Mohs micrographically controlled surgery and the treatment of malignant melanoma

Mohs micrographic surgery is a technique that offers surgeons and pathologists a means to examine the entire surgical margins of excised cutaneous malignancies in a more complete manner than conventional methods. Initially developed to treat nonmelanoma skin cancers, its use has been expanded to include histologic margin evaluation for treatment of malignant melanoma. Clinical studies demonstrate equivalent or better 5-year survival rates with Mohs surgery compared to conventional wide local excision. For surgical treatment of melanoma, it offers unique advantages for lesions requiring tissue conservation and accurate margin determination, particularly in anatomic sites where cosmetic and functional concerns are of importance (head and neck, hands, and feet), and for large or ill-defined lesions such as lentigo maligna or lentigo maligna melanoma.