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November 1988

Morphologic Basis for Adequate Surgical Excision of Basal Cell Epitheliomas

Author Affiliations

Department of Dermatology Faculty of Medicine Kyushu University Higashiku, Fukuoka 812, Japan

Arch Dermatol. 1988;124(11):1715-1716. doi:10.1001/archderm.1988.01670110071017

To the Editor.—  Wolf and Zitelli1 recommend excising a 4-mm margin of normal-appearing skin surrounding basal cell epitheliomas (BCEs), based on histologic studies utilizing Mohs surgery to track strands and/or nests of BCEs under light microscopy. However, the significance of the histologic adequacy of the excised margin has been a puzzle in terms of clinical recurrence; patients with histologic evidence of an incompletely removed BCE have a risk of aggressive tumor recurrence.2-4 Nevertheless, it is also known that the rate of recurrence is only a third in cases with a histologically positive margin.3,5 In the remaining cases, residual tumors either disappeared6 or did not recur.3,5,7 On the other hand, a fairly large number2 of recurrent BCEs have been considered to be adequately excised when examined histologically. Consequently, a more detailed study of the growth behavior of BCEs was deemed necessary in order to explain