Mohs micrographic surgery with melanoma antigen recognized by T cells 1 (MART-1) immunostaining for atypical intraepidermal melanocytic proliferation - 10/11/18
Abstract |
Background |
The efficacy of Mohs micrographic surgery (MMS) for atypical intraepidermal melanocytic proliferation (AIMP) is unknown.
Objective |
To ascertain the frequency of diagnostic change to melanoma (upstaging) and the frequency of local recurrence after MMS for AIMP. A secondary outcome was the frequency of subclinical spread (defined as the requirement for >1 stage of MMS to achieve tumor-free margins).
Methods |
Retrospective, cross-sectional study of 223 AIMP (with 92.4% located on the head, neck, hand, foot, or pretibial leg) patients treated with MMS with melanoma antigen recognized by T cells 1 (MART-1) immunostaining.
Results |
Upstaging to unequivocal melanoma in situ or invasive melanoma was identified in 18.8% (42/223) of all AIMP patients. The local recurrence rate was 0% (0/223) with a mean follow-up time of 2.7 years (998 days). Subclinical spread was present in 23.8% (53/223) of AIMP patients.
Limitations |
Single site, retrospective design, observational study, lack of objective criteria to diagnose AIMP.
Conclusion |
MMS with MART-1 immunostaining achieves excellent local control of specialty site AIMP and permits definitive removal of subclinical spread before reconstruction. The central debulking excision should be evaluated with formalin-fixed paraffin-embedded section staining, since a significant percentage of AIMP are reclassified as melanoma in situ or invasive melanoma.
Le texte complet de cet article est disponible en PDF.Key words : atypical intraepidermal melanocytic proliferation, local recurrence, melanoma, Mohs micrographic surgery, patient counseling, positive margin, subclinical spread, upstaging
Abbreviations used : AIMP, MART-1, MMS
Plan
Funding sources: None. |
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Conflicts of interest: Drs Etzkorn and Sobanko are supported by Dermatology Foundation Clinical Career Development Awards in Dermatologic Surgery. All other authors have no conflicts of interest to disclose. |
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Reprints not available from the authors. |
Vol 79 - N° 6
P. 1109 - décembre 2018 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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