Shave excision of benign facial melanocytic naevi: a patient's satisfaction survey.

BACKGROUND: Shave excision is a simple and quick procedure that is widely used for removal of benign naevi. Limited published data are available on patient acceptability of this procedure or its potential cosmetic outcomes. OBJECTIVES: To assess the patient's satisfaction with the procedure, to assess the risk of recurrence, and to determine the patient's perception of the scar. METHODS: Questionnaires were sent to 93 consecutive patients who had shave excision of benign facial naevi. RESULTS: Seventy-six patients (82%) with a total of 83 naevi responded. Twenty-eight percent of naevi were reported to have recurred 12 months after shave excision. A significantly higher recurrence rate was found with hairy naevi (41%, P= 0.04). More than half of the patients reported no scar or had a white and flat scar. Nineteen percent of scars were depressed, and 15% were raised; 7% were pigmented. The majority of patients were satisfied with the results. CONCLUSIONS: Despite a high recurrence rate, most patients were satisfied with the cosmetic outcomes after shave excision of benign facial naevi. The results of this study have helped us to provide our patients with more accurate information regarding cosmetic outcomes.

Incisional biopsy and melanoma prognosis.

BACKGROUND: There are many circumstances in clinical practice in which it is helpful to have a definitive diagnosis of melanoma before subjecting a patient to mutilating surgery. Previous studies on the effect of incisional biopsy on melanoma prognosis were conflicting and lacked a matched control group to account for the other prognostic indicators. OBJECTIVE: We set up this study to investigate the effect of incisional biopsy on melanoma prognosis. METHODS: The design was of a retrospective case control. Data were obtained from the database of the Scottish Melanoma Group; the database was set up in 1979 to collect detailed clinical, pathologic, and follow-up data on all patients diagnosed with melanoma in Scotland. Each incisional case was matched against 2 excision cases controlling for age, sex, sites, and Breslow thickness. The main outcome measures were time from initial biopsy to recurrence and to melanoma-related death. RESULTS: Two hundred sixty-five patients who had incisional biopsy before definitive excision of melanoma were included in the study; these were matched with 496 cases of excisional biopsy specimens. Cox's proportional hazard model for survival analysis showed that biopsy type had no significant effect on recurrence (P =.30) or melanoma-related death (P =.34). CONCLUSIONS: This study is the largest series on the effect of incisional biopsy on melanoma prognosis to date and the first to include matched controls. Melanoma prognosis is not influenced by incisional biopsy,. before definitive excision.