Shave excision of cutaneous melanocytic nevi. Indications, technique, results

Background and objective. Shave excision of nevi is a technique still under debate. Speed, simplicity, and the fact that it provides excised material for histologic examination are contrasted with the lack of excision margins and a higher rate of nevus recurrences. In this study, the pros and cons o f shave excision were evaluated. Patients and methods. Conventional excisions (268 nevi with intracutaneous butterfly sutures) and shave excisions (403 nevi) were compared with the pa tients' subjective assessments and objective parameters as recurrence, colo r, depth, surface smoothness of the scars, and the healing process. The nev i, found on the entire integument, ranged in diameter from 2 to 15 mm, with an average of 5 mm. A second excision was performed only in cases in which an early malignant melanoma could not be excluded. Results. Shave excisions were evaluated subjectively as being better. Shave excisions resulted in fewer complications (7.9% versus 15%), but recurrenc es were more frequent (18.1% versus 6.0%). There was no close realtionship between histopathologic finding of complete excision and recurrences. Conclusions. Small nevi without clinical suspicion of malignant melanoma ca n be removed with the shave excision technique with good results. Patients should be informed about the higher rate of recurrences. The appliance of t he shave technique requires exact knowledge and experience, enabling good h istopathologic examinations.