Severe Dysplqstic Nevi

Published in Dermatology

Journal Scan / Research · August 04, 2019

Outcomes of Surgical Re-Excision Versus Observation of Severely Dysplastic Nevi

Journal of the American Academy of Dermatology

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• At a single institution, consecutive severely dysplastic nevi (SDN) which were clinically observed vs. re-excised were analyzed to assess local recurrence and histological upstaging to cutaneous melanoma (CM). Of the 30observed cases, one patient developed local MIS recurrence at the initial biopsy site whereas there were no local recurrences in the re-excision group of 85cases. A total of 16% of partially biopsied cases were upstaged on re-excision compared with 5.6% of those excisionally biopsied cases (P = .199).

• While the study is limited by a small sample size at a single institution, this study reiterates the importance of excisional biopsy for concerning pigmented lesions. Re-excision appeared advisable for SDN with positive biopsy margins, however, further studies addressing the need for re-excision of completely biopsied SDN with standard margins are warranted.

– Margaret Hammond, MD

Recent retrospective cohort studies and a systematic review showed low rates of cutaneous melanoma (CM) at sites of histologically dysplastic nevi (DN) that were clinically observed vs completely excised,1-3 though few included severely dysplastic nevi (SDN).4 A multi-center, retrospective analysis of 467 moderately DN without clinical residual pigmentation following excisional biopsy showed lack of adverse patient Outcomes with observation alone.5 We analyzed consecutive SDN that were clinically observed vs re-excised to assess local recurrence and histological upstaging to CM or early/evolving CM, including melanoma in situ (MIS) and atypical intraepidermal melanocytic proliferation.

Journal of the American Academy of Dermatology

Outcomes of Surgical Re-Excision Versus Observation of Severely Dysplastic Nevi: A Single Institution, Retrospective Cohort Study

J Am Acad Dermatol 2019 Jul 17;[EPub Ahead of Print], NH Fleming, AR Shaub, E Bailey, SM Swetter 

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Benjamin Hidalgo-Matlock
Skin Care Physicians of Costa Rica

Clinica Victoria en San Pedro: 4000-1054
Momentum Escazu: 2101-9574

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