Poster presentation, P126

Official XXIst International Pigment Cell Conference website - 21-24 Sept 2011, Bordeaux - France | updated: September 04 2011

Treatment of giant congenital melanocytic nevus: pediatric expansion in infants

INTRODUCTION: Complete excision of the involved skin is the treatment of choice of giant congenital melanocytic nevi. Among surgical techniques, skin expansion provides a good quality replacement of the skin defect. For the last 23 years we have used this technique in the first months of life with overall good results. PATIENTS AND METHODS: We retrospectively included 52 consecutive patients who underwent tissue expansion before the age of one. Clinical follow-up by dermatologist and surgeon allowed to record early and late complications, and to assess aesthetic results. RESULTS: 36 infants underwent a single procedure and 16 had repeated skin expansion. The median age of first treatment was 5 months. The early complication rate was 25% at any stage of treatment. On average 95% of the nevus could be removed on the head and 90% on the trunk. In 15 children, long term assessment revealed later growth-related complications like widening of scars and morphological deformities. DISCUSSION: Early treatment of giant nevus improves social and aesthetic prognostic. The complication rate of skin expansion in infants is comparable to that of older children. This technique allows a high excision rate, even for giant nevus of the trunk. However, one must consider the possibility of late complications revealed by growth. However, considering the poor results of other treatments, we consider early skin expansion before the age of one year as the best option for giant melanocytic nevi.

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