The management of dysplastic naevi: A survey of the fellows of The Australasian College of Dermatologists

A five question, multiple-choice survey was distributed to all fellows of the Australasian College of Dermatologists via email in September 2015. This study sought to establish Australasian Dermatologists’ preferred re-excision margins in the management of dysplastic naevi. The survey featured questions regarding the management of mild, moderate and severely dysplastic naevi. Respondents were asked to consider a clinical scenario where they biopsied a lesion they suspected was a dysplastic naevus and wished to exclude the diagnosis of melanoma. Of the 547 fellows of the Australasian College of Dermatologists 218 responses were collected. Although all surveyed dermatologists would re-excise an incompletely removed severely dysplastic naevus, opinion was divided over whether to treat such a lesion as one would a melanoma or a dysplastic naevus, with 54.59% of respondents using a 5mm margin and the remainder opting for narrow margin re-excision (44.95%). When the same lesion was reported to be clear of margins by 1mm after biopsy, and the clinical suspicion for melanoma was high, 43.78% would re-excise with a 5mm margin. Comparison to previous surveys confirms these discrepancies in management are an international issue.

Dr. Jessica Witherspoon