This 10-year retrospective study examined excision margins achieved by Mohs MMS for melanoma in situ of the head and neck, an area particularly prone to subclinical extension. Results informed optimal margin guidelines and demonstrated that Mohs provides reliable margin clearance for head and neck melanoma in situ.

Standard 5-mm margins may be insufficient for melanoma in situ on the head and neck due to significant subclinical extension.

Mohs surgery with melanocyte immunostains offers superior margin assessment for head and neck melanoma in situ.