelson CC. Management of periocular cutaneous melanoma with a staged excision technique and permanent sections the square procedure. Ophthalmology. 2008;115(12):2295–300.e3.CrossRefPubMedGoogle Scholar
  72. 72.
    Abdelmalek M, Loosemore MP, Hurt MA, Hruza G. Geometric staged excision for the treatment of lentigo maligna and lentigo maligna melanoma: a long-term experience with literature review. Arch Dermatol. 2012;148(5):599–604.CrossRefPubMedGoogle Scholar
  73. 73.
    Bosbous MW, Dzwierzynski WW, Neuburg M. Staged excision of lentigo maligna and lentigo maligna melanoma: a 10-year experience. Plast Reconstr Surg. 2009;124(6):1947–55.CrossRefPubMedGoogle Scholar
  74. 74.
    Gaudy-Marqueste C, Perchenet A-S, Taséi A-M, Madjlessi N, Magalon G, Richard M-A, et al. The “spaghetti technique”: an alternative to Mohs surgery or staged surgery for problematic lentiginous melanoma (lentigo maligna and acral lentiginous melanoma). J Am Acad Dermatol. 2011;64(1):113–8.CrossRefPubMedGoogle Scholar
  75. 75.
    de Vries K, Greveling K, Prens LM, Munte K, Koljenović S, van Doorn MBA, et al. Recurrence rate of lentigo maligna after micrographically controlled staged surgical excision. Br J Dermatol. 2016;174(3):588–93.CrossRefPubMedGoogle Scholar
  76. 76.
    Cohen LM, McCall MW, Hodge SJ, Freedman JD, Callen JP, Zax RH. Successful treatment of lentigo maligna and lentigo maligna melanoma with Mohs’ micrographic surgery aided by rush permanent sections. Cancer. 1994;73(12):2964–70.CrossRefPubMedGoogle Scholar
  77. 77.
    Cohen LM, McCall MW, Zax RH. Mohs micrographic surgery for lentigo maligna and lentigo maligna melanoma. A follow-up study. Dermatol Surg Off Publ Am Soc Dermatol Surg Al. 1998;24(6):673–7.Google Scholar
  78. 78.
    Lee MR, Ryman WJ. Treatment of lentigo maligna with total circumferential margin control using vertical and horizontal permanent sections: a retrospective study. Australas J Dermatol. 2008;49(4):196–201.CrossRefPubMedGoogle Scholar
  79. 79.
    Connolly KL, Nijhawan RI, Dusza SW, Busam KJ, Nehal KS. Time to local recurrence of lentigo maligna: implications for future studies. J Am Acad Dermatol. 2016;74(6):1247–8.CrossRefPubMedPubMedCentralGoogle Scholar
  80. 80.
    Huilgol SC, Selva D, Chen C, Hill DC, James CL, Gramp A, et al. Surgical margins for lentigo maligna and lentigo maligna melanoma: the technique of mapped serial excision. Arch Dermatol. 2004;140(9):1087–92.CrossRefPubMedGoogle Scholar
  81. 81.
    Walling HW, Scupham RK, Bean AK, Ceilley RI. Staged excision versus Mohs micrographic surgery for lentigo maligna and lentigo maligna melanoma. J Am Acad Dermatol. 2007;57(4):659–64.CrossRefPubMedGoogle Scholar
  82. 82.
    Malhotra R, Chen C, Huilgol SC, Hill DC, Selva D. Mapped serial excision for periocular lentigo maligna and lentigo maligna melanoma. Ophthalmology. 2003;110(10):2011–8.CrossRefPubMedGoogle Scholar
  83. 83.
    Shin TM, Sobanko JF, Etzkorn JR, Miller CJ. Mohs surgery for Lentigo Maligna melanoma. In: Nehal KS, Busam KJ, editors. Lentigo maligna melanoma: challenges in diagnosis and management. Cham: Springer International Publishing; 2017.Google Scholar
  84. 84.
    Bene NI, Healy C, Coldiron BM. Mohs micrographic surgery is accurate 95.1% of the time for melanoma in situ: a prospective study of 167 cases. Dermatol Surg Off Publ Am Soc Dermatol Surg Al. 2008;34(5):660–4.Google Scholar
  85. 85.
    Zitelli JA, Brown C, Hanusa BH. Mohs micrographic surgery for the treatment of primary cutaneous melanoma. J Am Acad Dermatol. 1997;37(2 Pt 1):236–45.CrossRefPubMedGoogle Scholar
  86. 86.
    Temple CLF, Arlette JP. Mohs micrographic surgery in the treatment of lentigo maligna and melanoma. J Surg Oncol. 2006;94(4):287–92.CrossRefPubMedGoogle Scholar
  87. 87.
    Newman J, Beal M, Schram SE, Lee PK. Mohs micrographic surgery for lentigo maligna and lentigo maligna melanoma using Mel-5 immunostaining: an update from the university of Minnesota. Dermatol Surg Off Publ Am Soc Dermatol Surg Al. 2013;39(12):1794–9.Google Scholar
  88. 88.
