Frequency of and factors associated with positive or equivocal margins in conventional excision of atypical intraepidermal melanocytic proliferations (AIMP): A single academic institution cross-sectional study - 18/09/16
Abstract |
Background |
No evidence-based surgical guidelines exist for atypical intraepidermal melanocytic proliferation (AIMP), a descriptive histopathologic diagnosis with uncertain malignant potential.
Objective |
We sought to identify the frequency of and risk factors associated with positive or equivocal margins after conventional excision.
Methods |
We conducted a retrospective cross-sectional study of 413 AIMPs treated by conventional excision.
Results |
Positive or equivocal margins were seen in 2.9% (12/413) of conventional excisions of AIMP. Risk factors associated with positive or equivocal margins included anatomic location on the head and neck (5/51, 9.8%; odds ratio 6.91, 95% confidence interval 1.93-24.80) (P = .012) and a preoperative biopsy specimen that included melanoma in situ in the differential diagnosis (11/214, 5.1%; odds ratio 10.73, 95% confidence interval 1.37-83.88) (P = .006). The frequency of positive or equivocal margins did not differ significantly with surgical margins greater than or less than 5 mm (odds ratio 0.61, 95% confidence interval 0.18-2.07) (P = .457).
Limitations |
This was a single-site, retrospective observational study.
Conclusion |
AIMP has a significantly increased risk for incomplete excision when it is located on the head and neck or has a preoperative histologic differential diagnosis that includes melanoma in situ. These subsets of AIMP may benefit from Mohs micrographic surgery or staged surgical excision to confirm clear margins before reconstruction.
Le texte complet de cet article est disponible en PDF.Key words : atypical intraepidermal melanocytic proliferation, excision, melanoma, Mohs, positive margin, surgery
Abbreviations used : AIMP, CI, MIS, MMS
Plan
Supported by a Dermatology Foundation Clinical Career Development Award in Dermatologic Surgery to Dr Sobanko. |
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Conflicts of interest: None declared. |
Vol 75 - N° 4
P. 688-695 - octobre 2016 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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