Management of challenging congenital melanocytic nevi: Outcomes study of serial excision

Hassanein, Aladdin H.; Rogers, Gloria L.; Greene, Arin K.

doi:10.1016/j.jpedsurg.2014.08.020

Cited by 39 publications

(37 citation statements)

References 26 publications

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“…Although studies describe a complication rate of 4% in serial excision, no complications were reported in our experience. 4 Complication rates with expanders, however, range from 13%-20%, such as pain during the expansion, poor positioning, extrusion, and infection. 5 10.…”

Section: Discussionmentioning

confidence: 99%

“…2,4 The use of large grafts or tissue expanders is a common choice when more than three stages are required for resection. 4,5 Expander treatment, however, may take 3-6 months depending on the area to be reconstructed. During this period, the expander generates an uncomfortable and unsightly protuberance, and requires multiple injections for expansion.…”

Section: Introductionmentioning

confidence: 99%

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Giant congenital melanocytic nevi: 40 years of experience with the serial excision technique

Mutti

Mascarenhas

Paiva

et al. 2017

An. Bras. Dermatol.

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Although giant congenital melanocytic nevus is a rare lesion, it causes significant deformity and carries a risk of malignant degeneration. Different surgical techniques for the lesion removal are described, including serial resection, resection with skin grafting, and resection and coverage with expanded skin flap (skin expanders). The aim of this study is to report the author's 40 years of experience with cases requiring at least 4 serial excisions to complete the treatment. Serial resection is an effective, safe, and simple technique that requires a lot of patience. Treatment often results in a single linear scar, requires no donor sites, nor large flaps. It is not subject to potencial complications of expanders and avoid aesthetic deformities depending on the location.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Giant congenital melanocytic nevi: 40 years of experience with the serial excision technique

Mutti

Mascarenhas

Paiva

et al. 2017

An. Bras. Dermatol.

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“…Seri eksizyon tekniği; doku ekspansiyonu, greft veya flep uygulamalarına göre; hem daha az sofistike olması hem de daha az komplikasyona yol açması nedeni ile benzer vakalarda önerilen bir yöntemdir. 3,4,10 Bundan dolayı seri eksizyonun; tek seferde total eksizyona uygun olmayacak kadar geniş yüzey alanına sahip ve elektif olarak opere edilebilecek uygun boyutlardaki (bize göre <10 cm) benzer lezyonlarda kozmetik cerrahinin temel ilkelerini öğrenmiş tüm dermatologlar tarafından gerçekleştirilebilecek bir yöntem olduğunu düşünüyoruz. …”

Section: Discussionunclassified

“…

181

Seri Eksizyon Uygulanan Bir Konjenital Melanositik Nevüs Olgusu ve Diğer Tedavi Seçeneklerinin Gözden Geçirilmesi Ö ÖZ ZE ET T Bu çalışmada, kafa derisinde doğuştan beri var olan nevüsün tamamen alınması isteği ile kliniğimize başvuran, erişkin bir erkek olgu ve tedavide uygulanan seri eksizyon işlemi sunulmuştur.

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A Case of Congenital Melanocytic Nevus Treated with Serial Excision and a Brief Review of Other Therapeutic Options

