Comparative Treatment of Giant Congenital Melanocytic Nevi with Curettage or Er:YAG Laser Ablation Alone versus with Cultured Epithelial Autografts

Whang, Kyu Kwang; Kim, Myoungjoo; Song, Wonkeun; Cho, Soyun

doi:10.2310/6350.2005.31305

Cited by 29 publications

(31 citation statements)

References 25 publications

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“…The methods of choice include complete excision followed by reconstruction (skin graft, tissue expansion, local flaps), and incomplete excision (chemical peels, laser therapy, dermabrasion and curettage) [12] . In addition, cultured epithelial autograft (CEA) has also been employed in the treatment [13] . The use of tissue expansion has been incorporated in the management of large congenital melanocytic naevi with the use of local advancement and rotation flaps or as a full thickness skin graft.…”

Section: Discussionmentioning

confidence: 99%

Giant congenital melanocytic nevus - Reconstruction using multiple modalities: A case report

2017

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Congenital melanocytic naevi are neuroectodermal lesions that are mainly composed of melanocytes. They are present in 1% to 6% of all newborns. These lesions carry the risk of transforming into melanomas; however, the psychological effect of such disfiguring naevi is potentially of greater concern to both the child and parent. Several classifications for congenital melanocytic naevi have been proposed, the most common of which is the sub-classification according to their size as this affects the choice of treatment. Many treatment modalities have been utilized including surgical excision followed by reconstruction, curettage, dermabrasion, laser therapy and chemical peels. In this report, we present a case of an otherwise healthy eight-year-old girl with a giant congenital melanocytic naevus on the central face. The lesion was mostly excised with remaining satellite lesions dermabraded. The defect was then reconstructed with a full thickness skin graft harvested from the expanded supraclavicular skin, in addition to the ReCell (non-cultured epithelial autograft) technique. Within six months post-operation, excellent skin pigmentation and texture was achieved.

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Section: Discussionmentioning

confidence: 99%

Giant congenital melanocytic nevus - Reconstruction using multiple modalities: A case report

2017

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“…CMN is defined as a melanocytic nevus present at birth or one that appears within the first few months of life 2 . Usually CMNs are classified according to their size, or the size they are predicted to attain at adulthood.…”

Section: Discussionmentioning

confidence: 99%

“…Congenital melanocytic nevi (CMN) are tissue malformations of the neuroectoderm that are mainly comprised of melanocytes 1 , that are present at birth or appear within the first few months of life 2 . There are a variety of treatment options for managing CMN according to the size, thickness, location, patient age and risk of developing melanoma 1 .…”

Section: Introductionmentioning

confidence: 99%

“…There are a variety of treatment options for managing CMN according to the size, thickness, location, patient age and risk of developing melanoma 1 . These reconstructive options include serial excision, serial expansion with a tissue expander, full-thickness or split-thickness skin grafting, dermabrasion, curettage, and Er:YAG laser ablation with a cultured epithelial autograft 2,3 . Serial excision is a surgical technique which is the preferred treatment modality for medium-sized nevi that can be excised in two or three procedures without distorting adjacent structures 4 .…”

Section: Introductionmentioning

confidence: 99%

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Scar-Saving Flap during Serial Excision by Borrowing from the Opposite Side

Lim

Song

Whang³

2008

Ann Dermatol

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Background: Congenital melanocytic nevi may have various shapes according to the anatomic location. Therefore, it is desirable to apply proper surgical designs to the diverse forms considering the characteristics of the sites as well as the shape and size.Objective: The purpose of this article is to introduce a new scar-saving flap design for semicircular defects after removing congenital melanocytic nevi without excising additional normal skin.Methods: In most cases to excise semicircular nevi, normal skin should be excised to prevent dog ear, resulting in the long length of the scar. So we use a new scar-saving flap design by borrowing a partial length from the opposite side.Results: We used this new technique for 4 cases of large semicircular skin defects. In all cases, this method had some advantages from this perspective: (1) it does not require excision of normal adjacent skin to convert a semicircular defect into a crescent shape or to remove dog-ears (2) the final suture line is not much longer than the diameter of the original defect and (3) it makes the removal of a much larger volume possible in one procedure rather than using the classic serial excision technique, which consists of a central elliptical excision within the confines of the nevus. In this way the frequency of procedures and discomfort to the patient can be reduced.Conclusion: We think that a scar-saving flap design by borrowing a partial length from the opposite side can be a good strategy for a semicircular skin defect. (Ann Dermatol (Seoul) 20(3) 120∼125, 2008)

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“…Congenital melanocytic nevus (CMN) is defined as a tissue malformation of the neuroectoderm that presents at birth or it appears within the first few months of life 1,2 . CMNs are usually classified according to their current size or the size that the CMN is predicted to attain at adulthood: small (less than 1.5 cm in diameter), medium (1.5∼20 cm) and large (more than 20 cm) 3 .…”

Section: Introductionmentioning

confidence: 99%

A Combination of Dual-mode 2,940 nm Er:YAG Laser Ablation with Surgical Excision for Treating Medium-sized Congenital Melanocytic Nevus

Lim

Jeong

Whang³

2009

Ann Dermatol

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Background: There are various treatment options for congenital melanocytic nevus (CMN), including surgical excision, dermabrasions, curettage, laser treatment, chemical peels and cryosurgery. The proper choice of treatment depends on the size, location, thickness and clinical appearance of the nevi, the risk for developing melanoma, the psychological effect and the cosmetic component. Objective: The purpose of this study is to evaluate the outcome of a combination of surgical excision with Er: YAG laser ablation for treating CMNs. Methods: A total of 13 patients were included in this study. The nevus was excised as much as possible and only dermal suturing was performed, without epidermal suturing, for the primary closure. We then ablated the whole lesion, including the suture lines, by using a dual-mode 2,940 nm Er:YAG laser with three to five passes. All the lesions were followed up for 6 months and they were evaluated with respect to the healing status, infection, erythema, scarring, textural change and pigmentary change. Subject satisfaction was scored at the 16 th week by the patients. Results: Eleven (83%) of the 13 patients were clinically rated as having a good to excellent result by the physicians' Global Assessment Scale (GAS) scores for the lesions' reduction of size, the degree of scarring and the pigmentary change with only a one stage procedure. 10 (77%) of the total 13 patients reported a good to excellent result at four months after treatment. Conclusion: A combination of surgical excision with Er:YAG laser ablation as a one stage procedure is a safe, effective modality and it should be considered as one of the options for treating medium-sized CMNs.

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Comparative Treatment of Giant Congenital Melanocytic Nevi with Curettage or Er:YAG Laser Ablation Alone versus with Cultured Epithelial Autografts

Abstract: In view of the favorable outcome of CEA combined with curettage or Er:YAG laser ablation in the treatment of giant CMN, CEA is a safe and effective novel treatment adjunct that accelerates healing, with fewer side effects.

Cited by 29 publications

References 25 publications

Giant congenital melanocytic nevus - Reconstruction using multiple modalities: A case report

Giant congenital melanocytic nevus - Reconstruction using multiple modalities: A case report

Scar-Saving Flap during Serial Excision by Borrowing from the Opposite Side

A Combination of Dual-mode 2,940 nm Er:YAG Laser Ablation with Surgical Excision for Treating Medium-sized Congenital Melanocytic Nevus

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