Background

The efficacy of Mohs micrographic surgery (MMS) for atypical intraepidermal melanocytic proliferation (AIMP) is unknown.

Objective

To ascertain the frequency of diagnostic change to melanoma (upstaging) and the frequency of local recurrence after MMS for AIMP. A secondary outcome was the frequency of subclinical spread (defined as the requirement for >1 stage of MMS to achieve tumor-free margins).

Methods

Retrospective, cross-sectional study of 223 AIMP (with 92.4% located on the head, neck, hand, foot, or pretibial leg) patients treated with MMS with melanoma antigen recognized by T cells 1 (MART-1) immunostaining.

Results

Upstaging to unequivocal melanoma in situ or invasive melanoma was identified in 18.8% (42/223) of all AIMP patients. The local recurrence rate was 0% (0/223) with a mean follow-up time of 2.7 years (998 days). Subclinical spread was present in 23.8% (53/223) of AIMP patients.

Limitations

Single site, retrospective design, observational study, lack of objective criteria to diagnose AIMP.

Conclusion

MMS with MART-1 immunostaining achieves excellent local control of specialty site AIMP and permits definitive removal of subclinical spread before reconstruction. The central debulking excision should be evaluated with formalin-fixed paraffin-embedded section staining, since a significant percentage of AIMP are reclassified as melanoma in situ or invasive melanoma.

中文翻译：

---

Mohs显微外科手术，由T细胞1（MART-1）识别的黑色素瘤抗原进行非典型表皮内黑素细胞增殖的免疫染色

背景

莫氏显微外科手术（MMS）对非典型表皮内黑素细胞增殖（AIMP）的功效尚不清楚。

客观的

为了确定对AIMP进行MMS后诊断改变为黑色素瘤（分期）的频率和局部复发的频率。次要结果是亚临床扩散的频率（定义为要达到无肿瘤切缘的MMS> 1级的要求）。

方法

回顾性，横断面研究对接受MMS治疗并经T细胞1（MART-1）识别的黑色素瘤抗原的MMS治疗的223名AIMP（92.4％位于头，颈，手，足或胫前腿）的患者进行了回顾性研究。

结果

在所有AIMP患者中，有18.8％（42/223）的患者明确了原位明确的黑色素瘤或浸润性黑色素瘤。局部复发率为0％（0/223），平均随访时间为2.7年（998天）。AIMP患者中存在23.8％（53/223）的亚临床传播。

局限性

单部位，回顾性设计，观察性研究，缺乏客观标准来诊断AIMP。

结论

带有MART-1免疫染色的MMS可实现对特殊部位AIMP的出色局部控制，并允许在重建前明确清除亚临床扩散。中央下体切除术应使用福尔马林固定石蜡包埋的切片染色进行评估，因为很大一部分AIMP被重新分类为原位黑色素瘤或浸润性黑色素瘤。