Tight Surgical Margin for Skin Biopsies May Reduce the Need for Second Surgery

Tracing a 2-mm margin around a suspicious mole can ensure all potentially cancerous cells are removed and can reduce the need for future surgeries, according to the findings of a recent study. 

Patients with a dysplastic nevi (DN) that needs to be removed often have to undergo a second surgical procedure, depending on the results of the initial biopsy. In a prospective study, researchers sought to determine whether this second procedure could be avoided by defining a 2-mm margin of normal skin around a pigmented skin lesion.
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For their study, the researchers performed 151 biopsies on 138 patients. A total of 137 (90.7%) of the biopsied lesions were melanocytic, of which 86 (57%) were DN, 40 (26.5%) were nevi without atypia, and 11 (7.3%) were melanomas.

Overall, 68 (87.2%) of the 78 DNs included in the final analysis were removed with clear histopathologic margins. Additionally, the researchers did not observe any clinical evidence of recurrence at any of the biopsy sites over a median 16.9 months.

“The complete histopathologic removal of nearly 9 of 10 DN using a peripheral margin of 2 mm of normal skin and a depth at the dermis and subcutaneous fat junction has the potential to decrease second procedures at DN biopsy sites, thereby decreasing patient morbidity and saving health care dollars,” the researchers concluded.

—Melissa Weiss

Reference:

Terushkin V, Ng E, Stein JA, et al. A prospective study evaluating the utility of a 2-mm biopsy margin for complete removal of histologically atypical (dysplastic) nevi [published online October 2, 2017]. J Am Acad Dermatol. http://dx.doi.org/10.1016/j.jaad.2017.07.016.