A complete organized library of all my videos, digital slides, pics, & sample pathology reports is available here: kikoxp.com/posts/5084 (dermpath) & kikoxp.com/posts/5083 (bone/soft tissue sarcoma pathology).
Hi Jerad. I have recently had a severe dysplastic nevus removed from my back, and a mild to moderate atypical nevus removed from my right thigh. The severe nevus fell short of a melanoma in situ, and pathology advised a wide excision to treat it as a melanoma in situ. I am terrified of developing actual melanoma and cannot stop checking my body. My consultant discharged me and advised to just check myself going forward. I am 55 years old, and have always kept fit and healthy, and although I’ve looked after my skin most of my life, I did get surnburnt as a child and young adult. Is there any way to repair the UV damage? Am I high risk for developing melanoma?
My mole was diagnosed as an atypical compound melanocytic neoplasm but was recommend to be sent to a tumor board for a consult for melanoma due to its significant cytologic dermal atypia and lack of maturation at the base (also complete re-excision recommended). The tumor board consult was also inconclusive and requested a recut section. Is a recut section a common occurrence? Thank you for your videos, I have learned a lot about melanoma and nevus pathology. I had no idea that certain topics were so debated and how complex melanocytic lesions could be to diagnose.
See these for more explanation: Video (Melanoma Basics - short): kikoxp.com/posts/6063 Dysplastic nevus etc kikoxp.com/posts/6963 Nevus 101 video kikoxp.com/posts/3740 Video (Melanoma 101): kikoxp.com/posts/3764
I don’t have a specific video focusing on that comparison but these two videos will help. nevus video th-cam.com/video/jKZDqJez9jw/w-d-xo.html melanoma video th-cam.com/video/8N0IZZpF8ts/w-d-xo.html
Do I need to be worried about pre-cancerous cells in a compound nevus? They want to perform an excision on the location.. I’m 26 years old, what does this mean for my future? Is this odd to have at this age?
Does the pathology report say dysplastic/dysplasia/atypia/atypical nevus? Or just compound nevus (or compound melanocytic nevus)? I can’t give you advice since you aren’t my patient and I’m not your doctor but here is some general info. Regular compound nevi are totally benign and very common. I see them in people your age every day. And they are usually not excised (surgically removed) after biopsy. Dysplastic compound nevus is a complicated and controversial subject even in my subspecialized field. But the simplest explanation is that they are nevi that look abnormal under the microscope. I personally think that the vast majority of them are just funny looking benign nevi with little to no risk of turning malignant. But if they have moderate or severe atypia, most dermatologists I know like to surgically remove them (if only mild atypia, they usually leave them alone and don’t do more surgery after biopsy). But this varies among different dermatologists and experts have different beliefs about this. So in summary it’s important to find out exactly what your pathology report says and it’s also important to discuss all of this with your dermatologist. Dermatologists are very familiar with different types of nevus and how to handle them, but other types of doctors are often (not always) unfamiliar with the complexities around these different nevi. For this reason, I choose to only see MD/DO dermatologists for skin issues affecting me or my family. Please discuss all of this with your doctor so you can make healthcare decision that’s right for you. Best wishes for good health.
It’s a complicated topic. I give a brief summary in my #dermpath Survival Guide book: bit.ly/2Te2haB. But if you want more in-depth knowledge I would recommend reading the various papers on this topic in the literature.
Hey Jerad, my dermatologist pushed for me to excise 3 moderately dysplastic moles even though I told him I was uncomfortable with scarring and I had a history of body dysmorphia. I've started to research this topic and I'm starting to question the necessity of what he did. I'm starting to get upset because the scars are pretty big (5mm margins). I think he may have pushed to excise for primarily legal and financial reasons. Do you think it's unreasonable to think that? Thanks.
For most of my time in practice, the dermatologists I worked with routinely performed complete excision of moderate dysplastic nevus. There is growing evidence that may not be necessary but it’s still an area that has a lot of debate and controversy. Some of the dermatologists I’ve worked with recently and now willing to leave moderate dysplastic nevus and watch/wait, but I also know some very good dermatologists who still think it is a good idea to surgical excise them with negative margins to be on the safe side. I cannot speak for your dermatologist personally of course but what you are describing sounds similar to what I have seen other good dermatologists do in similar situations. Regardless, I am sorry for the scarring and any discomfort you are going through. I know scars can be a very frustrating issue for many patients. A lot of dermatologists I work with recommend using silicone scar tape or gel to help scars heal with better cosmetic results. They also recommend sun avoidance and sunscreen if the scar is exposed to sun. I’m not a dermatologist so not an expert at cosmetics but that is what I’ve heard from some of my very smart and compassionate dermatologist colleagues over the years. My best wishes for health, healing and peace for you!
![Atypical Moles: What Are They? [Dermatology] (2019)](http://i.ytimg.com/vi/AiGENQqlfzQ/mqdefault.jpg)
A complete organized library of all my videos, digital slides, pics, & sample pathology reports is available here: kikoxp.com/posts/5084 (dermpath) & kikoxp.com/posts/5083 (bone/soft tissue sarcoma pathology).
Dr Jerad, it is a very complicated subject to see in 5 minutes. Thanks for your effort.
Hi Jerad. I have recently had a severe dysplastic nevus removed from my back, and a mild to moderate atypical nevus removed from my right thigh. The severe nevus fell short of a melanoma in situ, and pathology advised a wide excision to treat it as a melanoma in situ. I am terrified of developing actual melanoma and cannot stop checking my body. My consultant discharged me and advised to just check myself going forward. I am 55 years old, and have always kept fit and healthy, and although I’ve looked after my skin most of my life, I did get surnburnt as a child and young adult. Is there any way to repair the UV damage? Am I high risk for developing melanoma?
