Predictive Value of Positive Margins in Diagnostic Biopsies of Dysplastic Nevi

Dysplastic nevi (DN) are common and controversial and the best choice for management of DN after diagnosis is not always clear. The presence of positive margins found on diagnostic biopsy is used by many dermatologists when deciding whether to re-excise these lesions. In order to quantify the predic...

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Main Authors: Jeffrey S. Dickman, Reem M. Haddad, Andrew Racette
Format: Article
Language:English
Published: Wiley 2020-01-01
Series:Dermatology Research and Practice
Online Access:http://dx.doi.org/10.1155/2020/6716145
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author Jeffrey S. Dickman
Reem M. Haddad
Andrew Racette
author_facet Jeffrey S. Dickman
Reem M. Haddad
Andrew Racette
author_sort Jeffrey S. Dickman
collection DOAJ
description Dysplastic nevi (DN) are common and controversial and the best choice for management of DN after diagnosis is not always clear. The presence of positive margins found on diagnostic biopsy is used by many dermatologists when deciding whether to re-excise these lesions. In order to quantify the predictive value of positive margins in diagnostic biopsies of DN, we performed a review and analysis of the concordance between the histological findings of biopsies and their subsequent excisions. A total of 122 pathology reports from diagnostic biopsies of DN with nevus cells present at the tissue margin were reviewed. Within this sample, 68 total postbiopsy excisions had been performed. The excisional pathology reports were reviewed for the presence of residual or recurrent nevus cells. Residual nevus cells were reported in 29 of 63 available excisional pathology reports illustrating a positive predictive value (PPV) of positive margins in diagnostic biopsies of DN of 46.0%. We present this value along with PPVs from the very few existing similar studies. The quantified predictive value of positive margins in diagnostic biopsies is useful information for providers who must make decisions regarding the best treatment options for patients with DN. The low PPV of positive margins lends further evidence that DN of moderate severity or less may simply be monitored.
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spelling doaj-art-f6d91d27e6144dcd802609b63c065dfc2025-02-03T05:51:45ZengWileyDermatology Research and Practice1687-61051687-61132020-01-01202010.1155/2020/67161456716145Predictive Value of Positive Margins in Diagnostic Biopsies of Dysplastic NeviJeffrey S. Dickman0Reem M. Haddad1Andrew Racette2HonorHealth Internal Medicine Residency, Scottsdale, AZ 85255, USAKCU-GMEC Phoenix Dermatology Program, Mesa, AZ 85206, USAKCU-GMEC Phoenix Dermatology Program, Mesa, AZ 85206, USADysplastic nevi (DN) are common and controversial and the best choice for management of DN after diagnosis is not always clear. The presence of positive margins found on diagnostic biopsy is used by many dermatologists when deciding whether to re-excise these lesions. In order to quantify the predictive value of positive margins in diagnostic biopsies of DN, we performed a review and analysis of the concordance between the histological findings of biopsies and their subsequent excisions. A total of 122 pathology reports from diagnostic biopsies of DN with nevus cells present at the tissue margin were reviewed. Within this sample, 68 total postbiopsy excisions had been performed. The excisional pathology reports were reviewed for the presence of residual or recurrent nevus cells. Residual nevus cells were reported in 29 of 63 available excisional pathology reports illustrating a positive predictive value (PPV) of positive margins in diagnostic biopsies of DN of 46.0%. We present this value along with PPVs from the very few existing similar studies. The quantified predictive value of positive margins in diagnostic biopsies is useful information for providers who must make decisions regarding the best treatment options for patients with DN. The low PPV of positive margins lends further evidence that DN of moderate severity or less may simply be monitored.http://dx.doi.org/10.1155/2020/6716145
spellingShingle Jeffrey S. Dickman
Reem M. Haddad
Andrew Racette
Predictive Value of Positive Margins in Diagnostic Biopsies of Dysplastic Nevi
Dermatology Research and Practice
title Predictive Value of Positive Margins in Diagnostic Biopsies of Dysplastic Nevi
title_full Predictive Value of Positive Margins in Diagnostic Biopsies of Dysplastic Nevi
title_fullStr Predictive Value of Positive Margins in Diagnostic Biopsies of Dysplastic Nevi
title_full_unstemmed Predictive Value of Positive Margins in Diagnostic Biopsies of Dysplastic Nevi
title_short Predictive Value of Positive Margins in Diagnostic Biopsies of Dysplastic Nevi
title_sort predictive value of positive margins in diagnostic biopsies of dysplastic nevi
url http://dx.doi.org/10.1155/2020/6716145
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