    Bhardwaj SS, Tope WD, Lee PK. Mohs micrographic surgery for lentigo maligna and lentigo maligna melanoma using Mel-5 immunostaining: University of Minnesota experience. Dermatol Surg Off Publ Am Soc Dermatol Surg Al. 2006;32(5):690–696–697.Google Scholar
  89. 89.
    Valentín-Nogueras SM, Brodland DG, Zitelli JA, González-Sepúlveda L, Nazario CM. Mohs micrographic surgery using MART-1 immunostain in the treatment of invasive melanoma and melanoma in situ. Dermatol Surg Off Publ Am Soc Dermatol Surg Al. 2016;42(6):733–44.Google Scholar
  90. 90.
    Bricca GM, Brodland DG, Ren D, Zitelli JA. Cutaneous head and neck melanoma treated with Mohs micrographic surgery. J Am Acad Dermatol. 2005;52(1):92–100.CrossRefPubMedGoogle Scholar
  91. 91.
    Stigall LE, Brodland DG, Zitelli JA. The use of Mohs micrographic surgery (MMS) for melanoma in situ (MIS) of the trunk and proximal extremities. J Am Acad Dermatol. 2016;75(5):1015–21.CrossRefPubMedGoogle Scholar
  92. 92.
    Kai AC, Richards T, Coleman A, Mallipeddi R, Barlow R, Craythorne EE. Five-year recurrence rate of lentigo maligna after treatment with imiquimod. Br J Dermatol. 2016;174(1):165–8.CrossRefPubMedGoogle Scholar
  93. 93.
    Spenny ML, Walford J, Werchniak AE, Beltrani V, Brennick JB, Storm CA, et al. Lentigo maligna (melanoma in situ) treated with imiquimod cream 5%: 12 case reports. Cutis. 2007;79(2):149–52.PubMedGoogle Scholar
  94. 94.
    Van Meurs T, Van Doorn R, Kirtschig G. Treatment of lentigo maligna with imiquimod cream: a long-term follow-up study of 10 patients. Dermatol Surg Off Publ Am Soc Dermatol Surg Al. 2010;36(6):853–8.Google Scholar
  95. 95.
    Powell AM, Robson AM, Russell-Jones R, Barlow RJ. Imiquimod and lentigo maligna: a search for prognostic features in a clinicopathological study with long-term follow-up. Br J Dermatol. 2009;160(5):994–8.CrossRefPubMedGoogle Scholar
  96. 96.
    Ly L, Kelly JW, O’Keefe R, Sutton T, Dowling JP, Swain S, et al. Efficacy of imiquimod cream, 5%, for lentigo maligna after complete excision: a study of 43 patients. Arch Dermatol. 2011;147(10):1191–5.CrossRefPubMedGoogle Scholar
  97. 97.
    Wong JG, Toole JWP, Demers AA, Musto G, Wiseman MC. Topical 5% imiquimod in the treatment of lentigo maligna. J Cutan Med Surg. 2012;16(4):245–9.CrossRefPubMedGoogle Scholar
  98. 98.
    Fleming CJ, Bryden AM, Evans A, Dawe RS, Ibbotson SH. A pilot study of treatment of lentigo maligna with 5% imiquimod cream. Br J Dermatol. 2004;151(2):485–8.CrossRefPubMedGoogle Scholar
  99. 99.
    Powell AM, Russell-Jones R, Barlow RJ. Topical imiquimod immunotherapy in the management of lentigo maligna. Clin Exp Dermatol. 2004;29(1):15–21.CrossRefPubMedGoogle Scholar
  100. 100.
    Naylor MF, Crowson N, Kuwahara R, Teague K, Garcia C, Mackinnis C, et al. Treatment of lentigo maligna with topical imiquimod. Br J Dermatol. 2003;149(Suppl 66):66–70.CrossRefPubMedGoogle Scholar
  101. 101.
    Cotter MA, McKenna JK, Bowen GM. Treatment of lentigo maligna with imiquimod before staged excision. Dermatol Surg Off Publ Am Soc Dermatol Surg Al. 2008;34(2):147–51.Google Scholar
  102. 102.
    Kirtschig G, van Meurs T, van Doorn R. Twelve-week treatment of lentigo maligna with imiquimod results in a high and sustained clearance rate. Acta Derm Venereol. 2015;95(1):83–5.CrossRefPubMedGoogle Scholar
  103. 103.
    Etzkorn JR, Shin TM, Sobanko JF, Miller CJ. Risk factors for upstaging of melanoma after conventional wide local excision. J Am Acad Dermatol. 2017;77:341–8.Google Scholar
  104. 104.
    Borah GL, Rankin MK. Appearance is a function of the face. Plast Reconstr Surg. 2010;125(3):873–8.CrossRefPubMedGoogle Scholar
  105. 105.
    Kaiser S, Vassell R, Pinckney RG, Holmes TE, James TA. Clinical impact of biopsy method on the quality of surgical management in melanoma. J Surg Oncol. 2014;109(8):775–9.CrossRefPubMedGoogle Scholar
  106. 106.