I am in the same position ...how melanoma in situ is treated ...what is the adequate surgical margins
My mole was diagnosed as an atypical compound melanocytic neoplasm but was recommend to be sent to a tumor board for a consult for melanoma due to its significant cytologic dermal atypia and lack of maturation at the base (also complete re-excision recommended). The tumor board consult was also inconclusive and requested a recut section. Is a recut section a common occurrence? Thank you for your videos, I have learned a lot about melanoma and nevus pathology. I had no idea that certain topics were so debated and how complex melanocytic lesions could be to diagnose.
Shouldn't the nomenclature and management follow the pathological principles rather than the other way around?
What is your grade for this dysplastic nevus?
How to make such a distinction that it is not a melanoma
See these for more explanation:
Video (Melanoma Basics - short): kikoxp.com/posts/6063
Dysplastic nevus etc kikoxp.com/posts/6963
Nevus 101 video kikoxp.com/posts/3740
Video (Melanoma 101): kikoxp.com/posts/3764
Is there any difference from local immunossupression between adolescents adults?
My Daughter have mole at the back, I would like to ask if it dysplastic nevus. pls message me 😭
@Jerad Gardener Pls.could u explain how do we differentiate Dysplastic nevus from a melanoma in situ???
I don’t have a specific video focusing on that comparison but these two videos will help. nevus video th-cam.com/video/jKZDqJez9jw/w-d-xo.html melanoma video th-cam.com/video/8N0IZZpF8ts/w-d-xo.html
@@JMGardnerMD can u send any chart or way for easy memorization of eczaema, psoriasis, E multiforme, lichen planus, etc...
I have a lot of that in my #dermpath Survival Guide book: bit.ly/2Te2haB
Do I need to be worried about pre-cancerous cells in a compound nevus? They want to perform an excision on the location..
I’m 26 years old, what does this mean for my future? Is this odd to have at this age?
Does the pathology report say dysplastic/dysplasia/atypia/atypical nevus? Or just compound nevus (or compound melanocytic nevus)? I can’t give you advice since you aren’t my patient and I’m not your doctor but here is some general info. Regular compound nevi are totally benign and very common. I see them in people your age every day. And they are usually not excised (surgically removed) after biopsy. Dysplastic compound nevus is a complicated and controversial subject even in my subspecialized field. But the simplest explanation is that they are nevi that look abnormal under the microscope. I personally think that the vast majority of them are just funny looking benign nevi with little to no risk of turning malignant. But if they have moderate or severe atypia, most dermatologists I know like to surgically remove them (if only mild atypia, they usually leave them alone and don’t do more surgery after biopsy). But this varies among different dermatologists and experts have different beliefs about this. So in summary it’s important to find out exactly what your pathology report says and it’s also important to discuss all of this with your dermatologist. Dermatologists are very familiar with different types of nevus and how to handle them, but other types of doctors are often (not always) unfamiliar with the complexities around these different nevi. For this reason, I choose to only see MD/DO dermatologists for skin issues affecting me or my family. Please discuss all of this with your doctor so you can make healthcare decision that’s right for you. Best wishes for good health.
Jerad Gardner, MD My report says its a ‘Compound Nevus with Moderate Atypia’ - thank you for the long message, greatly appreciate your words!
Enjoying your videos. Dr. Gardner! Could you comment on nevus with Architecture disorder and risk with melanoma? Thanks so much!
It’s a complicated topic. I give a brief summary in my #dermpath Survival Guide book: bit.ly/2Te2haB. But if you want more in-depth knowledge I would recommend reading the various papers on this topic in the literature.
Thank for the the details
Please use a pointer or pen to point on particular the morphology.
👍🏾👍🏾👍🏾👍🏾👍🏾👍🏾❤❤❤❤❤❤
Hey Jerad, my dermatologist pushed for me to excise 3 moderately dysplastic moles even though I told him I was uncomfortable with scarring and I had a history of body dysmorphia. I've started to research this topic and I'm starting to question the necessity of what he did. I'm starting to get upset because the scars are pretty big (5mm margins). I think he may have pushed to excise for primarily legal and financial reasons. Do you think it's unreasonable to think that? Thanks.
For most of my time in practice, the dermatologists I worked with routinely performed complete excision of moderate dysplastic nevus. There is growing evidence that may not be necessary but it’s still an area that has a lot of debate and controversy. Some of the dermatologists I’ve worked with recently and now willing to leave moderate dysplastic nevus and watch/wait, but I also know some very good dermatologists who still think it is a good idea to surgical excise them with negative margins to be on the safe side. I cannot speak for your dermatologist personally of course but what you are describing sounds similar to what I have seen other good dermatologists do in similar situations. Regardless, I am sorry for the scarring and any discomfort you are going through. I know scars can be a very frustrating issue for many patients. A lot of dermatologists I work with recommend using silicone scar tape or gel to help scars heal with better cosmetic results. They also recommend sun avoidance and sunscreen if the scar is exposed to sun. I’m not a dermatologist so not an expert at cosmetics but that is what I’ve heard from some of my very smart and compassionate dermatologist colleagues over the years. My best wishes for health, healing and peace for you!
Is there any difference from local immunossupression between adolescents adults?
I don’t understand this question