Q. Why does nevus recur?

Answered by
Dr. Shaunak Patel
and medically reviewed by Dr. Sneha Kannan
This is a premium question & answer published on Feb 16, 2016 and last reviewed on: Apr 18, 2019

Hi doctor,

About a year ago, I had nevus excision. Neither shaving nor laser, it was total excision. But two days ago I have realized that the nevus has come back there along the edges of the scar, the same shape of the scar. The biopsy report of the first one is compound nevus and there is nothing abnormal. There is no note as dysplastic or something like that. I visited my dermatologist today and he said we will follow it for the next 3 months. I have been becoming paranoiac. I need some advice. You please see the pictures of old and new ones. Thanks in advance.



Welcome to icliniq.com.

I understand your complaint and gone through the photos (attachment removed to protect patient identity).

Any nevus is a collection of melanocytes that are able to multiply violently. Hence, even if a small section is left it can potentially regrow. You can go for elliptical excision with at least 5 mm margin and then laser sessions to blow out the reminder.

Hi doctor,

Thanks for your reply. Could you say something about its appearance for now from the picture?



Welcome back to icliniq.com.

Looks like it has come back, whether just like before or maybe less than that. As for now we have to wait and see. Once it has reached full size, we can think about elliptical incision and all that.

Hi doctor,

Is the new one a compound nevus or something like melanoma? Do I have to panic? If it seems like bad thing, I do not want to be late. I do not want to cut again if it is unnecessary. I did not get the operation because of esthetic issues. It is about 3-4 mm for now. Thanks in advance for your reply.



Welcome back to icliniq.com.

Only biopsy can establish the degree of dysplasia, but it is always better to be safe than take chances. Hence, excision is my choice of treatment for any patient.

Your case was of compound nevus where the cells are both in dermis and epidermis. Hence, if some deeper tissue is left in dermis, then chances are there for recurrence.

Safe and best alternative is elliptical excision or a punch biopsy up to the subcutaneous fat including 2-3 mm of normal tissue. I always get good results with it.

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