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Stanford University School of Medicine

In situ melanoma patients now eligible for quicker procedure at Stanford Medicine

image.img.620.highWhen a dear friend learned that the dark patch of skin near her eye was lentigo maligna, an early stage of melanoma, her worries began. She wondered what her face would look like after the surgery. She knew that her cancer would be removed layer by layer, using a technique called Mohs surgery. But she also knew that until doctors were sure they had removed all the cancer, she would have to wait at home with an open wound for a tissue sample to be analyzed. It was five long days.

Now, patients at Stanford Medicine do not have to wait days. Researchers have recently validated a type of tissue analysis allowing them to perform Mohs surgeries for melanoma in situ. The technique has also been shown to reduce the rate of recurrence, as I write in a recent article.

The Mohs procedure has been around since the 1930s, but most commonly used to remove basal cell and squamous cell skin cancer. With the development of a special stain, melanoma, too, can be analyzed quickly, allowing for one-day, outpatient procedures.

While reporting, I heard first-hand about the procedure from Edyth Ledbetter, 70, a patient of Tyler Hollmig, MD, clinical assistant professor of dermatology, who is shown in the photo above. Ledbetter, a grandmother from Lodi, Calif., lost about silver dollar-sized piece of skin on her nose. But, using the new method, Hollmig was able to remove the tumor and, after a quick analysis of specially-stained slides, which were ready within hours instead of days, he could start caring for the wound. Hollmig moved a flap of skin from Ledbetter's forehead to cover the wound on her nose and she went home the same day.

Two months later, even though her healing was not yet completed, she told Hollmig that her friends couldn't tell she'd had surgery. For Hollmig, that was great news: "Hearing that from a patient is my best reward."

Previously: This summer's Stanford Medicine magazine shows some skinRebuilding Cassie's smile: A lung transplant patient's struggle with skin cancer and To boldly go into a scar-free future: Stanford researchers tackle wound healing
Photo by Norbert von der Groeben

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