This 81 year-old woman was referred by her dermatologist in Calabasas for Mohs surgery of a lentigo maligna (melanoma in situ) on the right lateral canthus (near corner of eyelid). The patient was from Simi Valley and noted that the pigmented patch had been present for 8-9 years.

The skin cancer was removed by Mohs micrographic surgery, using MART-1 immunostains to check the surgical margins. Following removal of her melanoma, the surgical defect measured 3.0 x 2.8 cm. In order to close the defect without distorting the eyelid the wound was closed with both a side-to-side repair  and an adjacent-tissue full-thickness skin graft. This type of repair was described in the literature by Dr. Kaufman (Dermatologic Surgery, volume 30, pages 1349-1353, 2004 and also volume 31, pages 1704-1706, 2005). In this repair the inferior portion of the defect is closed in a side-to-side fashion, and a resultant protrusion of tissue is removed, thinned and used as a skin graft for the remaining defect closer to the eyelid margin. By using adjacent tissue, the color, texture, and thickness is more similar than if the graft had been taken from another location. The area healed very well, and the patient was very pleased with the final cosmetic result.