Original articleLow rates of clinical recurrence after biopsy of benign to moderately dysplastic melanocytic nevi
Section snippets
Patients and nevus biopsies
This study was approved by our university institutional review board. Patients were recruited from our pigmented lesion clinic, in which approximately 7 new patients are seen each week and more than 1000 patients with history of numerous or atypical nevi and/or personal or family history of melanoma are monitored. The charts of patients scheduled for examination were reviewed before their visit to determine whether any previously biopsied melanocytic nevi were appropriate for the study. Earlier
Rates of nevus recurrence
During an 8-month period, 271 sites of previously biopsied melanocytic nevi were assessed for clinical recurrence in 115 patients (Table I). In most cases, nevi at the follow-up visit presented as a well-healed hypopigmented scar (Fig 1, A). In some cases, on the other hand, pigmentation was seen within the scar (Fig 1, B), and interpreted as nevus recurrence. After histologic re-evaluation of original biopsy specimens, 195 lesions were classified as DN, 61 were classified as BN, and 15 were
Discussion
It is clear from the literature that patients with DN are at increased risk for developing melanoma.9, 10, 11 Although 20% to 50% of melanomas appear to arise from a pre-existing nevus,12, 13, 14 the annual risk of individual nevi transforming into a melanoma is extremely low–estimated to be only 1 in 200,000.15 The annual risk is higher for DN (estimated 1 in 10,000),16 raising the question of whether incompletely removed DN should be re-excised with clear margins to prevent potential
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Cited by (45)
Dysplastic nevus part II: Dysplastic nevi: Molecular/genetic profiles and management
2023, Journal of the American Academy of DermatologyDysplastic Nevi: Morphology and Molecular and the Controversies In-between
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2020, Actas Dermo-SifiliograficasPathologists' agreement on treatment suggestions for melanocytic skin lesions
2020, Journal of the American Academy of DermatologyCitation Excerpt :Pathologists were also given only 4 different options for treatment suggestions, which may have limited the ability to fully communicate their suggestions. Furthermore, we are currently refining the MPATH-Dx schema, in light of new research evidence on class II and III categories, and we are aware that there is disagreement on some of the MPATH-Dx classifications and their respective treatment recommendations.2-5 Strengths of our study include the broad spectrum and high number of cases and the large number of participating pathologists from across the United States.
Persistent/Recurrent Melanocytic Nevi, Traumatized Nevi, and Nevi Changing Under Therapy
2019, Pathology of Melanocytic TumorsRecurrence of moderately dysplastic nevi with positive histologic margins
2017, Journal of the American Academy of DermatologyCitation Excerpt :We found a very small number of recurrences (6 of 147, or ∼4%). This rate is lower than previously reported in several studies,12-15 and is comparable with the rate reported by Goodson et al,5 who speculated that the lower recurrence seen in their study may have been a result of deeper shaves performed in an attempt to excise the lesion (rather than superficial biopsies to minimize scarring). However, in our study, all the MDN had atypical melanocytes present at the tissue edge, and so we cannot easily explain why the recurrence rate in our sample is so low.
Supported by the Department of Dermatology, the Huntsman Cancer Foundation, and the National Institutes of Health (Dr Grossman)
Conflicts of interest: None declared.
Reprints not available from the authors.