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.

CONCLUSION

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.