Retrospective multicenter study on severely dysplastic melanocytic nevi: evaluating the need for re-excision and the risk of recurrence or progression
Severely dysplastic melanocytic nevi (SMD) are histologically challenging lesions with no consensus on optimal management. While complete excision is widely recommended, the necessity of additional reexcision remains debated. This retrospective, multicenter observational cohort study evaluated the...
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PAGEPress Publications
2025-05-01
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| Series: | Dermatology Reports |
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| Online Access: | https://www.pagepress.org/journals/dr/article/view/10349 |
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| author | Cesare Ariasi Carlo Cota Cesare Massone Carmine D'Acunto Pietro Danese Maurizio Lombardo Davide Melandri Francesca Scarpellini Rosa Rinaldi Paola Pasquini Paolo Incardona Piergiacomo Calzavara-Pinton Paola Monari |
| author_facet | Cesare Ariasi Carlo Cota Cesare Massone Carmine D'Acunto Pietro Danese Maurizio Lombardo Davide Melandri Francesca Scarpellini Rosa Rinaldi Paola Pasquini Paolo Incardona Piergiacomo Calzavara-Pinton Paola Monari |
| author_sort | Cesare Ariasi |
| collection | DOAJ |
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Severely dysplastic melanocytic nevi (SMD) are histologically challenging lesions with no consensus on optimal management. While complete excision is widely recommended, the necessity of additional reexcision remains debated. This retrospective, multicenter observational cohort study evaluated the risk of recurrence and disease progression in patients with SMD by comparing those who underwent a single complete excision to those who underwent a secondary widening procedure with 5 mm margins. A total of 226 patients (230 SMD lesions) were included, with diagnoses based on the 2018 World Health Organization (WHO) criteria. Among them, 13.5% underwent re-excision despite clear margins, while 86.5% were followed clinically. Over a minimum 5-year follow-up period, no patient in either group experienced recurrence at the excision site or progression to melanoma. These findings suggest that complete excision with clear margins is sufficient for managing SMD, with no added benefit from routine re-excision. Avoiding unnecessary surgical procedures could reduce patient anxiety, healthcare costs, and surgical morbidity. Given the lack of standardized guidelines, further prospective studies are needed to refine clinical decision-making for SMD management.
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| format | Article |
| id | doaj-art-f92a20023432440391520ed8f23bbddd |
| institution | Kabale University |
| issn | 2036-7392 2036-7406 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | PAGEPress Publications |
| record_format | Article |
| series | Dermatology Reports |
| spelling | doaj-art-f92a20023432440391520ed8f23bbddd2025-08-20T03:53:51ZengPAGEPress PublicationsDermatology Reports2036-73922036-74062025-05-0110.4081/dr.2025.10349Retrospective multicenter study on severely dysplastic melanocytic nevi: evaluating the need for re-excision and the risk of recurrence or progressionCesare Ariasi0Carlo Cota1Cesare Massone2Carmine D'Acunto3Pietro Danese4Maurizio Lombardo5Davide Melandri6Francesca Scarpellini7Rosa Rinaldi8Paola Pasquini9Paolo Incardona10Piergiacomo Calzavara-Pinton11Paola Monari12Department of Dermatology, University of BresciaUnit of Dermatopathology, San Gallicano Dermatological Institute, RomeDermatology Unit, Galliera Hospital, GenoaDermatology Unit and Burn Center AUSL Romagna, Cesena HospitalDermatology Unit, Carlo Poma Hospital ASST MantovaMelanoma Skin Centre, Department of Medicine and Surgery, Ospedale di Circolo e Fondazione Macchi, ASST dei Sette Laghi, VareseDermatology Unit and Burn Center AUSL Romagna, Cesena HospitalDepartment of Pathology, AUSL Romagna, Cesena HospitalPathology Unit, Carlo Poma Hospital ASST MantovaUnit of Dermatopathology, San Gallicano Dermatological Institute, RomeDepartment of Pathology, ASST Spedali Civili di BresciaDepartment of Dermatology, University of BresciaDepartment of Dermatology, University of Brescia Severely dysplastic melanocytic nevi (SMD) are histologically challenging lesions with no consensus on optimal management. While complete excision is widely recommended, the necessity of additional reexcision remains debated. This retrospective, multicenter observational cohort study evaluated the risk of recurrence and disease progression in patients with SMD by comparing those who underwent a single complete excision to those who underwent a secondary widening procedure with 5 mm margins. A total of 226 patients (230 SMD lesions) were included, with diagnoses based on the 2018 World Health Organization (WHO) criteria. Among them, 13.5% underwent re-excision despite clear margins, while 86.5% were followed clinically. Over a minimum 5-year follow-up period, no patient in either group experienced recurrence at the excision site or progression to melanoma. These findings suggest that complete excision with clear margins is sufficient for managing SMD, with no added benefit from routine re-excision. Avoiding unnecessary surgical procedures could reduce patient anxiety, healthcare costs, and surgical morbidity. Given the lack of standardized guidelines, further prospective studies are needed to refine clinical decision-making for SMD management. https://www.pagepress.org/journals/dr/article/view/10349Severely dysplastic melanocytic nevidysplastic nevusmelanoma risk |
| spellingShingle | Cesare Ariasi Carlo Cota Cesare Massone Carmine D'Acunto Pietro Danese Maurizio Lombardo Davide Melandri Francesca Scarpellini Rosa Rinaldi Paola Pasquini Paolo Incardona Piergiacomo Calzavara-Pinton Paola Monari Retrospective multicenter study on severely dysplastic melanocytic nevi: evaluating the need for re-excision and the risk of recurrence or progression Dermatology Reports Severely dysplastic melanocytic nevi dysplastic nevus melanoma risk |
| title | Retrospective multicenter study on severely dysplastic melanocytic nevi: evaluating the need for re-excision and the risk of recurrence or progression |
| title_full | Retrospective multicenter study on severely dysplastic melanocytic nevi: evaluating the need for re-excision and the risk of recurrence or progression |
| title_fullStr | Retrospective multicenter study on severely dysplastic melanocytic nevi: evaluating the need for re-excision and the risk of recurrence or progression |
| title_full_unstemmed | Retrospective multicenter study on severely dysplastic melanocytic nevi: evaluating the need for re-excision and the risk of recurrence or progression |
| title_short | Retrospective multicenter study on severely dysplastic melanocytic nevi: evaluating the need for re-excision and the risk of recurrence or progression |
| title_sort | retrospective multicenter study on severely dysplastic melanocytic nevi evaluating the need for re excision and the risk of recurrence or progression |
| topic | Severely dysplastic melanocytic nevi dysplastic nevus melanoma risk |
| url | https://www.pagepress.org/journals/dr/article/view/10349 |
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