To the Editor: As the incidence of melanoma in situ (MIS)/invasive melanoma (IM) of the head, neck, and special sites (HNS) has increased in the last decade, so has the use of comprehensive margin assessment (CMA) techniques, including Mohs micrographic surgery (MMS), with an added trend of increased use of immunohistochemistry special stains such as MART-1. 1 Lee M.P. Sobanko J.F. Shin T.M. et al. Evolution of excisional surgery practices for melanoma in the United States. JAMA Dermatol. 2019; 155: 1244-1251 Crossref Scopus (10) Google Scholar This is not surprising considering that more recent studies show improved local recurrence and overall survival outcomes with MMS compared to wide local excision, along with a distinct advantage in areas of cosmetic and functional importance. 2 Sharma A.N. Foulad D.P. Doan L. Lee P.K. Mesinkovska N.A. Mohs surgery for the treatment of lentigo maligna and lentigo maligna melanoma—a systematic review. J Dermatolog Treat. 2020; ([E-pub ahead of print]): 1-7https://doi.org/10.1080/09546634.2019.1690624 Crossref PubMed Scopus (6) Google Scholar , 3 Demer A.D. Vance K.K. Cheraghi N. Reich H.C. Lee P.K. Benefit of Mohs micrographic surgery over wide local excision for melanoma of the head and neck: a rational approach to treatment. Dermatol Surg. 2019; 45: 381-389 Crossref PubMed Scopus (7) Google Scholar , 4 Cheraghlou S. Christensen S.R. Agogo G.O. Girardi M. Comparison of survival after Mohs micrographic surgery vs wide margin excision for early-stage invasive melanoma. JAMA Dermatol. 2019; 155: 1252-1259 Crossref Scopus (12) Google Scholar , 5 Hanson J. Demer A. Liszewski W. Forman N. Maher I. Improved overall survival of melanoma of the head and neck treated with Mohs micrographic surgery versus wide local excision. J Am Acad Dermatol. 2020; 82: 149-155 Abstract Full Text Full Text PDF PubMed Scopus (13) Google Scholar This study evaluates additional outcome measures of CMA surgical approaches for treatment of MIS/IM.