Non-pigmented intradermal melanocytic nevi are benign lesions that are usually removed for cosmetic reasons. There is a lack of consensus on the best technique used for excision of these lesions. With regard to this, a randomized clinical trial was conducted to compare cosmetic outcomes and risk of recurrence after shave excision with elliptical excision of intradermal melanocytic nevi. The participants underwent shave excision or elliptical excision with sutured closure of intradermal melanocytic nevi of the face or back. Recurrence, patient satisfaction, cosmetic outcome, post-operative discomfort, scar size, discoloration, and presence of hypertrophic or keloid scars were assessed at 3, 6, and 9 months.

The results of this study published in the Dermatologic Surgery journal demonstrated that 145 nevi were removed from 45 patients (86.7% women, mean age: 52.1 ± 12.5 years). The recurrence rate was 11.7%, occurring only after shave excision; 94.1% of recurrences were observed at 3-month follow-up. Although shave excision was associated with less discomfort 48 hours after intervention, there was a higher chance of involving lateral and deep margins (p <0.001). Scars were larger after elliptical excision and suture than after shave excision (p <0.01). The mean patient satisfaction rate was higher in the shave excision group (p <0.004). It was thus concluded that shave excision of intradermal melanocytic nevi is associated with higher rates of involved surgical margins and recurrence in comparison to elliptical excision. However, it provides superior cosmesis and patient satisfaction.

Source: Dermatol Surg. 2020 Sep 8. doi: 10.1097/DSS.0000000000002666. Online ahead of print.