Chang TT, Somach SC, Wagamon K et al.
Case Western Reserve University School of Medicine, Cleveland, OH, USA.
J Am Acad Dermatol 2009;60:990–3.
Editor’s note: The authors of this study investigated margins of excision of melanocytic lesions excised by punch removal. Punch excision of melanocytic nevi is becoming more common and dermatopathologists are often asked to report excision margins. However, the cylindrical nature and small size of the sample can make this difficult. The current authors conducted a retrospective study involving 266 patients who had 405 melanocytic nevi removed by either punch or fusiform excision. Of the 206 non-bisected punch excisions, 62 (30%) had initial positive margins, 65 (32%) had negative initial but final positive margins (after additional non-routine deeper levels were obtained), and 79 (38%) had negative initial and final margins. Of the 159 bisected punch excisions, 36 (23%) had positive initial margins, 40 (25%) had negative initial but positive final margins, and 83 (52%) had negative initial and final margins. Of the 40 ellipse excisions, only two (5%) had initial negative and final positive margins and 38 (95%) had negative initial and final margins.