Expanded Biopsy Margin for Dysplastic Nevi Reduces Need for Second Procedure

Use of a 2-mm peripheral biopsy margin for the complete removal of histologically dysplastic nevi (DN) can reduce the number of unnecessary second procedures at DN biopsy sites, thus decreasing patient morbidity and lowering healthcare costs, according to results from a prospective study published in the Journal of the American Academy of Dermatology.

The study evaluated the use of a saucerization biopsy technique for complete histologic removal of clinically atypical or dysplastic nevi. The researchers performed a total of 151 biopsies in 138 patients. Overall, 90.7% (137 of 151) of the lesions subjected to biopsy were shown to be melanocytic in origin. Of these, 86 (57.0%) were DN, 40 (26.5%) were nevi without atypia, and 11 (7.3%) were melanomas. Of the 78 DN, 68 (87.2%) were removed with clear histopathologic margins. There was no clinical evidence of recurrence at any of the biopsy sites that were observed and not re-excised over a median of 16.9 months.

A major limitation of the study was that few biopsies were performed on the face. Overall, 64% (97 of 151) of the clinically atypical nevi removed were on the trunk, 23% (34 of 151) were on the lower extremities, 12% (18 of 151) were on the upper extremities, and 1% (2 of 151) were on the head and neck.

Use of a saucerization biopsy method with a 2-mm peripheral margin of normal skin was shown to remove nearly 9 of 10 DN completely. This technique has the potential to decrease repeat procedures at DN biopsy sites, in turn reducing patient morbidity rates and reducing healthcare costs.

Reference

Terushkin V, Ng E, Stein JA, et al. A prospective study evaluating the utility of a 2-mm biopsy margin for complete removal of histologically atypical (dysplastic) nevi [published online September 16, 2017]. J Am Acad Dermatol. doi:10.1016/j.jaad.2017.07.016