Indications, Histopathological Correlation, and Patient-Reported Outcomes in Nevus Excision: A Prospective Observational Study

Abstract

Objective: Melanocytic nevi are among the most common benign growths of melanocytes. Although usually benign, these lesions are frequently excised for a variety of clinical and patient-centered indications, including aesthetic concerns, fear of malignancy, symptomatic lesions, physical interference, or patient preference. This study aims to define the indications for nevus excision, systematically evaluate patient-reported outcomes, optimize surgical decision-making, improve therapeutic planning, and contribute to advancing individualized, patient-centered care in plastic surgery. Methods: This study was designed as a prospective observational study. The study was conducted in the same clinical setting between August 2025 and October 2025. A total of 154 adult patients aged 18 to 85 years were included in the study. For each excised nevus, indications, histopathological diagnoses, and patient satisfaction were recorded for each excision. Satisfaction was evaluated at >1 month follow-up using a Numeric Rating Scale (NRS 1–10). Results: The median age of patients was 35 (IQR: 28–45). The majority of procedures (n=169, 65.8%) were conducted for aesthetic reasons. Pathology revealed that 181 cases (70.4%) were intradermal nevi. Overall clinicopathological concordance was 81.7%. The lowest satisfaction was observed in cosmetic excisions (mean score: 8.38±1.78), while the highest was noted in excisions performed due to patient fear of malignancy (mean score: 9.63±0.96) (p = 0.007). Conclusion: While nevus excision yields high overall satisfaction, scores are lower in aesthetic cases; thus, comprehensive preoperative counseling is essential to align patient expectations with surgical outcomes.