RECURRENT LENTIGO MALIGNA INVADING A SKIN-GRAFT SUCCESSFULLY TREATED WITH MOHS MICROGRAPHIC SURGERY

Lentigo maligna is a pigmented lesion occurring on sun-exposed skin th at may become lentigo maligna melanoma. The tumor can behave in an agg ressive fashion, causing significant cosmetic disfigurement, often ext ending significantly further than the clinical margin. Complete surgic al excision is the treatment of choice. The authors describe a 74-year -old woman with a large lentigo maligna of the left cheek, upper and l ower eyelids, and preauricular skin that had recurred twice. The tumor was removed using Mohs' micrographic surgery with rush permanent sect ions and was found to infiltrate extensively the split-thickness skin graft that had been placed five years earlier. Lentigo maligna can inv ade and replace a skin graft. Although destructive modalities and conv entional surgery are recommended by some authors, Mohs' micrographic s urgery offers the greatest likelihood of cure, the ability to examine nearly 100 percent of the surgical margins, and maximal tissue sparing . Complete excision of lentigo maligna at its earliest recognition may prevent invasive lentigo maligna melanoma and will limit cosmetic dis figurement.