The “collerette” technique for skin excision and biopsy: an efficient method for managing lentigo maligna of the head and neck

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Abstract

Background

Melanoma is responsible for 75% of all skin cancer-related deaths. Lentigo maligna (LM), the most prevalent melanoma in situ (MIS), accounts for 79–83% of all MIS. Its location in the head and neck area requires that tissue be spared in the course of clearing the tumor.

Methods

We conducted a therapeutic study based on our practice experience with the so-called “collarette” skin biopsy technique used in the management of LM.

Results

Thirty-one patients were diagnosed with LM in the head and neck area. These included 16 women and 15 men with a mean ± standard deviation (SD) age of 64.4 ± 13.6 years (range: 33–88 years). The majority (36%) of lesions were located on the cheek. To clear the tumor, surgery was performed using margins of >10 mm in 71% of cases. The average surface area of the surgical defect was 5.8 cm2 (range: 1.1–15.5 cm2). Reconstructive skin grafts were performed in the majority (68%) of cases. After the removal of the central tumor, 16 cases of MIS and 15 cases of invasive melanoma were identified. Only one patient experienced recurrence over a mean ± SD follow-up of 31 ± 16 months.

Conclusions

The so-called “collarette” or “spaghetti” skin excision and biopsy technique is an advantageous and efficient way to achieve tumor clearance and represents an equally effective alternative to Mohs micrographic surgery in the treatment of LM in the head and neck area.

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