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.
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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Melanoma Rates Before and After AJCC 7 Enactment, JAMA Dermatol; ePub 2019 Mar 6; Isom, et al
Melanoma Risk and Moderately Dysplastic Nevi, JAMA Dermatol; ePub Oct 10; Kim, Berry, et al
Sentinel Lymph Node Positivity Markers in Melanoma, J Am Acad Dermatol; ePub 2018 Sep 18; Conic, et al