PMID- 27421628
OWN - NLM
STAT- MEDLINE
DCOM- 20170424
LR  - 20170918
IS  - 1097-6787 (Electronic)
IS  - 0190-9622 (Linking)
VI  - 75
IP  - 4
DP  - 2016 Oct
TI  - Frequency of and factors associated with positive or equivocal margins in
      conventional excision of atypical intraepidermal melanocytic proliferations
      (AIMP): A single academic institution cross-sectional study.
PG  - 688-695
LID - S0190-9622(16)30315-2 [pii]
LID - 10.1016/j.jaad.2016.05.034 [doi]
AB  - BACKGROUND: No evidence-based surgical guidelines exist for atypical
      intraepidermal melanocytic proliferation (AIMP), a descriptive histopathologic
      diagnosis with uncertain malignant potential. OBJECTIVE: We sought to identify
      the frequency of and risk factors associated with positive or equivocal margins
      after conventional excision. METHODS: We conducted a retrospective
      cross-sectional study of 413 AIMPs treated by conventional excision. RESULTS:
      Positive or equivocal margins were seen in 2.9% (12/413) of conventional
      excisions of AIMP. Risk factors associated with positive or equivocal margins
      included anatomic location on the head and neck (5/51, 9.8%; odds ratio 6.91, 95%
      confidence interval 1.93-24.80) (P = .012) and a preoperative biopsy specimen
      that included melanoma in situ in the differential diagnosis (11/214, 5.1%; odds 
      ratio 10.73, 95% confidence interval 1.37-83.88) (P = .006). The frequency of
      positive or equivocal margins did not differ significantly with surgical margins 
      greater than or less than 5 mm (odds ratio 0.61, 95% confidence interval
      0.18-2.07) (P = .457). LIMITATIONS: This was a single-site, retrospective
      observational study. CONCLUSION: AIMP has a significantly increased risk for
      incomplete excision when it is located on the head and neck or has a preoperative
      histologic differential diagnosis that includes melanoma in situ. These subsets
      of AIMP may benefit from Mohs micrographic surgery or staged surgical excision to
      confirm clear margins before reconstruction.
CI  - Copyright (c) 2016 American Academy of Dermatology, Inc. Published by Elsevier
      Inc. All rights reserved.
FAU - Zhang, Junqian
AU  - Zhang J
AD  - Perelman School of Medicine, University of Pennsylvania, Philadelphia,
      Pennsylvania.
FAU - Miller, Christopher J
AU  - Miller CJ
AD  - Department of Dermatology, University of Pennsylvania Health System,
      Philadelphia, Pennsylvania.
FAU - Sobanko, Joseph F
AU  - Sobanko JF
AD  - Department of Dermatology, University of Pennsylvania Health System,
      Philadelphia, Pennsylvania.
FAU - Shin, Thuzar M
AU  - Shin TM
AD  - Department of Dermatology, University of Pennsylvania Health System,
      Philadelphia, Pennsylvania.
FAU - Etzkorn, Jeremy R
AU  - Etzkorn JR
AD  - Department of Dermatology, University of Pennsylvania Health System,
      Philadelphia, Pennsylvania. Electronic address: jeremy.etzkorn@uphs.upenn.edu.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Observational Study
DEP - 20160712
PL  - United States
TA  - J Am Acad Dermatol
JT  - Journal of the American Academy of Dermatology
JID - 7907132
RN  - Melanoma, Cutaneous Malignant
SB  - IM
MH  - Academic Medical Centers
MH  - Adult
MH  - Aged
MH  - Biopsy, Needle
MH  - Confidence Intervals
MH  - Cross-Sectional Studies
MH  - Female
MH  - Humans
MH  - Immunohistochemistry
MH  - Logistic Models
MH  - Male
MH  - Melanocytes/pathology
MH  - Melanoma/mortality/*pathology/*surgery
MH  - Middle Aged
MH  - Mohs Surgery/*adverse effects/methods
MH  - Neoplasm Recurrence, Local/epidemiology/*pathology
MH  - Neoplasm Seeding
MH  - Odds Ratio
MH  - Prognosis
MH  - Retrospective Studies
MH  - Risk Assessment
MH  - Skin Neoplasms/mortality/*pathology/*surgery
MH  - Survival Analysis
MH  - Young Adult
OTO - NOTNLM
OT  - *Mohs
OT  - *atypical intraepidermal melanocytic proliferation
OT  - *excision
OT  - *melanoma
OT  - *positive margin
OT  - *surgery
EDAT- 2016/07/17 06:00
MHDA- 2017/04/25 06:00
CRDT- 2016/07/17 06:00
PHST- 2016/01/18 00:00 [received]
PHST- 2016/05/07 00:00 [revised]
PHST- 2016/05/22 00:00 [accepted]
PHST- 2016/07/17 06:00 [entrez]
PHST- 2016/07/17 06:00 [pubmed]
PHST- 2017/04/25 06:00 [medline]
AID - S0190-9622(16)30315-2 [pii]
AID - 10.1016/j.jaad.2016.05.034 [doi]
PST - ppublish
SO  - J Am Acad Dermatol. 2016 Oct;75(4):688-695. doi: 10.1016/j.jaad.2016.05.034. Epub
      2016 Jul 12.