Management of Dysplastic Nevi: The Role of Complete Surgical Excision

Atypical moles, also called dysplastic nevi (DN), are considered by many to reside in the grey portion of the spectrum between benign nevi and melanoma. Because of the difficulty of assessing the behavior of an individual DN, and the association with an increased overall risk of melanoma, physicians and patients have grappled with the choice between observation and surgical excision.1 In the absence of a reliable predictive test or formal management guidelines, many physicians elect complete surgical excision of DN. The prevalence of DN is believed to be at least 8-10 percent in susceptible populations,2,3 posing a large health burden. An improved understanding of their role in and relationship with melanoma thus remains an important objective. In pursuit of this goal, our research team examined detailed outcomes of surgical excision of DN, as well as the association of DN with melanoma.1 This pivotal data was analyzed for clinically relevant measures and sorted by grade of atypia, forming the first published evidence of specific DN excision outcomes.