Survey on the Management of Dysplastic Nevus by Dermatologists in the Center-Spain Section of the Spanish Academy of Dermatology and Venereology (AEDV)

• Published in: Actas dermo-sifiliográficas (English ed.) Vol. 114; no. 10; pp. 850 - 857
• Main Authors: Hernández, G Baeza, Rubio-Aguilera, R Francisco, Morán, C Martínez, Garrido, H Álvarez, Garrido-Ríos, A A, Borbujo, J
• Format: Journal Article
• Language: English; Spanish
• Published: Spain 01.11.2023
• Subjects: Dysplastic nevus; bordes; encuesta; biopsia; España; manejo clínico; Spain; Survey; Clinical management; Biopsy; Surgical margins; nevus displásico; márgenes
• ISSN: 2173-5778; 1578-2190
• DOI: 10.1016/j.ad.2023.07.015

There are no clinical guidelines on the management of dysplastic nevus (DN). The aims of this study were to determine the percentage of dermatologists in the center-Spain section of the Spanish Academy of Dermatology and Venereology (AEDV) who would manage a histologically confirmed DN with a watch-and-wait approach or with wider surgical margins and to investigate whether their attitudes would vary depending on whether or not the patient had a personal and/or family history of melanoma. We collected data from an anonymous survey sent to 738 dermatologists between June 15 and July 31, 2022. The independent variables were degree of dysplasia (low vs. high), margin status (positive vs. negative), and a personal or family history of melanoma (yes vs. no in both cases). The dependent variables were attitude towards management (watch-and-wait vs. re-excision with a surgical margin of 1 to 4 mm or re-excision with a surgical margin of 5 to 10 mm). We obtained 86 responses to the questionnaire. When pathology indicated a low-grade DN, 60.5% of dermatologists stated they would obtain a surgical margin of 1 to 4 mm if the first margins were positive, and 97.7% would watch and wait if the report described negative margins. For high-grade DNs, 1.2% of dermatologists would watch and wait to manage DN with positive margins; 68.8% would use this approach for negative margins. A family or personal history of melanoma had no influence on most of the dermatologists' attitudes. Management strategies for DN among dermatologists from the center-Spain section of the AEDV varied, particularly when faced with low-grade DN with positive margins and high-grade DN with negative margins. A family or personal history of melanoma did not influence clinical attitudes in most cases.