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Recurrent Nevus Phenomenon: A Clinicopathological Study of 328 Patients
Author(s) -
King R,
Ziegler D,
Page RN,
Mihm MC,
Googe PB
Publication year - 2005
Publication title -
journal of cutaneous pathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 75
eISSN - 1600-0560
pISSN - 0303-6987
DOI - 10.1111/j.0303-6987.2005.320dq.x
Subject(s) - medicine , pathology , melanocytic nevus , atypia , melanoma , nevus , hyperplasia , dermatology , epidermis (zoology) , anatomy , cancer research
Background: Recurrent nevi may histologically resemble malignant melanoma Design: Recurrent nevi with clinical history, original melanocytic neoplasm and recurrence were included. Proliferation marker Ki‐67 was used when residual and recurrent nevus was present on the same slide. Results: There were 356 biopsies from 328 patients (ages 6 to 93 years (mean = 31), female: male = 255:101, time to recurrence 1–63 months (mean = 7.85)). Sites: back (170), abdomen (46), arm (46), leg (34), head and neck (26), chest (26), and buttock (8). Initial biopsies: 208 nevi, 142 dysplastic nevi, 1 blue, 1 pigmented spindle cell, 2 Spitz nevi, and 2 melanomas in situ. 3 patterns of recurrence were observed: 1) junctional melanocytic hyperplasia with epidermal effacement and scar, 2) compound melanocytic proliferation with epidermal effacement and scar, and 3) junctional melanocytic hyperplasia with retained retiform epidermis. Recurrent and residual nevi had similar proliferation rates. Conclusion: Recurrent nevi occurred more commonly in females and on the trunk. Cytologic atypia, asymmetry, and retention of retiform epidermis were worrisome histologic features. Clinical history, effacement of the epidermis and limitation of changes to the scar, distinguished recurrence from melanoma. Low proliferation rate may be a useful adjunct to distinguish recurrent nevi from melanoma.