Jeon Hana, Wang Yen James, Smart Chandra
*Department of Dermatology, Johns Hopkins School of Medicine, Baltimore, Maryland; †Department of Dermatology, David Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, California; ‡Department of Pathology and Laboratory Medicine, Ronald Reagan UCLA Medical Center, Los Angeles, California.
Dermatol Surg. 2015 Sep;41(9):1020-3. doi: 10.1097/DSS.0000000000000437.
It is a common practice to biopsy clinically atypical nevi, which may signify an individual's increased risk of developing melanoma. There is no consensus in the current literature, however, as to what the best method is to manage biopsy-proven atypical nevi.
The objective was to compare margin clearance rates between reshave excision and full-thickness surgical excision performed to manage biopsy-proven atypical nevi.
In this retrospective observational study, histopathology specimens from 201 patients whose atypical nevi were surgically removed were analyzed.
For the majority (76%-79%) of the atypical nevi studied, all atypical melanocytes were removed by the initial shave biopsy. Of those atypical nevi with positive margins, shave re-excision was shown to have a lower clearance rate (76.2%) when compared with surgical excision (87.5%).
This study shows that in most cases, no residual atypical melanocytes are left after the initial shave biopsy. However, of the lesions where margins are not clear, full-thickness surgical excision may have a higher rate of success at eventual clearance than reshave excision.
对临床非典型痣进行活检是一种常见做法，这可能表明个体患黑色素瘤的风险增加。然而，目前的文献对于处理经活检证实的非典型痣的最佳方法尚无共识。
目的是比较为处理经活检证实的非典型痣而进行的再次削除切除术和全层手术切除的切缘清除率。
在这项回顾性观察研究中，分析了201例手术切除非典型痣的组织病理学标本。
对于大多数（76%-79%）研究的非典型痣，所有非典型黑素细胞在初次削除活检时均被清除。在那些切缘阳性的非典型痣中，再次削除切除术的清除率（76.2%）低于手术切除（87.5%）。
本研究表明，在大多数情况下，初次削除活检后不会残留非典型黑素细胞。然而，在切缘不清晰的病变中，全层手术切除最终清除的成功率可能高于再次削除切除术。
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