Frequency of and factors associated with positive or equivocal margins in conventional excision of atypical intraepidermal melanocytic proliferations (AIMP): A single academic institution cross-sectional study

Melanoma and melanoma in-situ diagnosis after excision of atypical intraepidermal melanocytic proliferation: A retrospective cross-sectional analysis

“…We aim to elucidate AIMP ontology and to add data to a growing body of dermatologic and dermatopathologic literature describing surgical outcomes of ambiguous melanocytic lesions. [2][3][4] We report the percentage of AIMP biopsies with post-excision melanoma/MIS diagnoses, describe clinical and histopathologic biopsy characteristics associated with this outcome, and evaluate the margins used for complete AIMP excision. This data will aid in patient counseling and surgical planning for AIMP.…”

Atypical Melanocytic Proliferations: A Review of the Literature

“…There is no established nomenclature for how to refer to lesions whose histological features do not fit into a “benign” or “malignant” category. In the literature, a variety of terms have been used, such as “atypical intraepidermal melanocytic proliferation” (AIMP), 12–16 “borderline melanocytic tumor” (BMT) with intraepidermal and dermal variants, 17–23 “de novo intraepidermal melanocytic dysplasia” (DNIEMD), 24,25 “atypical junctional melanocytic hyperplasia” (AJMH), 26–29 “pagetoid melanocytic proliferation” (PMP), 26,30 and “minimal deviation melanoma” (MDM). 31–42 Of these terms, one of the most commonly used is AIMP.…”

“…In cosmetically concerning areas, the use of Mohs micrographic surgery or staged excision with circumferential margin assessment may warrant consideration. In a retrospective analysis of 413 AIMPs treated with conventional excision, Zhang and colleagues 12 found that AIMPs on the head/neck, especially those with a preoperative histologic diagnosis of MIS on the differential, were associated with a higher frequency (12.5%, 4/32) of incomplete removal after conventional excision. The authors hypothesized that a preoperative diagnosis of AIMP may have been due to inadequate sampling of MIS, or that there is similar clinical behavior between AIMP and MIS.…”

“…An increased rate of incomplete excision was also seen for AIMPs on acral surfaces; however, this result was not statistically significant. 12…”

Commentary: Factors associated with positive or equivocal margins of atypical intraepidermal melanocytic proliferations

“…1 I also request that the authors take into consideration that my commentary on their article is not a personal attack on them but rather a reflection of what I have learned at Ackerman's multiheaded microscope.…”