The outcome of using different surgical modalities and laser therapy in the treatment of small‐ and medium‐sized congenital melanocytic nevi: a systematic review

Abstract

Objectives The purpose of this study is to review the published articles regarding different surgical modalities including laser therapy in the treatment of congenital melanocytic nevi (CMN).Methods A systematic review was done using several databases including PubMed, Ovid Medline, Google Scholar, and Medline to search for articles related to surgical excisions and different treatment modalities of CMN.Results Fourteen studies were included according to the inclusion and exclusion criteria.The results have shown that the Q-switched ruby laser therapy was the most commonly used laser therapy to treat CMN. Overall, using laser therapy had positive outcomes in CMN treatment. However, limited knowledge was available regarding patient satisfaction with the outcomes of laser therapy. ConclusionWe concluded that the most acceptable surgical choice was using excision with tissue expanders. Laser-intense pulsed light (IPL) alone and in combination with Erbium:yttrium-aluminum-garnet (Er:YAG) has a risk of recurrence. Combination of types of the laser is more effective than a single one. ALMutairi and Al-hothaliOutcome of surgical modalities and laser in treatment of congenital melanocytic nevi Review 541

Updates in the Management of Congenital Melanocytic Nevi

“…Advantages of excision include the potential for a single procedure and improved cosmesis over other modalities like laser for small and medium CMN [71,72]. Disadvantages include its invasive nature, anesthesia requirement, the risk of infection, and possible scarring/disfigurement [73,74].…”

Medium-Sized Congenital Melanocytic Nevus with Halo Phenomenon: A Report of Two Cases

“…For the treatment of large-sized CMN, fresh cultured epithelial autograft (CEA) after curettage or erbium:yttrium-aluminum-garnet (Er:YAG) ablation was found to be a novel option with high patient satisfaction and fewer side effects. 10 On the other hand, less is known regarding effectiveness of surgical treatments for medium-sized CMN, and the patients satisfaction with such treatments. Based on a systematic review, the most acceptable surgical treatment of a mediumsized CMN would be to excise using tissue expanders, as it was shown to have few complications and high patient satisfaction.…”

“…Based on a systematic review, the most acceptable surgical treatment of a mediumsized CMN would be to excise using tissue expanders, as it was shown to have few complications and high patient satisfaction. 10,11 In terms of laser therapy, Qswitched ruby laser with wavelength at 694 nm was shown to be efficacious in treating medium-sized CMN as it allows for highly selective destruction of pigment-laden cells. 10,12 Parents are highly concerned about the psychosocial difficulties their child may face due to CMN, and may prefer surgical removal despite the low melanoma risk.…”

“…10,11 In terms of laser therapy, Qswitched ruby laser with wavelength at 694 nm was shown to be efficacious in treating medium-sized CMN as it allows for highly selective destruction of pigment-laden cells. 10,12 Parents are highly concerned about the psychosocial difficulties their child may face due to CMN, and may prefer surgical removal despite the low melanoma risk. 9 Healthcare professionals should focus on clear communication about melanoma risk, indications for surgery, and expected outcome to best support families' decisionmaking.…”

Treatment of Facial Nevi with Ideal Design and Splitting Technique

“…If it is too deep, it will leave a depressed scar and local skin pigmentation (3,4). Surgical treatment is applicable to any type of nevus, regardless of the size (5). It mainly includes direct excision, serial excision, skin graft, skin ap transplantation, and the use of tissue expander (6,7).…”