Clinical Edge

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Melanoma Risk and Moderately Dysplastic Nevi

JAMA Dermatol; ePub Oct 10; Kim, Berry, et al

Close observation with routine skin surveillance is a reasonable management approach for moderately dysplastic nevi with positive histologic margins, according to a recent study. However, having ≥2 biopsied dysplastic nevi (with 1 that is a moderately dysplastic nevus) appears to be associated with increased risk for subsequent cutaneous melanoma (CM) at a separate site. A multicenter, retrospective, cohort study was conducted of patients aged ≥18 years with moderately dysplastic nevi with positive histologic margins and ≥3 years of follow-up data. Records were reviewed for patient demographics, biopsy type, pathologic findings, and development of subsequent CM at the biopsy site or elsewhere on the body. Researchers found:

  • A total of 467 moderately dysplastic nevi with positive histologic margins from 438 patients (193 women and 245 men; mean [SD] age, 46.7 [16.1] years) were evaluated.
  • No cases developed into CM at biopsy sites, with a mean (SD) follow-up time of 6.9 (3.4) years.
  • However, 100 patients (22.8%) developed a CM at a separate site.
  • History of CM was significantly associated with the risk of development of subsequent CM at a separate site, as were prior biopsied dysplastic nevi.
Citation:

Kim CC, Berry EG, Marchetti MA, et al. Risk of subsequent cutaneous melanoma in moderately dysplastic nevi excisionally biopsied but with positive histologic margins. [Published online ahead of print October 10, 2018]. JAMA Dermatol. doi:10.1001/jamadermatol.2018.3359.

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Must Reads in Dermatopathology

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