To determine if locally recurrent cutaneous squamous cell carcinoma (cSCC) leads to increased patient morbidity, and, if so, to what extent. The main outcome will be the margin required to clear locally recurrent cSCC versus that of similar primary cSCC. Secondary outcomes will analyze number of mohs micrographic surgery (MMS) layers, the difference in area between the clinical lesion and the defect size, closure types and sizes, loss of function, and referrals (radiation, oncology, reconstruction, etc.) required for treatment.

This project is a pilot study to determine if use of the J-Tip Needle-Free Injection System, used to administer local anesthesia, has any effects on the appearance of skin samples when viewed under a microscope compared with skin samples that have been injected with local anesthesia using a needle. If use of the J-Tip device for local anesthesia delivery is shown not to alter the microscopic appearance of skin, anesthesia for skin biopsies in the future may potentially be performed without a needle, allowing for less fear and pain.

This study is for patients with melanoma. This study is being done to answer if a 1-centimeter margin as good as a 2-centimeter margin at reducing the risk of melanoma returning.