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. 2017 Feb;76(2):244-249.
doi: 10.1016/j.jaad.2016.08.054. Epub 2016 Nov 9.

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

Kathleen Engeln  1 , Kaitlin Peters  2 , Jonhan Ho  3 , Jaroslaw Jedrych  3 , Daniel Winger  4 , Laura Korb Ferris  2 , Timothy Patton  5
Affiliations

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

Kathleen Engeln et al. J Am Acad Dermatol. 2017 Feb.

Abstract

Background: 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.

Objective: We 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.

Methods: A 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.

Results: In 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.

Limitations: This was a retrospective study at a single institution.

Conclusion: Re-excision of all SDN may not be necessary.

Keywords: dysplastic; melanoma; nevus; pigmented lesion; re-excision; severe atypia.

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