Bryan Hiscox1, Melissa R Hardin2, Ida F Orengo1, Theodore Rosen1, Mohsin Mir1, A Hafeez Diwan3. 1. Department of Dermatology, Baylor College of Medicine, Houston, Texas. 2. Department of Pathology and Immunology, Baylor College of Medicine, Houston, Texas. 3. Department of Dermatology, Baylor College of Medicine, Houston, Texas; Department of Pathology and Immunology, Baylor College of Medicine, Houston, Texas. Electronic address: ahdiwan@bcm.edu.
Abstract
BACKGROUND: The Pigmented Lesion Subcommittee of the Melanoma Prevention Working Group recently published a consensus statement that incompletely excised moderately dysplastic nevi (MDN) without clinical residual pigmentation can be observed and not re-excised. However, data regarding recurrence of MDN with positive histologic margins are quite scant. OBJECTIVE: We sought to extend the reported findings with a study to determine the recurrence rate of MDN with positive histologic margins. METHODS: We performed a retrospective study on MDN with positive histologic margins that were not re-excised and for which at least 1 year of clinical follow-up was available. RESULTS: We found a total of 147 such nevi from January 1, 2007, to December 31, 2013. Six MDN (5 compound and 1 junctional) or 4% recurred with an average recurrence time of 1.7 years. All of these MDN were evaluated by shave biopsies. LIMITATIONS: Subjectivity in grading of atypia is a limitation of this study. CONCLUSION: These data from a large study focusing exclusively on recurrence of MDN with positive histologic margins support the conclusion of the Pigmented Lesion Subcommittee that incompletely excised MDN do not require re-excision.
BACKGROUND: The Pigmented Lesion Subcommittee of the Melanoma Prevention Working Group recently published a consensus statement that incompletely excised moderately dysplastic nevi (MDN) without clinical residual pigmentation can be observed and not re-excised. However, data regarding recurrence of MDN with positive histologic margins are quite scant. OBJECTIVE: We sought to extend the reported findings with a study to determine the recurrence rate of MDN with positive histologic margins. METHODS: We performed a retrospective study on MDN with positive histologic margins that were not re-excised and for which at least 1 year of clinical follow-up was available. RESULTS: We found a total of 147 such nevi from January 1, 2007, to December 31, 2013. Six MDN (5 compound and 1 junctional) or 4% recurred with an average recurrence time of 1.7 years. All of these MDN were evaluated by shave biopsies. LIMITATIONS: Subjectivity in grading of atypia is a limitation of this study. CONCLUSION: These data from a large study focusing exclusively on recurrence of MDN with positive histologic margins support the conclusion of the Pigmented Lesion Subcommittee that incompletely excised MDN do not require re-excision.
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