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A nongrading histologic approach to Clark (dysplastic) nevi: A potential to decrease the excision rate
Daniel F Lozeau1, Michele J Farber1, Jason B Lee1
1Department of Dermatology and Cutaneous Biology, Thomas Jefferson University, Philadelphia, Pennsylvania.
Journal of the American Academy of Dermatology
|November 10, 2015
Summary
A nongrading approach to diagnosing Clark nevi (dysplastic nevi) resulted in fewer excisions compared to traditional methods. This method maintained a low rate of diagnostic changes, suggesting it is a viable alternative for managing these lesions.
Area of Science:
- Dermatopathology
- Oncology
- Histopathology
Background:
- Dysplastic nevi are often treated as melanoma precursors despite limited evidence.
- Histologic grading of dysplastic nevi may lead to unnecessary excisions.
Purpose of the Study:
- To evaluate a nongrading diagnostic approach for Clark nevi (dysplastic nevi).
- To determine the diagnostic uncertainty rate and re-excision outcomes for Clark nevi using this approach.
Main Methods:
- A nongrading approach was applied to melanocytic nevi diagnosed between 2007 and 2013.
- Diagnostic uncertainty rate was calculated as re-excisions divided by total Clark nevi.
Main Results:
- The nongrading approach yielded an 11.1% diagnostic uncertainty/excision recommendation rate.
- Melanoma was diagnosed in 2% of the re-excised specimens.
Conclusions:
- The nongrading approach for Clark nevi reduces excision rates compared to previous methods.
- This approach maintains a low rate of diagnostic change, comparable to grading methods.
