Melanoma and melanoma in-situ diagnosis after excision of atypical intraepidermal melanocytic proliferation: A retrospective cross-sectional analysis Journal Article

   


Authors: Blank, N. R.; Hibler, B. P.; Tattersall, I. W.; Ensslin, C. J.; Lee, E. H.; Dusza, S. W.; Nehal, K. S.; Busam, K. J.; Rossi, A. M.
Article Title: Melanoma and melanoma in-situ diagnosis after excision of atypical intraepidermal melanocytic proliferation: A retrospective cross-sectional analysis
Abstract: Background: There is little evidence to guide surgical management of biopsies yielding the histologic descriptor atypical intraepidermal melanocytic proliferation (AIMP). Objective: Determine frequency of and factors associated with melanoma and melanoma in-situ (MIS) diagnoses after excision of AIMP and evaluate margins used to completely excise AIMP. Methods: Retrospective, cross-sectional study of 1127 biopsies reported as AIMP and subsequently excised within one academic institution. Results: Melanoma (in situ, stage 1A) was diagnosed after excision in 8.2% (92/1127) of AIMP samples. Characteristics associated with melanoma/MIS diagnosis included age 60-79 years (odds ratio [OR] 8.1, 95% confidence interval [CI] 2.5-26.2), age ≥80 years (OR 7.2, 95% CI 1.7-31.5), head/neck location (OR 4.9, 95% CI 3.1-7.7), clinical lesion partially biopsied (OR 11.0, 95% CI 6.7-18.1), and lesion extending to deep biopsy margin (OR 15.1, 95% CI 1.7-136.0). Average ± standard deviation surgical margin used to excise AIMP lesions was 4.5 ± 1.8 mm. Limitations: Single-site, retrospective, observational study; interobserver variability across dermatopathologists. Conclusion: Dermatologists and pathologists can endeavor to avoid ambiguous melanocytic designations whenever possible through excisional biopsy technique, interdisciplinary communication, and ancillary studies. In the event of AIMP biopsy, physicians should consider the term a histologic description rather than a diagnosis, and, during surgical planning, use clinicopathologic correlation while bearing in mind factors that might predict true melanoma/MIS. © 2019 American Academy of Dermatology, Inc.
Keywords: excision; melanoma; biopsy; melanoma in situ; atypical melanocytic proliferation; ambiguous melanocytic lesions; atypical intraepidermal melanocytic proliferation; atypical junctional melanocytic hyperplasia; atypical junctional melanocytic proliferation; lentiginous junctional melanocytic proliferation
Journal Title: Journal of the American Academy of Dermatology
Volume: 80
Issue: 5
ISSN: 0190-9622
Publisher: Mosby Elsevier  
Date Published: 2019-05-01
Start Page: 1403
End Page: 1409
Language: English
DOI: 10.1016/j.jaad.2019.01.005
PUBMED: 30654079
PROVIDER: scopus
PMCID: PMC6857840
DOI/URL:

https://www.scopus.com/inward/record.uri?eid=2-s2.0-85062903360&doi=10.1016%2fj.jaad.2019.01.005&partnerID=40&md5=e7948db174661fa173deb2ae88eed4c3
Notes: Article -- Export Date: 1 May 2019 -- Source: Scopus
Altmetric
What is Altmetric?
Citation Impact
What is Dimensions Citation Badge?
BMJ Impact Analytics
MSK Authors
  1. Kishwer S Nehal
    279 Nehal
  2. Stephen Dusza
    289 Dusza
  3. Erica H Lee
    136 Lee
  4. Klaus J Busam
    690 Busam
  5. Anthony Rossi
    235 Rossi
  6. Brian Phillip Hibler
    55 Hibler
  7. Nina Blank
    9 Blank
  8. Ian William Tattersall
    1 Tattersall
Related MSK Work