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Purpose of Review <p>In order to address the question of whether all histologically dysplastic nevi (DN) require re-excision following biopsy, this review evaluates the literature on the natural history of DN, diagnosis, evolving management practices, and recurrence and upstaging risk. Particular attention is given to management strategies for moderate DN.</p> Recent Findings <p>Several studies suggest that re-excision of DN often yields no residual lesion after biopsy. Melanoma upstaging rates are generally low, particularly outside of severely dysplastic and/or partially sampled lesions. The available data support clinical monitoring of histologically mild DN, and re-excision of severe DN. Emerging evidence support the appropriateness of clinical observation of histologically moderate DN with clear or involved margins, particularly when there is no clinical residuum.</p> Summary <p>Most DN are not obligate precursors to melanoma but rather are markers of increased melanoma risk. Published literature supports clinical observation is appropriate for mild and many moderate DN. Re-excision is typically recommended for severe DN, and partially sampled moderate DN with clinical residuum. Standardized DN reporting and better understanding of molecular changes associated with DN may help refine management recommendations.</p>

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Do All Dysplastic Nevi Need Re-Excision?

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年9月5日

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  • J. Alex Miles,
  • Michael E. Ming,
  • Emily Y. Chu

摘要

Purpose of Review

In order to address the question of whether all histologically dysplastic nevi (DN) require re-excision following biopsy, this review evaluates the literature on the natural history of DN, diagnosis, evolving management practices, and recurrence and upstaging risk. Particular attention is given to management strategies for moderate DN.

Recent Findings

Several studies suggest that re-excision of DN often yields no residual lesion after biopsy. Melanoma upstaging rates are generally low, particularly outside of severely dysplastic and/or partially sampled lesions. The available data support clinical monitoring of histologically mild DN, and re-excision of severe DN. Emerging evidence support the appropriateness of clinical observation of histologically moderate DN with clear or involved margins, particularly when there is no clinical residuum.

Summary

Most DN are not obligate precursors to melanoma but rather are markers of increased melanoma risk. Published literature supports clinical observation is appropriate for mild and many moderate DN. Re-excision is typically recommended for severe DN, and partially sampled moderate DN with clinical residuum. Standardized DN reporting and better understanding of molecular changes associated with DN may help refine management recommendations.