Diagnosis and treatment of nevomelanocytic lesions of the skin. A community-based study
S. D. DeCoste and R. S. Stern
Department of Dermatology, Beth Israel Hospital, Boston, MA 02215.
BACKGROUND AND DESIGN. Nevomelanocytic lesions of the skin are frequently
removed. However, little data are available concerning the diagnostic
accuracy, histologic features, and methods of removal for these common
lesions. We identified 2935 consecutive nevomelanocytic lesions examined at
four pathology laboratories to determine the accuracy of the preoperative
diagnosis, the characteristics of the patients treated, and the methods
used for removal. RESULTS. Of 2935 melanocytic lesions, 2087 (71%) were
benign nevi, 684 (22%) were dysplastic nevi, 72 (3%) were blue nevi, and 76
(3%) were lentigines. Lentiginous melanocytic hyperplasias with cytologic
atypia (20) and melanoma (26) each represented less than 1% of such
lesions. Diagnostic accuracy varied by the pathologic diagnosis and the
specialty of the treating physician. Dermatologists and plastic surgeons
had the highest diagnostic accuracy. Techniques used to remove melanocytic
lesions varied by physician specialty and type of lesion. CONCLUSIONS.
Despite the high frequency of removal, the methods used to remove
nevomelanocytic lesions vary widely. Improving the clinician's ability to
distinguish type of lesion may improve care. Studies that determine optimal
means for their removal are warranted.
