Diagnostic Excisional Biopsies With Clear Margins Sufficient for Melanoma in Situ
In study, only one local recurrence seen in patient with involved margins at the excisional biopsy who did not undergo wide excision
By Dermsquared Editorial Team | September 09, 2025
WEDNESDAY, Sept. 3, 2025 (HealthDay News) -- For treating melanoma in situ (MIS), diagnostic excisional biopsies with clear margins may be sufficient, according to a study published online Sept. 3 in JAMA Dermatology.
Clio Dessinioti, M.D., from Andreas Sygros Hospital in Athens, Greece, and colleagues examined local recurrence and prognosis in non-lentigo maligna (non-LM)/non-acral lentiginous melanoma (non-ALM) MIS in a retrospective cohort study involving patients diagnosed from 1991 to 2023 who were followed up for at least one year. The analysis included 401 patients with 403 non-LM/non-ALM MIS.
The researchers found that excisional biopsy was initially used for treatment for all lesions, followed by wide excision for 92.3 percent. Only one local recurrence occurred in a patient with involved margins at the excisional biopsy who did not undergo wide excision; an invasive melanoma developed 14 months later. Clear excisional biopsy margins with no wide excision were seen for 30 lesions in 30 patients; they had no recurrence at a median of 8.1 years of follow-up. No recurrences occurred at a median follow-up of 4.3 years among 23 patients with 23 lesions with wide excision with margins that were narrower than the standard 0.5 cm. Six patients (1.5 percent) developed a lesion suspicious for recurrence near the excision scar during follow-up, which was excised; on histopathology, this showed nevus or solar lentigo. There were no metastases observed or melanoma-specific deaths reported.
"These findings provide support that non-LM/non-ALM MIS excised with clear histopathological margins in the excisional biopsy may not require additional treatment," the authors write.
One author disclosed ties to the biopharmaceutical industry.