Pekmezci¹

2016

Turkiye Klinikleri J Dermatol

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onjenital melanositik nevüs (KMN), yenidoğanların %1-6'sında gö-rülebilmektedir.1 Erişkinlerdeki boyutlarına (en geniş akslarına) göre; küçük (<1,5 cm), orta (1,(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)9 cm) ve büyük (>20 cm) olarak sınıflandırılmaktadır.2 KMN genel olarak, hem malignite riski hem de kozmetik nedenlerle opere edilmektedir.3 Malignite riski küçük ve orta boy nevüslerde daha düşük olmakla beraber büyük nevüslerde %5 civarındadır. 181Seri Eksizyon Uygulanan Bir Konjenital Melanositik Nevüs Olgusu ve Diğer Tedavi Seçeneklerinin Gözden Geçirilmesi Ö ÖZ ZE ET T Bu çalışmada, kafa derisinde doğuştan beri var olan nevüsün tamamen alınması isteği ile kliniğimize başvuran, erişkin bir erkek olgu ve tedavide uygulanan seri eksizyon işlemi sunulmuştur. Lezyon bölgesinin özellikleri nedeni ile tek seansta eksizyonun komplikasyona yol açabileceğini dü-şündüğümüz, 4,3 cm orta boy konjenital melanositik nevüs olgusuna, iki aşamalı seri eksizyon planlanmıştır. İki ay ara ile gerçekleştirilen seri eksizyonun aşamaları makalede ayrıntıları ile açıklanmıştır. İkinci operasyondan bir yıl sonra tekrar görülen olguda, operasyon bölgesindeki iz değerlendirilmiş ve olgu memnuniyeti araştırılmıştır. Farklı düzeylerde küçük cerrahi işlemler, henüz yeterli olmasa da son yıllarda ülkemizdeki dermatoloji pratiğinde giderek artmaktadır. Bu olgu aracılığı ile hem konjenital melanositik nevüste tedavi seçenekleri gözden geçirilmiş, hem de ülke-mizde küçük cerrahi işlemlerin dermatologlar arasında daha fazla yaygınlaşması amaçlanmıştır.A An na ah h t ta ar r K Ke e l li i m me e l le er r: : Cerrahi uygulamalar, küçük; nevüs, pigmente A AB BS S T TR RA AC CT T Here, it is presented a serial excision performed on an adult male patient who applied to our clinic, requesting total removal of the nevus which exists since birth on his scalp. It is planned a two stage serial excision of 4.3 cm congenital melanocytic nevus, otherwise would cause some complications if excised in one session, due to the unique features of the operation site. The stages of the serial excision, which are performed two months apart, explained in detail in the article. One year after the second excision, both the operation site evaluated and the patient satisfaction investigated. In the last few years, although still not sufficient, the ratio of minor surgical operations performed in dermatology practice is gradually increasing in our country. Via this case; while a review of congenital melanocytic nevus treatment is being made, it is also intended to pave the way for little surgical practice more prevalant among the dermatologists. Ya zış ma Ad re si/Cor res pon den ce: Erkin PEKMEZCİ

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The superiority of the autografts inactivated by high hydrostatic pressure to decellularized allografts in a porcine model

et al. 2016

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We are developing a novel skin regeneration therapy in which the inactivation of nevus tissue via high hydrostatic pressure (HHP) is used in the reconstruction of the dermis in combination with a cultured epidermal autograft. In this study, we used a porcine skin graft model to explore whether autologous skin including cellular debris inactivated by HHP or allogeneic skin decellularized by HHP is better for dermal reconstruction. Grafts (n = 6) were prepared for five groups each: autologous skin without pressurization group (control group), autologous skin inactivated by 200 MPa group, autologous skin inactivated by 1000 MPa group, allogeneic skin decellularized by 200 MPa group, and allogeneic skin decellularized by 1000 MPa group. All of the grafts at 1, 4, and 12 weeks showed complete engraftment macroscopically. The mean areas of the grafts of the control group (p < 0.01) and autologous 200 MPa group (p < 0.01) were larger than that of the allogeneic 1000 MPa group at four weeks after implantation. The thickness of the control group and autologous 200 MPa group was comparable, and that of the autologous 200 MPa group was significantly thicker than that of the allogeneic 200 MPa group (p < 0.01). This suggests that the autologous dermis was superior to the allogeneic decellularized dermis as a skin graft, and that HHP at 200 MPa provided a better outcome than HHP at 1000 MPa. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 2653-2661, 2017.

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Management of challenging congenital melanocytic nevi: Outcomes study of serial excision

Cited by 39 publications

References 26 publications

Giant congenital melanocytic nevi: 40 years of experience with the serial excision technique

Giant congenital melanocytic nevi: 40 years of experience with the serial excision technique

A Case of Congenital Melanocytic Nevus Treated with Serial Excision and a Brief Review of Other Therapeutic Options

The superiority of the autografts inactivated by high hydrostatic pressure to decellularized allografts in a porcine model

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