title: Recurrence of moderately dysplastic nevi with positive histologic margins.
abstract: BACKGROUND
  The Pigmented Lesion Subcommittee of the Melanoma Prevention Working Group recently published a consensus statement that incompletely excised moderately dysplastic nevi (MDN) without clinical residual pigmentation can be observed and not re-excised. However, data regarding recurrence of MDN with positive histologic margins are quite scant.
  
  
  OBJECTIVE
  We sought to extend the reported findings with a study to determine the recurrence rate of MDN with positive histologic margins.
  
  
  METHODS
  We performed a retrospective study on MDN with positive histologic margins that were not re-excised and for which at least 1 year of clinical follow-up was available.
  
  
  RESULTS
  We found a total of 147 such nevi from January 1, 2007, to December 31, 2013. Six MDN (5 compound and 1 junctional) or 4% recurred with an average recurrence time of 1.7 years. All of these MDN were evaluated by shave biopsies.
  
  
  CONCLUSIONS
  Subjectivity in grading of atypia is a limitation of this study.
  
  
  CONCLUSIONS
  These data from a large study focusing exclusively on recurrence of MDN with positive histologic margins support the conclusion of the Pigmented Lesion Subcommittee that incompletely excised MDN do not require re-excision.
authors.affiliation: Department of Dermatology, Baylor College of Medicine, Houston, Texas.
authors.forename: Bryan
authors.initials: B
authors.lastname: Hiscox
authors.affiliation: Department of Pathology and Immunology, Baylor College of Medicine, Houston, Texas.
authors.forename: Melissa R
authors.initials: MR
authors.lastname: Hardin
authors.affiliation: Department of Dermatology, Baylor College of Medicine, Houston, Texas.
authors.forename: Ida F
authors.initials: IF
authors.lastname: Orengo
authors.affiliation: Department of Dermatology, Baylor College of Medicine, Houston, Texas.
authors.forename: Theodore
authors.initials: T
authors.lastname: Rosen
authors.affiliation: Department of Dermatology, Baylor College of Medicine, Houston, Texas.
authors.forename: Mohsin
authors.initials: M
authors.lastname: Mir
authors.affiliation: Department of Dermatology, Baylor College of Medicine, Houston, Texas; Department of Pathology and Immunology, Baylor College of Medicine, Houston, Texas. Electronic address: ahdiwan@bcm.edu.
authors.forename: A Hafeez
authors.initials: AH
authors.lastname: Diwan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D000072662:Margins of Excision; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D018365:Neoplasm, Residual; D009506:Nevus / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000473:pathology / Q000601:surgery*; D055815:Young Adult
keywords: excision; histologic margins; moderately dysplastic nevi; observation versus re-excision; positive margins; recurrence; treatment of moderately dysplastic nevi