Clinical Analysis of Serial (Staged) Excision for Congenital Melanocytic Nevi: A Single-center Experience
- Author:
Min Young LEE
1
;
Ji Yeon BYUN
;
Kyu Kwang WHANG
Author Information
1. Department of Dermatology, College of Medicine, Ewha Womans University, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Melanocytic nevi;
Dermatologic surgery;
Staged excision
- MeSH:
Arm;
Buttocks;
Carbon Dioxide;
Cicatrix;
Dermatologic Surgical Procedures;
Humans;
Leg;
Male;
Medical Records;
Methods;
Mouth;
Nevus;
Nevus, Pigmented;
Nose;
Patient Satisfaction;
Retrospective Studies;
Skin;
Thorax
- From:Korean Journal of Dermatology
2019;57(9):527-531
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Serial (staged) excision of congenital melanocytic nevi (CMN) is an important treatment option for medium-sized CMN. However, few studies have investigated the outcomes of serial excision in detail.OBJECTIVE: We report our experience regarding serial excision of CMN, including methods to effectively reduce the procedural stages and scar length.METHODS: We retrospectively reviewed medical records of patients with CMN treated between 2008 and 2015; 33 patients (7 men and 26 women) underwent serial excision.RESULTS: The CMN were located on the face (n=11), arms (n=6), legs (n=11), and other areas of the body (n=11), including the back (n=2), chest (n=1), deltoid region (n=1), and buttocks (n=1). The mean CMN area was 19.7 cm². The mean number of surgical stages was 2.2. The mean interval between surgeries was 10.6 months. A marginal S-shaped incision along both edges of the nevus was preferred over elliptical excision, to reduce scarring. Pulsed dye, erbium:yttrium–aluminum–garnet (YAG), neodymium-doped:YAG, and carbon dioxide fractional lasers were used to improve the final outcomes and minimize scarring.CONCLUSION: Serial excision is an effective treatment option associated with greater patient satisfaction, particularly for medium-sized and hairy CMN. Conventional elliptical serial excision is associated with the formation of elongated scars and sacrifices normal skin adjacent to the lesion. The marginal S-shaped incision reduces scarring by dispersing mechanical tension on the scar without skin wastage. Compared with the elliptical excision method, the marginal S-shaped incision reduces the number of surgical stages and results in a cosmetically superior scar. Performing a marginal S-shaped incision is technically challenging in certain anatomical locations, such as the eyes, nose, and mouth. Therefore, it is necessary to combine this procedure with erbium:YAG and neodymium-doped:YAG ablation.
