Recurrent dysplastic nevus following shave excision

Distinguishing benign from malignant melanocytic lesions is an on-going challenge for the clinician and the histopathologist. The regrowth of benign melanocytic nevi at the dermoepidermal junction following inadequate excision has been shown to be confused with superficial spreading melanoma. The dysplastic nevus has atypical features in and of itself, which become even more compounded when the lesion recurs in the dermoepidermal junction following inadequate resection by shave excision. The use of Monsel's solution to achieve hemostasis at the biopsy site can itself also produce a clinically irregular area of hyperpigmentation, accompanied by a pathologic pigmented and cellular dermal reaction. A case of a dysplastic nevus recurring after inadequate shave excision is reported here. The resultant atypia were further compounded by the use of Monsel's solution for hemostasis in the initial excision, which could have led to a mistaken diagnosis of malignant melanoma. The spectrum of dysplastic nevi is reviewed.