The utility of re-excising mildly and moderately dysplastic nevi: A retrospective analysis  

Oleh:

Strazzula, Lauren ; Vedak, Priyanka ; Mai, P. Hoang ; Sober, Arthur ; Hensin, Tsao ; Kroshinsky, Daniela

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: JAAD: Journal of the American Academy of Dermatology (keterangan: ada di ClinicalKey) vol. 71 no. 06 (Dec. 2014), page 1071–1076 .
Topik: dermatopathology; dysplastic nevus; melanoma; nevus; pigmented lesions; surgical management

Ketersediaan

Perpustakaan FK Nomor Panggil: J15.K Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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Isi artikel

Background The management of dysplastic nevi (DN) is a highly debated and controversial topic within the dermatology community. Clinicians agree that margin-positive severely DN should be removed with a surgical margin, however, there is disagreement surrounding the appropriate management of margin-positive mildly and moderately DN. Objective We sought to evaluate the utility of re-excising margin-positive mildly and moderately DN. Methods A retrospective chart review was conducted on all adult patients given the diagnosis of a biopsy-proven DN from 2010 through 2011. The primary outcomes were defined as the presence of melanocytic residuum in re-excisional specimens and a clinically significant change in diagnosis. Results A total of 1809 mildly and moderately DN were diagnosed from 2010 through 2011. In all, 765 (42.3%) of these lesions were found to have positive surgical margins during biopsy, and 495 (64.7) of the 765 lesions were subsequently re-excised. Melanocytic residuum was present in 18.2% of re-excisional specimens. Re-excision resulted in a clinically significant alteration of the diagnosis in only 1 case (0.2%). Limitations Limitations include retrospective design and inability to assess for malignant transformation given limited follow-up. Conclusions Re-excising mildly and moderately DN results in a low histopathological yield and rarely results in a clinically significant change in diagnosis. As such, clinical monitoring of margin-positive lesions may be warranted.

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