This patient had a recurrent melanoma in situ on his scalp that was previously treated by his dermatologist with cryosurgery and a topical medication. The patient was referred to Dr. Morganroth by his dermatologist to cure this complicated skin cancer that did not respond to treatment. Dr. Morganroth is one a handful of double board certified and fellowship-trained Mohs surgeons in the SF Bay Area who performs Mohs surgery for melanoma in situ. Since this tumor was recurrent and large, Dr. Morganroth submitted skin for permanent histology evaluation following the clear margins with Mohs surgery to ensure the tumor was cured. The defect pictured is following confirmation of clear margins and is a few days after the Mohs surgery was completed. Now that the edges were clear by Moh surgery and confirmed by permanent histology, Dr. Morganroth reconstructed the defect with a triple rotation flap.