Rutgers-Robert Wood Johnson Medical School, Somerset, New Jersey.
Dermatol Surg. 2014 Jan;40(1):40-5. doi: 10.1111/dsu.12391. Epub 2013 Dec 10.
Dysplastic nevi (DN) have been a matter of controversy since their initial description in 1978 because of differences in the clinical and histological terminology, and large studies on histological outcomes of excising moderate to severely DN have not previously been described.
To determine the clinical characteristics of DN and histologic outcomes of excised moderate and severe DN.
Retrospective chart review of patients with DN or Clark's nevi at the Dermatology Department at Rutgers-Robert Wood Johnson Medical School in Somerset, New Jersey, from January 2009 to June 2012. Three hundred ninety-three lesions from 380 patients were included in this study.
Histologic results of excised moderate and severe DN.
Thirty-four percent of DN were excised because of the presence of moderate or severe atypia, personal history of melanoma, or both. None of the excised lesions showed evidence of melanoma; 81.6% of excisions showed scar or granulation tissue. Only 14% of excised lesions were found to have residual lesions, and 4.4% showed recurrent nevi.
In 134 excisions of moderate to severe DN, no melanoma was identified. Most of the excisions showed scar or granulation tissue. The rate of residual lesions after shave biopsy of moderate or severe DN was lower than after punch biopsy.
自 1978 年首次描述发育不良痣 (DN) 以来，由于临床和组织学术语的差异，一直存在争议，并且之前尚未描述过切除中度至重度 DN 的组织学结果的大型研究。
确定 DN 的临床特征以及切除中度和重度 DN 的组织学结果。
回顾性分析 2009 年 1 月至 2012 年 6 月在新泽西州萨默塞特的罗格斯-罗伯特伍德·约翰逊医学院皮肤科就诊的 DN 或 Clark 痣患者的病历。本研究共纳入 380 例患者的 393 个病变。
切除的中度和重度 DN 的组织学结果。
由于中度或重度非典型性、黑色素瘤个人史或两者兼有，34%的 DN 被切除。切除的病变均未发现黑色素瘤证据；81.6%的切除标本显示瘢痕或肉芽组织。仅 14%的切除病变发现有残留病变，4.4%的病变显示复发性痣。
在 134 例中度至重度 DN 的切除标本中，未发现黑色素瘤。大多数切除标本显示瘢痕或肉芽组织。中度或重度 DN 刮除活检后的残留病变率低于打孔活检。
