The inadequacy of punch-excised melanocytic lesions

Sampling through the block for the determination of "margins"

Timothy T. Chang, Stephen C. Somach, Kyle Wagamon, Ally-Khan Somani, Jerome Pomeranz, Christine Jaworsky, Jonathan Bass, Harry L. Winfield, Jessica E. Sigel, Arlene S. Rosenberg

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Background: Dermatopathologists often are asked by clinicians to report margins on punch excisions of melanocytic lesions. Objective: We sought to determine the adequacy of surgical margins on melanocytic lesions submitted with intention of complete excision using punch removal technique. Methods: We conducted prospective analysis of surgical margins on 266 consecutive patients who underwent attempted complete removal of 405 melanocytic nevi submitted as punch and fusiform excisions. Results: Of 206 nonbisected punch excisions, 127 (62%) had final positive margins. Of 159 bisected punch excisions, 76 (48%) had final positive margins. Of 40 elliptical excisions, two (5%) had final positive margins. Limitations: Information on the perilesional rim of nonpigmented skin included in the excision was not available. Conclusions: Of punch excisions, 56% had positive margins. Importantly, 30% of these punch excised specimens were negative on initial levels but had positive margins after extensive sectioning, affirming that fusiform excisions are the preferred method to evaluate margins in melanocytic lesions.

Original languageEnglish (US)
Pages (from-to)990-993
Number of pages4
JournalJournal of the American Academy of Dermatology
Volume60
Issue number6
DOIs
StatePublished - Jun 2009
Externally publishedYes

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Pigmented Nevus
Skin
Margins of Excision

ASJC Scopus subject areas

  • Dermatology

Cite this

The inadequacy of punch-excised melanocytic lesions : Sampling through the block for the determination of "margins". / Chang, Timothy T.; Somach, Stephen C.; Wagamon, Kyle; Somani, Ally-Khan; Pomeranz, Jerome; Jaworsky, Christine; Bass, Jonathan; Winfield, Harry L.; Sigel, Jessica E.; Rosenberg, Arlene S.

In: Journal of the American Academy of Dermatology, Vol. 60, No. 6, 06.2009, p. 990-993.

Research output: Contribution to journalArticle

Chang, TT, Somach, SC, Wagamon, K, Somani, A-K, Pomeranz, J, Jaworsky, C, Bass, J, Winfield, HL, Sigel, JE & Rosenberg, AS 2009, 'The inadequacy of punch-excised melanocytic lesions: Sampling through the block for the determination of "margins"', Journal of the American Academy of Dermatology, vol. 60, no. 6, pp. 990-993. https://doi.org/10.1016/j.jaad.2008.09.037
Chang, Timothy T. ; Somach, Stephen C. ; Wagamon, Kyle ; Somani, Ally-Khan ; Pomeranz, Jerome ; Jaworsky, Christine ; Bass, Jonathan ; Winfield, Harry L. ; Sigel, Jessica E. ; Rosenberg, Arlene S. / The inadequacy of punch-excised melanocytic lesions : Sampling through the block for the determination of "margins". In: Journal of the American Academy of Dermatology. 2009 ; Vol. 60, No. 6. pp. 990-993.
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