Department of Dermatology, Baylor College of Medicine, Houston, Texas.
Department of Pathology and Immunology, Baylor College of Medicine, Houston, Texas.
J Am Acad Dermatol. 2017 Mar;76(3):527-530. doi: 10.1016/j.jaad.2016.09.009. Epub 2016 Dec 24.
The Pigmented Lesion Subcommittee of the Melanoma Prevention Working Group recently published a consensus statement that incompletely excised moderately dysplastic nevi (MDN) without clinical residual pigmentation can be observed and not re-excised. However, data regarding recurrence of MDN with positive histologic margins are quite scant.
We sought to extend the reported findings with a study to determine the recurrence rate of MDN with positive histologic margins.
We performed a retrospective study on MDN with positive histologic margins that were not re-excised and for which at least 1 year of clinical follow-up was available.
We found a total of 147 such nevi from January 1, 2007, to December 31, 2013. Six MDN (5 compound and 1 junctional) or 4% recurred with an average recurrence time of 1.7 years. All of these MDN were evaluated by shave biopsies.
Subjectivity in grading of atypia is a limitation of this study.
These data from a large study focusing exclusively on recurrence of MDN with positive histologic margins support the conclusion of the Pigmented Lesion Subcommittee that incompletely excised MDN do not require re-excision.
色素性病变工作组的色素斑分会最近发表了一项共识声明，即对于临床无残留色素的不完全切除的中度异型性痣（MDN）可以观察而无需再次切除。然而，关于有阳性组织学边界的 MDN 复发的数据却相当稀少。
我们旨在通过一项研究来扩展已有报道，以确定有阳性组织学边界的 MDN 的复发率。
我们对未再次切除且至少有 1 年临床随访的有阳性组织学边界的 MDN 进行了回顾性研究。
我们在 2007 年 1 月 1 日至 2013 年 12 月 31 日期间共发现了 147 例这样的痣。其中有 6 例 MDN（5 例复合痣和 1 例交界痣）或 4%复发，平均复发时间为 1.7 年。所有这些 MDN 均通过削除活检进行评估。
本研究中对异型性分级的主观性是一个局限性。
这项专门针对有阳性组织学边界的 MDN 复发的大型研究的数据支持色素斑分会的结论，即不完全切除的 MDN 不需要再次切除。