    Stell VH, Norton HJ, Smith KS, Salo JC, White RL. Method of biopsy and incidence of positive margins in primary melanoma. Ann Surg Oncol. 2007;14(2):893–8.CrossRefPubMedGoogle Scholar
  107. 107.
    Karimipour DJ, Schwartz JL, Wang TS, Bichakjian CK, Orringer JS, King AL, et al. Microstaging accuracy after subtotal incisional biopsy of cutaneous melanoma. J Am Acad Dermatol. 2005;52(5):798–802.CrossRefPubMedGoogle Scholar
  108. 108.
    Santillan AA, Messina JL, Marzban SS, Crespo G, Sondak VK, Zager JS. Pathology review of thin melanoma and melanoma in situ in a multidisciplinary melanoma clinic: impact on treatment decisions. J Clin Oncol Off J Am Soc Clin Oncol. 2010;28(3):481–6.CrossRefGoogle Scholar
  109. 109.
    Zhang J, Miller CJ, Sobanko JF, Shin TM, Etzkorn JR. Diagnostic change from atypical intraepidermal melanocytic proliferation to melanoma after conventional excision-a single academic institution cross-sectional study. Dermatol Surg Off Publ Am Soc Dermatol Surg Al. 2016;42(10):1147–54.Google Scholar
  110. 110.
    Zhang J, Miller CJ, Sobanko JF, Shin TM, Etzkorn JR. Frequency of and factors associated with positive or equivocal margins in conventional excision of atypical intraepidermal melanocytic proliferations (AIMP): a single academic institution cross-sectional study. J Am Acad Dermatol. 2016;75(4):688–95.CrossRefPubMedGoogle Scholar
  111. 111.
    van Dijk MCRF, Aben KKH, van Hees F, Klaasen A, Blokx WA, Kiemeney LALM, et al. Expert review remains important in the histopathological diagnosis of cutaneous melanocytic lesions. Histopathology. 2008;52(2):139–46.CrossRefPubMedGoogle Scholar
  112. 112.
    Shin TM, Etzkorn JR, Sobanko JF, Margolis DJ, Gelfand JM, Chu EY, et al. Clinical factors associated with subclinical spread of in situ melanoma. J Am Acad Dermatol. 2017;76(4):707–13.CrossRefPubMedGoogle Scholar
  113. 113.
    Chuang GS, Leach BC, Wheless L, Lang PG, Cook J. Preoperative expectations and values of patients undergoing Mohs micrographic surgery. Dermatol Surg Off Publ Am Soc Dermatol Surg Al. 2011;37(3):311–9.Google Scholar
  114. 114.
    Hussain W, Affleck A, Al-Niaimi F, Cooper A, Craythorne E, Fleming C, et al. Safety, complications and patients’ acceptance of Mohs micrographic surgery under local anaesthesia: results from the U.K. MAPS (Mohs Acceptance and Patient Safety) Collaboration Group. Br J Dermatol. 2017;176(3):806–8.CrossRefPubMedGoogle Scholar
  115. 115.
    Alam M, Ibrahim O, Nodzenski M, Strasswimmer JM, SIB J, Cohen JL, et al. Adverse events associated with mohs micrographic surgery: multicenter prospective cohort study of 20,821 cases at 23 centers. JAMA Dermatol. 2013;149(12):1378–85.CrossRefPubMedPubMedCentralGoogle Scholar
  116. 116.
    Merritt BG, Lee NY, Brodland DG, Zitelli JA, Cook J. The safety of Mohs surgery: a prospective multicenter cohort study. J Am Acad Dermatol. 2012;67(6):1302–9.CrossRefPubMedPubMedCentralGoogle Scholar
  117. 117.
    Starling J, Thosani MK, Coldiron BM. Determining the safety of office-based surgery: what 10 years of Florida data and 6 years of Alabama data reveal. Dermatol Surg Off Publ Am Soc Dermatol Surg Al. 2012;38(2):171–7.Google Scholar
  118. 118.
    DeBloom JR, Zitelli JA, Brodland DG. The invasive growth potential of residual melanoma and melanoma in situ. Dermatol Surg Off Publ Am Soc Dermatol Surg Al. 2010;36(8):1251–7.Google Scholar
  119. 119.
    Hübner J, Waldmann A, Geller AC, Weinstock MA, Eisemann N, Noftz M, et al. Interval cancers after skin cancer screening: incidence, tumour characteristics and risk factors for cutaneous melanoma. Br J Cancer. 2017;116(2):253–9.CrossRefPubMedGoogle Scholar
  120. 120.
    Tzellos T, Kyrgidis A, Mocellin S, Chan A-W, Pilati P, Apalla Z. Interventions for melanoma in situ, including lentigo maligna. Cochrane Database Syst Rev. 2014;12:CD010308.Google Scholar
  121. 121.
    Moyer JS, Rudy S, Boonstra PS, Kraft C, Chinn SB, Baker SR, et al. Efficacy of staged excision with permanent section margin control for cutaneous head and neck melanoma. JAMA Dermatol. 2017;153(3):282–8.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of DermatologyHospital of the University of PennsylvaniaPhiladelphiaUSA

Personalised recommendations