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Lentigo Maligna Treated With Microscopically Controlled Surgery: A 194-Patient Retrospective Study.

Gloria Baeza-Hernández^1,2,3, Ruggero Moro^1,4, Celia Requena¹

¹Dermatology Department, Instituto Valenciano de Oncología, Valencia, Spain.

International Journal of Dermatology

|May 15, 2026

Summary

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Skin Cancer

Skin Cancer

Skin cancer is a type of cancer that occurs when there is an abnormal growth of skin cells, usually triggered by damage to the DNA within the skin cells. It is primarily caused by exposure to ultraviolet (UV) radiation from the sun or artificial sources like tanning beds. Skin cancer is the most common type of cancer worldwide, and its incidence continues to rise.
Basal Cell Carcinoma (BCC): BCC is the most common type of skin cancer, accounting for about 80% of cases. It typically develops in...

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This summary is machine-generated.

Paraffin-embedded microscopically controlled surgery (MCS) offers excellent margin control for lentigo maligna (LM) and lentigo maligna melanoma (LMM). This technique demonstrates a low local recurrence rate, supporting its clinical value in treating these skin conditions.

Area of Science:

Dermatology and Surgical Oncology
Cutaneous Oncology
Surgical Pathology

Background:

Further research is needed to establish the clinical significance of paraffin-embedded microscopically controlled surgery (MCS) for lentigo maligna (LM) and lentigo maligna melanoma (LMM).
Accurate margin assessment is crucial for effective treatment and minimizing recurrence of these melanocytic neoplasms.

Purpose of the Study:

To evaluate the efficacy of paraffin-embedded MCS in achieving negative margins and its association with local recurrence rates in patients with LM and LMM.
To assess the clinical value of staged excision using paraffin-embedded MCS for LM and LMM.

Main Methods:

Retrospective observational study of histologically confirmed LM and LMM cases treated exclusively with paraffin-embedded MCS (staged excision).

Keywords:

Mohs surgery dermatology lentigo maligna lentigo maligna melanoma skin neoplasms slow Mohs

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Inclusion criteria required definitive treatment and a minimum follow-up of 6 months for recurrence-free cases.

Data collected included patient demographics, tumor characteristics, surgical margins, and local recurrence (LR) rates.

Main Results:

194 patients were included, with a median age of 72.5 years; most were primary tumors (82%) located on the face.
All patients achieved negative margins with paraffin-embedded MCS.
A low local recurrence (LR) rate of 3.6% (7/194) was observed over a median follow-up of 34 months, with a trend towards higher LR in LMM (7.5%) versus LM (2.1%).

Conclusions:

Paraffin-embedded MCS provides reliable margin control for LM and LMM.
The technique is associated with a low local recurrence rate, indicating its clinical value in managing these conditions.
Staged excision using paraffin-embedded MCS is an effective treatment modality for lentigo maligna and lentigo maligna melanoma.