Treatment Modalities, Efficacy, and Complications in Nasal Congenital Melanocytic Nevi: A Systematic Review

Nasal congenital melanocytic nevus (NCMN) is a common pigmented skin lesion affecting the nose since birth. Due to its conspicuous anatomic location and potential malignancy risk (1%-5%), treatment aims to achieve complete removal while preserving function and aesthetics. This review aims to provide clinical guidance on treatment selection for NCMN.

The authors searched PubMed, MEDLINE, EMBASE, CNKI, and the Cochrane (1957-2024). Eligible studies reporting treatment, patient satisfaction, and complications of NCMN were included. Reviews, nonclinical studies, unrelated topics, and studies without full-text were excluded. Two reviewers independently screened and extracted data.

Among the 711 articles screened, 18 studies met the inclusion criteria. Treatment modalities included laser therapy, cryotherapy, dermabrasion, chemical peels, surgical excision with skin grafting, and flap reconstruction. Flap-based reconstruction was most commonly used for larger or deeper lesions, while minimally invasive methods were typically used for small, superficial nevi. Reported complications include scar, pigmentation and depigmentation, recurrence, hypersensitivity, erythema, edema, flap necrosis, infection, venous vascular crisis, and absence of the nasofacial groove. Despite these complications, most studies reported high levels of patient satisfaction. However, heterogeneity in outcome measures and reporting limited direct comparison across treatment modalities.

This review highlights the importance of individualized treatment planning to achieve optimal aesthetic and functional outcomes in patients with nasal congenital melanocytic nevi. Treatment decisions should be guided by lesion size, anatomic location, and patient-specific factors. Future research should focus on standardized assessments and long-term follow-up to identify the most effective and safe therapeutic strategies for NCMN.