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371 Ltter Dear Editor, We read with interest the manuscript entitled “Surgical options for malignant skin tumors of the hand” by Yun et al. [1]. The guidelines for surgical excision of squamous cell carcinomas (SCCs) by the British Association of Dermatologists (BAD) [2] recommends that a minimum of 4 mm tumor border margin for SCCs less than 2 cm in diameter and low risk in nature. For tumors that are moderately, poorly or undifferentiated in nature, or larger than 2 cm in diameter, a 6 mm or greater tumor margin is recommended. The BAD guidelines are not specific to any anatomical area, and it is important to consider that wide and deep excisions on the hand could lead to significant functional impairment for patients. Cutaneous SCCs are relatively common on the hand and the initial management of such conditions has evolved from radical surgical excision to taking smaller margins [3]. A retrospective audit of 150 cases of cutaneous SCC of the hand was performed to assess adherence to BAD guidelines, and the resulting excision margins. A retrospective review of 150 patients who underwent surgical excision of SCCs to the hand, distal to the wrist crease, over a 10-year period from 2009 to 2019 was selected from our database. The electronic notes were reviewed to identify patient demographics, peripheral and deep margins on histology and the tumor subtype. Our data was collated and analyzed with Microsoft Excel (Microsoft Corp., Redmond, WA, USA). LETTER