title: Dysplastic nevi with severe atypia: Long-term outcomes in patients with and without re-excision.
abstract: BACKGROUND
  Dysplastic nevi with severe atypia (severely dysplastic nevi [SDN]) are frequently re-excised because of the concern that these lesions may in fact represent early melanoma. Data on long-term follow-up of these patients are limited.
  
  
  OBJECTIVE
  We sought to determine the rate of subsequent melanoma development in patients with SDN who underwent re-excision versus those who did not and to determine factors associated with decision to re-excise.
  
  
  METHODS
  A retrospective single institutional study was conducted with 451 adult patients (mean age 41.3 years) with SDN biopsied between November 1994 and November 2004, with clinical follow-up of at least 5 years.
  
  
  RESULTS
  In 451 patients with SDN, re-excision was performed on 36.6%. Two melanomas were diagnosed in the re-excision specimens. Subsequent metastatic melanoma developed in 7 patients, all of whom had a history of melanoma. Margin comments influenced decision to re-excise.
  
  
  CONCLUSIONS
  This was a retrospective study at a single institution.
  
  
  CONCLUSIONS
  Re-excision of all SDN may not be necessary.
authors.affiliation: Scripps Mercy Hospital, Pittsburgh, Pennsylvania.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Engeln
authors.affiliation: Department of Dermatology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
authors.forename: Kaitlin
authors.initials: K
authors.lastname: Peters
authors.affiliation: Department of Dermatopathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
authors.forename: Jonhan
authors.initials: J
authors.lastname: Ho
authors.affiliation: Department of Dermatopathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
authors.forename: Jaroslaw
authors.initials: J
authors.lastname: Jedrych
authors.affiliation: Clinical and Translational Science Institute, Pittsburgh, Pennsylvania.
authors.forename: Daniel
authors.initials: D
authors.lastname: Winger
authors.affiliation: Department of Dermatology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
authors.forename: Laura Korb
authors.initials: LK
authors.lastname: Ferris
authors.affiliation: Department of Dermatology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania. Electronic address: patttj@upmc.edu.
authors.forename: Timothy
authors.initials: T
authors.lastname: Patton
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002471:Cell Transformation, Neoplastic; D004416:Dysplastic Nevus Syndrome / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008545:Melanoma / Q000473:pathology*; D008875:Middle Aged; D012189:Retrospective Studies; D012720:Severity of Illness Index; D012878:Skin Neoplasms / Q000473:pathology*; D013997:Time Factors; D055815:Young Adult
keywords: dysplastic; melanoma; nevus; pigmented lesion; re-excision; severe atypia