Thomas L Hocker1, Ali Alikhan1, Nneka I Comfere2, Margot S Peters3. 1. Department of Dermatology, Mayo Clinic, Rochester, Minnesota. 2. Department of Dermatology, Mayo Clinic, Rochester, Minnesota; Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota. 3. Department of Dermatology, Mayo Clinic, Rochester, Minnesota; Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota. Electronic address: peters.margot@mayo.edu.
Abstract
BACKGROUND: Patients with multiple clinically dysplastic nevi are at increased risk for development of melanoma. However, the risk of melanoma arising in a histologically dysplastic nevus (HDN) is unknown. OBJECTIVE: We sought to determine the rate of melanoma development in patients with HDNs that approached a microscopic border but were not re-excised. METHODS: We performed a retrospective study of patients evaluated in our dermatology department from January 1, 1980, to December 31, 1989, who had a HDN that extended to within 0.2 mm of a microscopic punch, shave, or excision border and was not re-excised. RESULTS: The average follow-up in our cohort of 115 patients was 17.4 years (range: 0.0-29.9): 82 patients (71.3%) were followed up for longer than 10 years, 78 (67.8%) longer than 15 years, and 73 (63.4%) had more than 20 years of follow-up; 66 of 115 nevi were mildly dysplastic, 42 moderately dysplastic, and 7 had severe dysplasia. No patient developed metastatic melanoma or melanoma at the site of removal of a HDN. LIMITATIONS: This was a retrospective study performed at 1 large academic medical center. CONCLUSION: During a long-term follow-up period, no patient developed melanoma at the site of an incompletely or narrowly removed HDN, providing evidence that routine re-excision of mildly or moderately dysplastic nevi may not be necessary.
BACKGROUND:Patients with multiple clinically dysplastic nevi are at increased risk for development of melanoma. However, the risk of melanoma arising in a histologically dysplastic nevus (HDN) is unknown. OBJECTIVE: We sought to determine the rate of melanoma development in patients with HDNs that approached a microscopic border but were not re-excised. METHODS: We performed a retrospective study of patients evaluated in our dermatology department from January 1, 1980, to December 31, 1989, who had a HDN that extended to within 0.2 mm of a microscopic punch, shave, or excision border and was not re-excised. RESULTS: The average follow-up in our cohort of 115 patients was 17.4 years (range: 0.0-29.9): 82 patients (71.3%) were followed up for longer than 10 years, 78 (67.8%) longer than 15 years, and 73 (63.4%) had more than 20 years of follow-up; 66 of 115 nevi were mildly dysplastic, 42 moderately dysplastic, and 7 had severe dysplasia. No patient developed metastatic melanoma or melanoma at the site of removal of a HDN. LIMITATIONS: This was a retrospective study performed at 1 large academic medical center. CONCLUSION: During a long-term follow-up period, no patient developed melanoma at the site of an incompletely or narrowly removed HDN, providing evidence that routine re-excision of mildly or moderately dysplastic nevi may not be necessary.
Authors: Michael N Kent; Thomas G Olsen; Theresa A Feeser; Katherine C Tesno; John C Moad; Michael P Conroy; Mary Jo Kendrick; Sean R Stephenson; Michael R Murchland; Ayesha U Khan; Elizabeth A Peacock; Alexa Brumfiel; Michael A Bottomley Journal: JAMA Dermatol Date: 2017-12-01 Impact factor: 10.282
Authors: Caroline C Kim; Elizabeth G Berry; Michael A Marchetti; Susan M Swetter; Geoffrey Lim; Douglas Grossman; Clara Curiel-Lewandrowski; Emily Y Chu; Michael E Ming; Kathleen Zhu; Meera Brahmbhatt; Vijay Balakrishnan; Michael J Davis; Zachary Wolner; Nathaniel Fleming; Laura K Ferris; John Nguyen; Oleksandr Trofymenko; Yuan Liu; Suephy C Chen Journal: JAMA Dermatol Date: 2018-12-01 Impact factor: 10.282
Authors: Mustufa A Jafry; Sue Peacock; Andrea C Radick; Hannah L Shucard; Lisa M Reisch; Michael W Piepkorn; Stevan R Knezevich; Martin A Weinstock; Raymond L Barnhill; David E Elder; Kathleen F Kerr; Joann G Elmore Journal: J Am Acad Dermatol Date: 2019-12-17 Impact factor: 11.527