1. The “spaghetti technique”: An alternative to Mohs surgery or staged surgery for problematic lentiginous melanoma (lentigo maligna and acral lentiginous melanoma) 
Caroline Gaudy-Marqueste, MD, PhD, Anne-Sophie Perchenet, MD, Anne-Marie Taséi, MD, Nika Madjlessi, MD, Guy Magalon, MD, PhD, Marie-Aleth Richard, MD, PhD, Jean-Jacques Grob, MD, PhD 
Journal of the American Academy of Dermatology 
Volume 64, Issue 1, Pages (January 2011)
DOI: /j.jaad
Copyright © 2010 American Academy of Dermatology, Inc. Terms and Conditions

2. Fig 1
A, First step of the procedure. Resection of the “spaghetti” and immediate suture of the defect. B, New “spaghetti” procedure is performed beyond the non–tumor-free segments until tumor-free margins are obtained. C, Second step: Resection of the entire area including the tumor and immediate reconstruction of the defect.
Journal of the American Academy of Dermatology  , DOI: ( /j.jaad )
Copyright © 2010 American Academy of Dermatology, Inc. Terms and Conditions

3. Fig 2
Determination of tumor margins before tumor resection following 3 spaghetti procedures.
Journal of the American Academy of Dermatology  , DOI: ( /j.jaad )
Copyright © 2010 American Academy of Dermatology, Inc. Terms and Conditions

4. Fig 3
Outlining limits of a lentiginous melanoma: Resection of the spaghetti, division into anatomically defined segments, suture of the defect (upper panel). Macroscopic appearance of the spaghetti segment together with histologic sections (lower panel).
Journal of the American Academy of Dermatology  , DOI: ( /j.jaad )
Copyright © 2010 American Academy of Dermatology, Inc. Terms and Conditions

5. Fig 4
Photographic sequence of the first step of the “spaghetti” procedure.
Journal of the American Academy of Dermatology  , DOI: ( /j.jaad )
Copyright © 2010 American Academy of Dermatology, Inc. Terms and Conditions