he had 4 shave biopsy's of moles, 2 came back mild, 1 moderate and 1 severe. Had severe one removed thursday - diagnois on original biopsy states Junctional melanocytic nevus with architectural disorder and severe cytologic atypism of the melanocytes comments the lesion is close to a lateral inked edge. Now received a call, and no one is in office to answer, but his appt for June 2nd to remove stitches needs to be changed based on biopsy results, what could that mean?
My Husband Had Moles Removed and the Severe on Shows Lesion Close to a Letral Inked Edge
Doctor Answers 4
Our most dreaded call: The Atypical Nevus.
There are many theories behind the atypical mole. Are they "pre-cancerous"? We don't really know but the easiest way to explain to patients is that they are.
Atypical Nevi are graded as "mild, moderate, or severe". And there are variations among these depending on which pathologist reads them.
We all have our opinions, but usually we all follow certain guidelines. If moderate or severe, we re-excise. Different derms treat "mild" ATN differently. We either excise, or recommend the patient check it once per month and we follow it clinically. We will then re-excise if pigment returns or grows.
The most important thing to remember is to not get too excited because it is NOT melanoma. So trust that your Dermatologist will make the best recommendation and you can be an active part in any decision.
Appropriate Treatment for Atypical Moles
Atypical moles (also called dysplastic nevi) are usually rated by the pathologist as being mild, moderate, or severe. In our office, we will do an excision with suture closure to get clear margins for all moles that have moderate to severe atypia. If the margins are close to the edge, another procedure to remove more tissue may be indicated. Far a mildly atypical mole we will observe the area and, if any pigmentation recurs in the biopsy site in the future, a very small excision is done (often with a small punch biopsy tool) for a minimal scar. We also follow all of our "atypical mole" patients by doing full skin examinations every six months. I recommend you see a board certified dermatologist for both your surgery options as well as your follow-up examinations twice yearly.
Treatment for moles with severe atypia
Dysplastic moles (moles with some atypical features but still benign) can range in atypia from mild to moderate to severe. Severely atypical moles are very close in their histologic appearance to melanoma and need to be removed completely.
So if the biopsy shows that the severely atypical mole goes to a lateral margin, it should be removed so that it is completely out with a margin of normal skin.
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What you are describing is DYSPLASTIC NEVI. these have a slightly higher chance of developing cancer. Therefore they should be removed completely.
Also when you have dysplastic nevi you should follow up with you dermatologist on a regular basis for complete check from head to toe at least on a yealy or half yearly basis.