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Excision Margins for Melanoma in Awkward Places Like the Eyelid

David M. Reifler, MD
JAMA. 1993;269(5):588. doi:10.1001/jama.1993.03500050066019.
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To the Editor.  —I read with interest a recently published National Institutes of Health (NIH) consensus statement that identified several clinical directions for future research on the diagnosis and treatment of early melanoma of the skin.1 These included the determination of optimal margins for primary melanomas deeper than 1 mm and the investigation of alternative therapies for primary melanomas in which normal tissue conservation is critical. One of these (unmentioned) special locations is the eyelid, where consensus panel recommendations of excision margins (0.5 cm for melanoma in situ and 1 cm for thin invasive melanoma) represent radical sacrifices of eyelid tissue.From the few reported series in the ophthalmologic literature,2 it appears that cutaneous melanoma of the eyelid is rare but carries a relatively favorable prognosis in comparison with cutaneous melanomas of other sites. These differences in prognosis and unique aspects of eyelid anatomy may have important treatment


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