Outcomes of Biopsies and Excisions of Dysplastic Acral Nevi: A Study of 187 Lesions

Abstract

Routine excision of biopsy-proven dysplastic acral nevi may not be necessary.

The utility of re-excising mildly and moderately dysplastic nevi: A retrospective analysis

“…Similar studies examining the surgical outcome of DN have previously been performed and estimated that only 14% to 33% of re-excised margin-positive DN will contain residual atypical nevus. [9][10][11][12] All of these studies were substantially smaller in size and included severely DN in addition to mildly and moderately DN in their analysis. [9][10][11][12] It is unclear why the vast majority of re-excised specimens do not contain residual atypical nevus.…”

“…[9][10][11][12] All of these studies were substantially smaller in size and included severely DN in addition to mildly and moderately DN in their analysis. [9][10][11][12] It is unclear why the vast majority of re-excised specimens do not contain residual atypical nevus. Examination of the re-excisional specimen is limited by the number of sections taken during histopathological processing.…”

Frequent Occurrence of NRAS and BRAF Mutations in Human Acral Naevi

“…In particular, the presence of melanocytes above the basal layer is common in acral naevi and not necessarily associated with malignant behavior, as is the case in melanocytic tumors of other sites. Such factors can make it difficult to histologically distinguish benign from malignant melanocytic proliferations at acral sites, bearing the risk of misdiagnosis [7,8,9,10,11].…”

Surgical re-excision vs. observation for histologically dysplastic naevi: a systematic review of associated clinical outcomes

“…Only one study was not conducted in the U.S.A. (it was in New Zealand). More than half (seven of 12, 58%) of the included studies had primary outcomes focused on the development of melanoma at the site of HDN biopsy, with a third of studies assessing recurrence of HDN (four of 12, 33%), and one study assessing both outcomes (one of 12, 8%) . Half of the studies did not provide any demographic information about the study population …”

“…The duration of follow‐up time was not specified at all in a quarter of the studies, a minimum duration of follow‐up was specified in three studies (at least 2 years; at least 5 years) and a maximum duration of follow‐up was specified in part of one study (less than 5 years) . When quantified, follow‐up was less than 5 years (range 2–16 weeks; mean 3·56 years, range 1·17–8·72 years) in two studies, it was between 5 and 10 years in two studies (mean ± SD 5·5 ± 4·6 years; mean 6·17 years, range 5·03–9·78 years) and greater than 10 years in two studies (median 11·9 years, interquartile range 9–14·8 years; mean 17·4 years, range: 0–29·9 years).…”