Case of the Month! by Dr. Kevin Brenner

78 year old male who presents from his dermatologist with a pigmented lesion of the left cheek which has been increasing in size over the past few months.  The patient’s dermatologist performed a shave biopsy which revealed malignant melanoma in-situ, lentigo maligna type.

What is the best option for further management at this point?

   A. Close monitoring with skin examinations every 6 months.

   B. Punch biopsy of the central core of the lesion.

   C. Excision of the entire pigmented lesion.

   D. Wide local excision with 0.5cm margins.

   E. Wide local excision with 2.0cm margins.