title: Favorable long-term outcomes in patients with histologically dysplastic nevi that approach a specimen border.
abstract: BACKGROUND
  Patients with multiple clinically dysplastic nevi are at increased risk for development of melanoma. However, the risk of melanoma arising in a histologically dysplastic nevus (HDN) is unknown.
  
  
  OBJECTIVE
  We sought to determine the rate of melanoma development in patients with HDNs that approached a microscopic border but were not re-excised.
  
  
  METHODS
  We performed a retrospective study of patients evaluated in our dermatology department from January 1, 1980, to December 31, 1989, who had a HDN that extended to within 0.2 mm of a microscopic punch, shave, or excision border and was not re-excised.
  
  
  RESULTS
  The average follow-up in our cohort of 115 patients was 17.4 years (range: 0.0-29.9): 82 patients (71.3%) were followed up for longer than 10 years, 78 (67.8%) longer than 15 years, and 73 (63.4%) had more than 20 years of follow-up; 66 of 115 nevi were mildly dysplastic, 42 moderately dysplastic, and 7 had severe dysplasia. No patient developed metastatic melanoma or melanoma at the site of removal of a HDN.
  
  
  CONCLUSIONS
  This was a retrospective study performed at 1 large academic medical center.
  
  
  CONCLUSIONS
  During a long-term follow-up period, no patient developed melanoma at the site of an incompletely or narrowly removed HDN, providing evidence that routine re-excision of mildly or moderately dysplastic nevi may not be necessary.
authors.affiliation: Department of Dermatology, Mayo Clinic, Rochester, Minnesota.
authors.forename: Thomas L
authors.initials: TL
authors.lastname: Hocker
authors.affiliation: Department of Dermatology, Mayo Clinic, Rochester, Minnesota.
authors.forename: Ali
authors.initials: A
authors.lastname: Alikhan
authors.affiliation: Department of Dermatology, Mayo Clinic, Rochester, Minnesota; Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota.
authors.forename: Nneka I
authors.initials: NI
authors.lastname: Comfere
authors.affiliation: Department of Dermatology, Mayo Clinic, Rochester, Minnesota; Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota. Electronic address: peters.margot@mayo.edu.
authors.forename: Margot S
authors.initials: MS
authors.lastname: Peters
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D004416:Dysplastic Nevus Syndrome / Q000473:pathology* / Q000601:surgery*; D006801:Humans; D007223:Infant; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000473:pathology* / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult