1. What is the decision or change (e.g., clinical topic, practice guideline, system design, delivery of care) you are facing or struggling with where a summary of the evidence would be helpful?
The decision involves determining the most effective and safe practices for diagnosing and managing atypical nevi (dysplastic nevi). Specifically, the review would address whether to use dermoscopy with or without reflectance confocal microscopy (RFC) for identifying lesions for biopsy, and whether histologically dysplastic nevi with positive margins require re-excision or can be safely observed.
2. Why are you struggling with this issue?
This issue is challenging due to conflicting evidence and lack of standardized guidelines. There is variability in how healthcare providers manage atypical nevi, leading to inconsistent patient outcomes. The uncertainty about whether to re-excise dysplastic nevi with positive margins and the potential risks of overdiagnosis and unnecessary procedures complicate clinical decision-making.
3. What do you want to see changed? How will you know that your issue is improving or has been addressed?
The goal is to develop clear, evidence-based guidelines for the diagnosis and management of atypical nevi. Success will be measured by reduced practice variability, improved patient outcomes, and decreased unnecessary biopsies and treatments. Enhanced early detection of melanoma and better management strategies for atypical nevi will indicate progress.
4. When do you need the evidence report?
Fri, 05/01/2026
5. What will you do with the evidence report?
The evidence report will be used to develop the first evidence-based clinical guidelines for atypical nevi. This will help standardize care, improve early melanoma detection, reduce unnecessary procedures, and enhance overall patient outcomes. The guidelines will provide clinicians with clear recommendations, ensuring better management of atypical nevi and aligning with the American Academy of Dermatology’s commitment to evidence-based practice.
Supporting Documentation
Systematic Review Topic Nomination: Atypical Nevi (PDF, 239 KB)
Optional Information About You
What is your role or perspective? Professional Society
If you are you making a suggestion on behalf of an organization, please state the name of the organization American Academy of Dermatology
May we contact you if we have questions about your nomination? Yes
