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March 1991

Lentigo Maligna and Mohs

Arch Dermatol. 1991;127(3):421. doi:10.1001/archderm.1991.01680030147023

To the Editor.—  It was interesting to read the article1 in the July 1990 edition of the Archives on the use of Moh's micrographic technique in the treatment of lentigo maligna. Our experience may be different from Dhawan's, but seldom is anyone in the United Kingdom advocating a technique that treats a 1.5 × 0.7-cm lesion resulting in a 5 × 12-cm defect. In John Headington's2 review of Moh's technique in the same edition, he specifically excludes malignant melanoma from the list of pathologic conditions appropriate for serial micrographic surgery. Perhaps lentigo maligna should also be in this category.My reasons for putting it alongside melanoma would be twofold. First, there is the tendency for melanocyte dysplasia to occur as a field phenomenon. Wong3 studied the melanocytes in normal skin surrounding melanomas. In seven out of 12 specimens, abnormal melanocytes were seen at the edge of the 5-cm

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