Abstract
Background Complete removal of individual dysplastic nevi (DN) is often accomplished by a second surgical procedure after the initial biopsy. The choice to perform the second procedure is strongly influenced by histopathologic margin status of the initial biopsy specimen. Objective To evaluate the clinical and histopathologic outcomes of in toto biopsy of DN using a predetermined margin of normal skin. Methods We conducted a prospective study of a saucerization method using a defined 2-mm margin in patients undergoing biopsy of a pigmented skin lesion. Results We performed 151 biopsies in 138 patients. Overall, 137 of 151 lesions subjected to biopsy (90.7%) were melanocytic: 86 DN (57.0%), 40 nevi without atypia (26.5%), and 11 melanomas (7.3%). Of 78 DN, 68 (87.2%) were removed with clear histopathologic margins (8 DN were excluded because of inadequate processing). There was no clinical evidence of recurrence at any of the biopsy sites that were simply observed (i.e., not re-excised) over a median of 16.9 months. Limitations There were few biopsies performed on the face. Conclusions The complete histopathologic removal of nearly 9 of 10 DN using a peripheral margin of 2 mm of normal skin and a depth at the dermis and subcutaneous fat junction has the potential to decrease second procedures at DN biopsy sites, thereby decreasing patient morbidity and saving health care dollars.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1096-1099 |
| Number of pages | 4 |
| Journal | Journal of the American Academy of Dermatology |
| Volume | 77 |
| Issue number | 6 |
| DOIs | |
| State | Published - Dec 1 2017 |
| Externally published | Yes |
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Keywords
- atopic nevi
- biopsy
- dysplastic nevi
- margin
- melanoma
- prospective
- removal
- saucerization
ASJC Scopus subject areas
- Dermatology
Cite this
A prospective study evaluating the utility of a 2-mm biopsy margin for complete removal of histologically atypical (dysplastic) nevi. / Terushkin, Vitaly; Ng, Elise; Stein, Jennifer A.; Katz, Susan; Cohen, David E.; Meehan, Shane; Polsky, David.
In: Journal of the American Academy of Dermatology, Vol. 77, No. 6, 01.12.2017, p. 1096-1099.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - A prospective study evaluating the utility of a 2-mm biopsy margin for complete removal of histologically atypical (dysplastic) nevi
AU - Terushkin, Vitaly
AU - Ng, Elise
AU - Stein, Jennifer A.
AU - Katz, Susan
AU - Cohen, David E.
AU - Meehan, Shane
AU - Polsky, David
PY - 2017/12/1
Y1 - 2017/12/1
N2 - Background Complete removal of individual dysplastic nevi (DN) is often accomplished by a second surgical procedure after the initial biopsy. The choice to perform the second procedure is strongly influenced by histopathologic margin status of the initial biopsy specimen. Objective To evaluate the clinical and histopathologic outcomes of in toto biopsy of DN using a predetermined margin of normal skin. Methods We conducted a prospective study of a saucerization method using a defined 2-mm margin in patients undergoing biopsy of a pigmented skin lesion. Results We performed 151 biopsies in 138 patients. Overall, 137 of 151 lesions subjected to biopsy (90.7%) were melanocytic: 86 DN (57.0%), 40 nevi without atypia (26.5%), and 11 melanomas (7.3%). Of 78 DN, 68 (87.2%) were removed with clear histopathologic margins (8 DN were excluded because of inadequate processing). There was no clinical evidence of recurrence at any of the biopsy sites that were simply observed (i.e., not re-excised) over a median of 16.9 months. Limitations There were few biopsies performed on the face. Conclusions The complete histopathologic removal of nearly 9 of 10 DN using a peripheral margin of 2 mm of normal skin and a depth at the dermis and subcutaneous fat junction has the potential to decrease second procedures at DN biopsy sites, thereby decreasing patient morbidity and saving health care dollars.
AB - Background Complete removal of individual dysplastic nevi (DN) is often accomplished by a second surgical procedure after the initial biopsy. The choice to perform the second procedure is strongly influenced by histopathologic margin status of the initial biopsy specimen. Objective To evaluate the clinical and histopathologic outcomes of in toto biopsy of DN using a predetermined margin of normal skin. Methods We conducted a prospective study of a saucerization method using a defined 2-mm margin in patients undergoing biopsy of a pigmented skin lesion. Results We performed 151 biopsies in 138 patients. Overall, 137 of 151 lesions subjected to biopsy (90.7%) were melanocytic: 86 DN (57.0%), 40 nevi without atypia (26.5%), and 11 melanomas (7.3%). Of 78 DN, 68 (87.2%) were removed with clear histopathologic margins (8 DN were excluded because of inadequate processing). There was no clinical evidence of recurrence at any of the biopsy sites that were simply observed (i.e., not re-excised) over a median of 16.9 months. Limitations There were few biopsies performed on the face. Conclusions The complete histopathologic removal of nearly 9 of 10 DN using a peripheral margin of 2 mm of normal skin and a depth at the dermis and subcutaneous fat junction has the potential to decrease second procedures at DN biopsy sites, thereby decreasing patient morbidity and saving health care dollars.
KW - atopic nevi
KW - biopsy
KW - dysplastic nevi
KW - margin
KW - melanoma
KW - prospective
KW - removal
KW - saucerization
UR - http://www.scopus.com/inward/record.url?scp=85030235371&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85030235371&partnerID=8YFLogxK
U2 - 10.1016/j.jaad.2017.07.016
DO - 10.1016/j.jaad.2017.07.016
M3 - Article
C2 - 28982585
AN - SCOPUS:85030235371
VL - 77
SP - 1096
EP - 1099
JO - Journal of the American Academy of Dermatology
JF - Journal of the American Academy of Dermatology
SN - 0190-9622
IS - 6
ER -