To the Editor: In their Contempo Updates article
on treatment of primary cutaneous melanoma, Drs Kanzler and Mraz-Gernhard1 did not mention depth of excision. How deeply to
excise has been controversial. The principle of excision to fascia was recommended
by the 1992 National Institutes of Health (NIH) Consensus Conference.2
This general recommendation, however, does not specify the level of
facia to which excision should extend. Throughout the body, there exist superficial
and deep fascia. For instance, the abdomen has several fasciae: the fascia
of Camper and Scarpa and then the rectus sheath.
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