Clinical Analysis of Cultured Epidermal Autograft (JACE) Transplantation for Giant Congenital Melanocytic Nevus

Abstract

Background: Cultured epidermal transplantation (JACE) is performed for giant congenital melanocytic nevus (GCMN), but there are few reports on its postoperative course and surgical content or indications. We aimed to investigate the postoperative course of GCMN patients undergoing cultured epidermal autograft transplantation and compare the outcomes between 2 nevus tissue resection methods. Methods: Twelve GCMN patients aged 0 months to 8 years and 9 months were included in this single-center case series study. Cultured epidermal autograft transplantation was performed at 19 sites of the patients’ extremities and trunks, after excision of the nevus either by using an electric dermatome, which we initially used in 2017, or by curettage with a sharp spoon and use of a hydrosurgery system (Versajet), which we started performing in 2018. Univariate and multivariate analyses were performed for factors associated with postoperative hypertrophic scar formation. Results: In all cases, >90% of the grafts survived, and the dark brown color of the nevus was reduced. Average postoperative observation period was 16.5 months. Hypertrophic scar formation was observed postoperatively at 9 wound sites out of the 12 sites with GCMN removed with a dermatome and at only 1 site with GCMN removed by curettage with use of a hydrosurgery system. In the univariate and multivariate analyses, hypertrophic scar formation was associated with age at surgery. Conclusion: In cultured epidermal autograft transplantation for GCMN, nevus tissue removal at an early age by curettage with use of a hydrosurgery system can provide good results while reducing complications, including recurrence and hypertrophic scar formation.

Giant congenital melanocytic nevus in an Afghan child

“…2 Due to its tendency to the malignant transformation, increased risk of neurological abnormalities, and cosmetic reasons the timely treatment is essential. 9 , 10 Laser therapy, skin grafting, the curettage of the nevus tissue in newborns, and the cultured epidermal autograft (CEA) are reported for GCMN treatment. 9 The treatment options are mostly recommended in the early ages of the patients.…”

“… 9 , 10 Laser therapy, skin grafting, the curettage of the nevus tissue in newborns, and the cultured epidermal autograft (CEA) are reported for GCMN treatment. 9 The treatment options are mostly recommended in the early ages of the patients. 11 …”

“…9,10 Laser therapy, skin grafting, the curettage of the nevus tissue in newborns, and the cultured epidermal autograft (CEA) are reported for GCMN treatment. 9 The treatment options are mostly recommended in the early ages of the patients. 11 To our knowledge, there are no published data from the Ministry of Public Health (MoPH) of Afghanistan on the prevalence of the CMN in the country.…”

Giant Congenital Melanocytic Nevus in an Afghan Child

“…The GCMN is occurred 1 in 20000 to 1 in 50000 births 2 . Due to its tendency to the malignant transformation, increased risk of neurological abnormalities and cosmetic reasons the timely treatment is essential 7,8 . Laser therapy, Skin grafting, the curettage of the nevus tissue in newborns, and the cultured epidermal autograft (CEA) are reported for GCMN treatment 7 .The treatment options mostly recommended in the early ages of the patients 9 .…”

A Case of a Giant Congenital Melanocytic Nevus Treated by Curettage with the Application of Cultured Epidermal Autografts before 6 Months of Age

“…The color tone was improved, and hypertrophic scar formation was only observed in a limited area, which may indicate the effectiveness of both the early-start treatment strategy and the application of CEA. 5 …”