MOHS MICROGRAPHIC SURGERY FOR LENTIGO MALIGNA AND LENTIGO MALIGNA MELANOMA - A FOLLOW-UP-STUDY

BACKGROUND. We previously reported our experience using Mohs micrograp hic surgery (MMS) for 45 patients with lentigo maligna (LM) and lentig o maligna melanoma (LMM). The patients were treated between 1985 and 1 992. In our initial publication, all of the patients were free of loca l disease and evidence of metastases at an average of 29.2 months afte r therapy. OBJECTIVE. The purpose of this study was to report long-ter m follow-up of our previously published data. METHODS. MMS was perform ed in 26 patients with LM and 19 patients with LMM using frozen sectio ns followed by rush permanent sections. Follow-up was obtained by cont acting the referring physician, examination by one of our two Mohs sur geons, or by contacting the patient or his or her family. RESULTS. Aft er a median follow-up of 58.0 months (214.3 patient-years), there was one recurrence. This patient was a 56-year-old woman with five prior r ecurrences before MMS. Six patients were deceased of other causes duri ng the study. CONCLUSIONS. MMS using frozen and rush permanent section s resulted in a 97% cure rate for LM and LMM. Because MMS minimizes th e removal of normal tissue, and the cure rate exceeds that of conventi onal therapies, the authors recommend this technique for the treatment of LM and LMM. (C) 1998 by the American Society for Dermatologic Surg ery, Inc.