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

  • Mohammed Mesfer Alkahtani King Abdulaziz Medical City
  • Loujin Asad Department of Plastic, Reconstructive and Burns Surgery, King Abdulaziz Medical City, Jeddah, Saudi Arabia
  • Arwa Sindi Department of Plastic, Reconstructive and Burns Surgery, King Abdulaziz Medical City, Jeddah, Saudi Arabia
DOI: https://doi.org/10.18282/jsd.v2.i1.74
Keywords: congenital facial naevi, ReCell, dermabrasion, tissue expander, melanoma

Abstract

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.

References

Helmbold P, Rompel R, Petres J, Lübbe D, Marsch WC. Kongenitale melanozytäre Nävi (German) [Congenital melanocytic nevi]. Hautarzt 1999; 50(11): 779–784. doi: 10.1007/s001050050984.

Castilla EE, da Graca Dutra M, Orioli-Parreiras IM. Epi-demiology of congenital pigmented naevi: II. Risk factors. Br J Dermatol 1981; 104(4): 421–427. doi: 10.1111/j. 1365-2133.1981.tb15312.x.

Kopf AW, Bart RS, Hennessey P. Congenital nevocytic nevi and malignant melanomas. J Am Acad Dermatol 1979; 1(2): 123–130. doi: 10.1016/S0190-9622(79)70009-0.

Ruiz-Maldonado R. Measuring congenital melanocytic nevi. Pediatr Dermatol 2004; 21(2): 178–179. doi: 10.1111/j.0736-8046.2004.21222.x.

Zaal LH, Mooi WJ, Klip H, van der Horst CM. Risk of malignant transformation of congenital melanocytic nevi: A retrospective nationwide study from The Netherlands. Plast Reconstr Surg 2005; 116(7): 1902–1909. doi: 10.1097/01.prs.0000189205.85968.12.

Quaba AA, Wallace AF. The incidence of malignant mel-anoma (0 to 15 years of age) arising in “large” congenital nevocellular nevi. Plast Reconstr Surg 1986; 78(2): 174– 181. doi: 10.1097/00006534-198608000-00004.

Bauer BS, Vicari FA. An approach to excision of congen-ital giant pigmented nevi in infancy and early childhood. Plast Reconstr Surg 1988; 82(6): 1012–1021. doi: 10.1097/00006534-198812000-00012.

Pilney FT, Broadbent TR, Woolf RM. Giant pigmented nevi of the face: Surgical management. Plast Reconstr Surg 1967; 40(5): 469–474. doi: 10.1097/00006534- 1967-11000-00009.

Sbitany U, Caldwell EH. Treatment of a giant congenital hairy nevus of the ear. Plast Reconstr Surg 1986; 78(2): 242–244. doi: 10.1097/00006534-198608000-00019.

Weinberg MJ, Mahoney JL. Wound suturing—“How do I do it?” Univ Tor Med J 1989; 66(3): 21–27.

Gur E, Zuker RM. Complex facial nevi: A surgical algorithm. Plast Reconstr Surg 2000; 106(1): 25–35. doi: 10.1097/00006534-200007000-00005.

O’Neill TB, Rawlins J, Rea S, Wood F. Treatment of a large congenital melanocytic nevus with dermabrasion and autologous cell suspension (ReCELL®): A case report. J Plast Reconstr Aesthet Surg 2011; 64(12): 1672–1676. doi: 10.1016/j.bjps.2011.05.016.

Whang K, Kim M, Song W, Cho S. Comparative treatment of giant congenital melanocytic nevi with curettage or Er:YAG laser ablation alone versus with cultured epithelial autografts. Dermatol Surg 2005; 31(12): 1660– 1667. doi: 10.2310/6350.2005.31305.

Johnson HA. Permanent removal of pigmentation from giant hairy naevi by dermabrasion in early life. Br J Plast Surg 1977; 30(4): 321–323. doi: 10.1016/0007-1226(77) 90131-X.

Published
2020-03-07
Issue
Vol. 5 No. 2 (2020)
Section
Case Reports

Copyright (c) 2020 Alkahtani MM, et al.

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

Author(s) shall retain the copyright of their work and grant the Journal/Publisher rights for the first publication with the work concurrently licensed under the Creative Commons Attribution-Noncommercial 4.0 International License

Under this license, author(s) will allow third parties to download, reuse, reprint, modify, distribute and/or copy the content under the condition that the authors are given credit and that the work is not used for commercial purposes. No permission is required from the authors or the publisher.

This broad license intends to facilitate free access, as well as the unrestricted use of original works of all types. This ensures that the published work is freely and openly available in perpetuity.