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Q: It is not a common practice, but there are certain situations when a patient has a very ill-defined skin cancer. Since I am not a Mohs surgeon, I must rely on a local laboratory for my pathology services. When I am uncomfortable with the excision, meaning that I am unsure whether all the margins will be clear, I don't want to spend an hour or so doing a flap or a graft only to have to tear it out if I get a pathology report back with a dirty margin.