Outcomes of biopsies and excisions of dysplastic acral nevi: a study of 187 lesions.
BACKGROUND
Despite their frequency in clinical practice, controversy exists regarding the significance and management of dysplastic nevi (DN). Although the perception of DN as precursors to melanoma is questionable, excisions of biopsy-proven DN are commonplace in clinical practice. The management of dysplastic acral nevi is of interest given the challenge of surgery at acral sites.


OBJECTIVE
To determine the outcomes of biopsies of clinically atypical acral nevi and excisions of histologically dysplastic acral nevi (HDN).


METHODS
Retrospective review of consecutive patients at a private dermatology practice who had a biopsy of an atypical acral nevus from December 2004 to July 2012.


RESULTS
One hundred eighty-seven atypical acral nevi were biopsied from 168 patients (77 (41%) HDN, 108 (58%) common nevi). Based on initial histology, 30 (39%) HDN were recommended for excision and eight (10%) for clinical observation. Twenty-seven of the 77 HDN were excised; 23 (85%) revealed scar only, and four (15%) revealed residual DN not involving the margin.


CONCLUSIONS
Routine excision of biopsy-proven dysplastic acral nevi may not be necessary.
Department of Dermatology, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, New Jersey.
Tara
T
Bronsnick
Nadeem
N
Kazi
A Yasmine
AY
Kirkorian
Babar K
BK
Rao
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D002648:Child; D004416:Dysplastic Nevus Syndrome / Q000473:pathology* / Q000601:surgery*; D005121:Extremities; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012867:Skin / Q000473:pathology*; D012878:Skin Neoplasms / Q000473:pathology* / Q000601:surgery*; D057832:Watchful Waiting; D055815:Young Adult