With interest I read the article by Piepkorn and Barnhill in a recent issue of the Archives1 in which they discussed the resection margins in melanoma. As has been noted before,2 the Hunterian lecture of W. Sampson Handley in 1907 to the Royal Society of Surgeons of England,3 in which an excision margin of 2.5 cm was advised for the surgical treatment of melanoma, has been seen as a landmark article of the promulgation of wide local excision for these lesions. Handley based his conclusion only on the observation of a single autopsy case in which melanotic metastases were observed to enter lymphatic vessels. He conceded that he had no opportunities to study the primary melanoma. However, it had become fashionable that wide local resection should be the preferred treatment for melanoma.
One of the earlier reports that I could find on the matter was published in
Sanders CJG. Revising the Practice of Melanoma Margin Resections. Arch Dermatol. 1997;133(1):103-104. doi:10.1001/archderm.1997.03890370115021