Dysplastic nevi with severe atypia: Long-term outcomes in patients with and without re-excision

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• 作者：Kathleen Engeln ; MD^a ; Kaitlin Peters ; MD^c ; Jonhan Ho ; MD ; MS^d ; Jaroslaw Jedrych ; MD^d ; Daniel Winger ; MS^b ; Laura Korb Ferris ; MD ; PhD^c ; Timothy Patton ; DO^c ; ^{patttj@upmc.edu}
• 关键词：dysplastic ; melanoma ; nevus ; pigmented lesion ; re-excision ; severe atypia
• 刊名：Journal of the American Academy of Dermatology
• 出版年：2017
• 出版时间：February 2017
• 年：2017
• 卷：76
• 期：2
• 页码：244-249
• 全文大小：154 K
• 卷排序：76

文摘

Dysplastic nevi with severe atypia (severely dysplastic nevi [SDN]) are frequently re-excised because of the concern that these lesions may in fact represent early melanoma. Data on long-term follow-up of these patients are limited.ObjectiveWe sought to determine the rate of subsequent melanoma development in patients with SDN who underwent re-excision versus those who did not and to determine factors associated with decision to re-excise.MethodsA retrospective single institutional study was conducted with 451 adult patients (mean age 41.3 years) with SDN biopsied between November 1994 and November 2004, with clinical follow-up of at least 5 years.ResultsIn 451 patients with SDN, re-excision was performed on 36.6%. Two melanomas were diagnosed in the re-excision specimens. Subsequent metastatic melanoma developed in 7 patients, all of whom had a history of melanoma. Margin comments influenced decision to re-excise.LimitationsThis was a retrospective study at a single institution.ConclusionRe-excision of all SDN may not be necessary.