This 47 year-old woman was referred from Calabasas by her doctor for Mohs surgery of a probable recurrent lentigo maligna (melanoma in situ) on the right infraorbital cheek. The skin cancer was originally excised by a Beverly Hills plastic surgeon 15 years earlier. Beginning one year before she presented to our office, she developed redness near the surgery site and had two laser treatments in Mexico. She presented to our office and expressed an interest in having a plastic surgeon complete the reconstruction after the Mohs surgery was complete. A biopsy was performed and confirmed that the pink-brown patch on her cheek was a recurrent melanoma in situ.
The lentigo maligna was removed by Mohs micrographic surgery using MART-1 immunostains to assure complete clearance of the surgical margins. Immunostains work by attaching directly to the target cells (i.e. melanocytes) to more clearly evaluate clearance of the surgical margins. Following removal of the tumor, the surgical defect measured 2.9 x 2.4 cm. The patient and her husband requested that Dr. Kaufman complete the reconstruction. The defect was reconstructed using an advancement flap, designed to recruit tissue from the lateral cheek and avoid deviation of the nearby eyelid. The patient and her husband were quite pleased with the final result and followed up with her dermatologist.