Confusion about dysplastic nevi

This topic has 9 replies, 5 voices, and was last updated 8 years, 6 months ago by messedmelanocytes.

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- May 14, 2017 at 1:00 pm
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matthew111
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I always thought a dysplastic nevi mole was considered normal, but looking at some things people have said they got a dysplastic nevi mole and had to go back for more excision with margins and it sounded like it was almost as bad as melanoma. My mom had a mole removed that was dysplastic nevi stage 1 and didn't need to go back for more excision. At what stage does it require more excision?

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- - May 14, 2017 at 6:41 pm
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  MichelleRHG
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  Hi,I’ve had dozens of nevi biopsied (before and after my melanoma diagnosis).They are described as minimally, moderately or severely atypical, so I guess a different staging description.I have never had a severe one, but my dermatologist always goes back for another excision if its described as moderate . That involves sutures. Possibly of interest to you is that she did her fellowship at MDAnderson Cancer Center so was trained to be very aggressive and when she opened her practice she got the reputation of being very aggressive with benign nevi. She told me she had no idea that others didn’t re-excise like she did . She thought it was normal practice to do that . Anyway, years later when I met her she does not excise if they are minimally atypical/dysplastic.
  - May 14, 2017 at 6:43 pm
    
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    MichelleRHG
    Participant
    
    I should say she was aggressive with nevi that were minimally atypical. Correction !
  - May 14, 2017 at 7:27 pm
    
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    Jamie1960
    Participant
    
    My dermatologist (Hopkins trained) is similarly aggressive with atypical nevi, resulting in 3-5 biopsies annually resulting in 1 annual WLE by surgical oncologist in each of the past several years. Given the possibility of metastasis, I am all in favor of cutting frequently (and often too). Knock wood, but this approach is holding the line so far.
  - May 14, 2017 at 8:19 pm
    
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    matthew111
    Participant
    
    Do nevi grow over time to different stages if you don't remove them? And once they are severely atypical does that mean they will become melanoma? I am confused becasue they are not melanoma so why do they need to re-excise them?
  - May 14, 2017 at 9:50 pm
    
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    Jamie1960
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    The Medscape website has detailed information under "Atypical Mole" which may help answer your question.
  - May 15, 2017 at 6:07 am
    
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    matthew111
    Participant
    
    Jamie I just read the medscape atricle and it says a nevi has 1 in 200,000 risk of becoming melanoma. That is a pretty small risk so why is there a need to go back and re-excise them?
  - May 15, 2017 at 11:13 am
    
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    Jamie1960
    Participant
    
    My guess (and this is what it is) would be that family history, overall number of nevi, appearance and / or pathology change the stated risk in a statistically significant way. If there is any doubt, ever, cut to the point of clean margins and do whatever else is recommended by your doctor (s) in order to hold the line at Stage I / II.
    
    Make no mistake, melanoma is indifferent to our survival; none of us at risk can afford indifference to its potential or actual presence. Be proactive and safe.
    
    Best of luck !
  - May 15, 2017 at 11:13 am
    
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    ed williams
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    Matthew111, here is some stuff from NIH about the differences of Dysplastic Nevi and Melanoma. https://www.cancer.gov/types/skin/moles-fact-sheet#q4 If this doesn't do the trick then maybe it is time to ask the professionals like a dermatologist.
- - May 16, 2017 at 1:58 am
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  messedmelanocytes
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  MathewIII i can totally appreciate your questions on this; I have the same train of thought as I wait for another WLE on a dysplastic nevi for clear margins. My pathology report doesn't say if it was moderate or severe which is odd enough. The way it has been explained to me is that no matter how remote the chance of a dysplastic nevi developing into mm, those chance, even if slim are completely removed by a short procedure, a few stitches and in a week or so you don't even know anything was done, so the benfits are huge in relation to the minimaly invasive procedure. As my doc siad, not doing it, is risky, so why take the chance, this can be cut out and taken down to a zero risk, if we can do that we should.
  
  I only have two types of markings on my skin, freckles and atypical nevi, none of my moles have even borders, the number of dysplastic nevi would be about 30 or so I'd say, so I guess I will have to get used to being sliced up on a regular basis. It doesn't make sense to play these odds….so slice and hack away they may.