There is little evidence to guide surgical management of biopsies yielding the histologic descriptor atypical intraepidermal melanocytic proliferation (AIMP).
Determine frequency of and factors associated with melanoma and melanoma in-situ (MIS) diagnoses after excision of AIMP and evaluate margins used to completely excise AIMP.
Retrospective, cross-sectional study of 1127 biopsies reported as AIMP and subsequently excised within one academic institution.
Melanoma (in situ, stage 1A) was diagnosed after excision in 8.2% (92/1127) of AIMP samples. Characteristics associated with melanoma/MIS diagnosis included age 60-79 years (odds ratio [OR] 8.1, 95% confidence interval [CI] 2.5-26.2), age ≥80 years (OR 7.2, 95% CI 1.7-31.5), head/neck location (OR 4.9, 95% CI 3.1-7.7), clinical lesion partially biopsied (OR 11.0, 95% CI 6.7-18.1), and lesion extending to deep biopsy margin (OR 15.1, 95% CI 1.7-136.0). Average ± standard deviation surgical margin used to excise AIMP lesions was 4.5 ± 1.8 mm.
Single-site, retrospective, observational study; interobserver variability across dermatopathologists.
Dermatologists and pathologists can endeavor to avoid ambiguous melanocytic designations whenever possible through excisional biopsy technique, interdisciplinary communication, and ancillary studies. In the event of AIMP biopsy, physicians should consider the term a histologic description rather than a diagnosis, and, during surgical planning, use clinicopathologic correlation while bearing in mind factors that might predict true melanoma/MIS.Le texte complet de cet article est disponible en PDF.
Key words : ambiguous melanocytic lesions, atypical intraepidermal melanocytic proliferation, atypical junctional melanocytic hyperplasia, atypical junctional melanocytic proliferation, atypical melanocytic proliferation, biopsy, excision, lentiginous junctional melanocytic proliferation, melanoma, melanoma in situ
Abbreviations used : AIMP, CI, MIS, OR
| Funding sources: Supported in part through the National Institutes of Health/National Cancer Institute Cancer Center Support Grant P30 CA008748.
| Conflicts of interest: Dr Rossi served as a consultant for Merz, Dynamed, Can Scientific, Biofrontera, Evolus, Quantia MD, and Lam Therapeutics and on the advisory board for Allergan Inc. Dr Rossi has received research grants from American Society for Laser Medicine and Surgery and the Skin Cancer Foundation. All other authors have no conflicts of interest to disclose.