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Should I get excision or Moh's to remove the melanoma on my face? (photo)

A 2x1x1mm shave bx came back as lentigo maligna and moderately atypical junctional melanocytes present as single cells along the dermal epidermal junction. The differential diagnosis includes melanoma in situ, lentigo maligna type and a junctional nevus. Should I get a new bx? An excision will have a significant impact on the way I look and even slow Mohs will impact my face.

Doctor Answers (3)

Treatment of Melanoma on Face

+2
Best option to cure the lentigo maligna (melanoma in situ) on your face is Mohs surgery, usually performed with immunostains (to help "light up" the melanocytes when viewed under the microscope). In my opinion your best option for Mohs is to see a fellowship-trained Mohs surgeon who is a member of the American College of Mohs Surgery. Best one of these to see is one who has a lot of experience treating lentigo malignas on the face. In my opinion best option for reconstruction is whoever you feel will give you the best cosmetic result, whether that would be the Mohs surgeon or plastic surgeon with facial reconstruction experience. Good luck.


Los Angeles Dermatologic Surgeon
4.5 out of 5 stars 7 reviews

Lentigo maligna of face

+2
MOHs is by far the best treatment option in this case, as the recurrence rates and clearance will always be better than Standard excision. However there are other options such as immunotherapy with imiquimod. Seek a specialist who does MOHS but also is competent in reconstructive surgery and general dermatology. We would gladly see you in our clinic.  I wish you the best. Regardless, there will be a scar that will need to be intricately taken into consideration and finding the right physician in this situation is imperative. Dr Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
5.0 out of 5 stars 44 reviews

Treating a melanoma or atypical pigmented lesion on the face

+2
Treating an early melanoma or atypical pigmented lesion on the face can be done with a high cure rate and preserving normal tissue using the Mohs or slow Mohs surgical technique. If the melanoma is deeply invasive, then you may or may not need additional workup. I would recommend seeing a fellowship trained Mohs surgeon who belongs to the American College of Mohs Surgery (ACMS). Every melanoma is unique and this advice is generic. Specific details about your care should be discussed with your official physicians. 

Omar Ibrahimi, MD
Stamford Dermatologic Surgeon
5.0 out of 5 stars 9 reviews

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