Diagnosis and treatment of nevomelanocytic lesions of the skin. A community-based study

Abstract

Background and design: Nevomelanocytic lesions of the skin are frequently removed. However, little data are available concerning the diagnostic accuracy, histologic features, and methods of removal for these common lesions. We identified 2935 consecutive nevomelanocytic lesions examined at four pathology laboratories to determine the accuracy of the preoperative diagnosis, the characteristics of the patients treated, and the methods used for removal.

Results: Of 2935 melanocytic lesions, 2087 (71%) were benign nevi, 684 (22%) were dysplastic nevi, 72 (3%) were blue nevi, and 76 (3%) were lentigines. Lentiginous melanocytic hyperplasias with cytologic atypia (20) and melanoma (26) each represented less than 1% of such lesions. Diagnostic accuracy varied by the pathologic diagnosis and the specialty of the treating physician. Dermatologists and plastic surgeons had the highest diagnostic accuracy. Techniques used to remove melanocytic lesions varied by physician specialty and type of lesion.

Conclusions: Despite the high frequency of removal, the methods used to remove nevomelanocytic lesions vary widely. Improving the clinician's ability to distinguish type of lesion may improve care. Studies that determine optimal means for their removal are warranted.