Favorable long-term outcomes in patients with histologically dysplastic nevi that approach a specimen border - 21/03/13
Abstract |
Background |
Patients with multiple clinically dysplastic nevi are at increased risk for development of melanoma. However, the risk of melanoma arising in a histologically dysplastic nevus (HDN) is unknown.
Objective |
We sought to determine the rate of melanoma development in patients with HDNs that approached a microscopic border but were not re-excised.
Methods |
We performed a retrospective study of patients evaluated in our dermatology department from January 1, 1980, to December 31, 1989, who had a HDN that extended to within 0.2 mm of a microscopic punch, shave, or excision border and was not re-excised.
Results |
The average follow-up in our cohort of 115 patients was 17.4 years (range: 0.0-29.9): 82 patients (71.3%) were followed up for longer than 10 years, 78 (67.8%) longer than 15 years, and 73 (63.4%) had more than 20 years of follow-up; 66 of 115 nevi were mildly dysplastic, 42 moderately dysplastic, and 7 had severe dysplasia. No patient developed metastatic melanoma or melanoma at the site of removal of a HDN.
Limitations |
This was a retrospective study performed at 1 large academic medical center.
Conclusion |
During a long-term follow-up period, no patient developed melanoma at the site of an incompletely or narrowly removed HDN, providing evidence that routine re-excision of mildly or moderately dysplastic nevi may not be necessary.
Le texte complet de cet article est disponible en PDF.Key words : atypical nevus, Clark nevus, dysplastic nevus, histologically dysplastic nevus, long-term follow-up, melanoma, re-excision
Plan
Funding sources: None. |
|
Conflicts of interest: None declared. |
Vol 68 - N° 4
P. 545-551 - avril 2013 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?