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Real-time Intraoperative Dermoscopic Monitoring of Common Acquired Melanocytic Nevi Following Shave Excision

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Abstract Background: The treatment of common acquired melanocytic nevus (CAMN) is mostly desired for cosmetic purposes due to which a number of “faster and less traumatizing” techniques have been developed.… Click to show full abstract

Abstract Background: The treatment of common acquired melanocytic nevus (CAMN) is mostly desired for cosmetic purposes due to which a number of “faster and less traumatizing” techniques have been developed. The major cause of recurrence is incomplete removal; there is a need for early detection of any residual pigment. Aims and Objectives: This study aimed to assess the recurrence of common acquired melanocytic nevi and whether dermoscopy can be used as a noninvasive tool for the assessment of residual pigment following shave excision. Materials and Methods: A total of 100 patients of age more than 18 years with clinical features suggestive of common acquired melanocytic nevi were enrolled in the study. The nevi were assessed clinically and dermoscopically and, if found benign, were excised using shave excision. The specimen obtained was sent for histopathological examination. Dermoscopy was used immediately after shave excision for observing any residual pigment and, if present, was removed using radiofrequency current. The patients were followed up at 6 and 12 weeks for recurrence. Results: On histopathology, 87% nevi were intradermal, 8% were compound, and 5% had insufficient tissue for diagnosis, which were clinically diagnosed as junctional nevi. Dermoscopy immediately after shave excision helped in detecting residual pigment in 91% nevi, which was immediately ablated with radiofrequency, thus decreasing the risk of recurrences. Recurrences were seen in 33% nevi and all were intradermal with the presence of hair in the majority (66.67%) of them. Conclusion: Shave excision is a minimally invasive and easily performed procedure. Dermsocopy can be used for assessing residual pigment after shave excision and thus reducing the risk of recurrences. On combining shave excision with radiofrequency ablation and assessing by dermoscopy, majority of patients were satisfied with the cosmetic results. Using dermoscope for follow-up helps in early recognition of recurrence and thus appropriate treatment can be provided at the earliest.

Keywords: acquired melanocytic; shave excision; common acquired; melanocytic nevi; residual pigment; excision

Journal Title: Journal of Cutaneous and Aesthetic Surgery
Year Published: 2022

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