Related Experiment Videos
Surgical treatment of pigmented melanocytic nevi depending upon their size and location
J Kruk-Jeromin1, E Lewandowicz, J Rykała
1Department of Plastic Surgery, Medical University of Lódź, Poland.
Abstract:
Cutaneous melanocytic nevi may cause cosmetic defects and represent a risk of malignant transformation. Most problems are posed by nevi of the face or those covering large areas of the body, the so-called giant congenital nevus. From 1986 until 1995, 295 patients with pigmented nevi underwent surgical treatment. The method employed depended upon the size and location of the melanocytic nevus. Results were evaluated according to a three-stage scale with consideration of the cosmetic outcome and satisfaction of the patients. Good results were obtained in 280 patients, satisfactory ones in 11 patients, and unsatisfactory ones (requiring corrective treatment) in 4 patients. Small and medium size nevi (up to 5 cm in diameter) can be removed in a one-stage procedure with suturing of the wound, local plasty or free-tissue skin graft. Blepharal and central facial lesions are best reconstructed with full-tissue skin grafting. Large nevi (over 5 cm in diameter) mandate a staged excision or removal at one-stage with prior use of a tissue expander or presuturing. Giant nevi require staged treatment with the use of an intermediate thickness skin graft or removal of superficial layers of the nevus, always preceded however by a histopathological examination.
Insights
Surgical treatment for cutaneous melanocytic nevi, including giant congenital nevi, yielded good or satisfactory cosmetic results in 98% of 295 patients. Treatment methods were tailored to nevus size and location for optimal outcomes.
Area of Science:
- Dermatology
- Plastic Surgery
- Oncology
Background:
- Cutaneous melanocytic nevi can cause cosmetic concerns and carry a risk of malignant transformation.
- Facial nevi and giant congenital nevi present significant management challenges.
Purpose of the Study:
- To evaluate the surgical treatment outcomes for cutaneous melanocytic nevi.
- To correlate treatment methods with nevus characteristics and patient satisfaction.
Main Methods:
- Surgical excision and reconstruction for 295 patients with pigmented nevi between 1986 and 1995.
- Treatment strategies were individualized based on nevus size (small, medium, large, giant) and location.
- Outcomes were assessed using a three-stage scale evaluating cosmetic results and patient satisfaction.
Main Results:
- Good results were achieved in 280 patients (94.9%), satisfactory in 11 (3.7%), and unsatisfactory (requiring revision) in 4 (1.4%).
- Small/medium nevi (<5 cm) treated with one-stage procedures (suturing, plasty, grafting).
- Large nevi (>5 cm) and giant nevi required staged excision, tissue expansion, or superficial removal, often with skin grafting.
Conclusions:
- Surgical management of cutaneous melanocytic nevi can achieve high rates of successful cosmetic outcomes and patient satisfaction.
- Tailoring surgical techniques to nevus size and location is crucial for optimal results.
- Histopathological examination is essential prior to treating giant nevi.