Laser therapy of giant congenital melanocytic nevi

Giant congenital melanocytic nevi (GCMN) are rare disfiguring potentially malignant lesions present at birth. The approach of these patients is based on two main considerations: attempt to minimize the risk of malignancy, and obtain an acceptable cosmetic result. Sometimes they are too large to be removed by multiple surgical excision or by use of osmotic expander. The objective of treatment of giant congenital nevi is to obtain ablation without side effects or after-effects from aesthetics. But for the moment such treatment doesn't exist. The aim of this review was to access treatment of GCMN with lasers as an alternative to surgery. Lasers should only be regarded as a treatment option for GCMN that cannot be surgically excised. For the moment laser therapy of GCMN should be restricted to well controlled studies or to individual patients in whom surgical procedures are not possible or would result in unacceptable scarring. Today ultrashort high energy pulsed CO2 laser and the normal mode ruby laser are the two lasers available. But the results are too unforeseeable, and painful with these two lasers. The combined use of normal mode and Q-switched ruby lasers or ultrashort high energy pulsed CO2 laser and Q-switched ruby or Nd:YAG lasers can give us a solution. In the future perhaps new Q-switched laser could give us a better way of treatment, with less pain, and no scars. We need an improvement of the technology in this field and hopefully the picosecond systems will be available in the future.