Early curettage of giant congenital naevi in children

Abstract

Early curettage of giant congenital naevi in new-born infants, if performed during the first few weeks after birth, can have a substantial effect on the pigmentation of the lesions, reducing the number of pigmented cells and leaving only moderate scars. We describe our experience in a series of nine congenital naevi treated by curettage between the first and seventh week after birth. Histological changes that occur in the naevus during the first few days after birth mean that early treatment is needed to obtain a cosmetic improvement. Curettage as an early treatment for giant congenital naevi in new-born infants provides cosmetic improvement and might decrease the risk of malignancy; however, the lesions are not cured. Naevus cells persist in the deep dermal layers and may come to the surface, such that close monitoring is needed long after curettage. The cosmetic improvement is likely to benefit the child's psychological development.

Skin Regeneration for Giant Pigmented Nevus Using Autologous Cultured Dermal Substitutes and Epidermis Separated From Nevus Skin

“…The former includes laser treatment, curettage, and cryotherapy with dry ice. [11][12][13][14][15] None of these treatments, however, are able to achieve complete excision of nevus. Complete excision is desirable because the possibility of malignant melanoma cannot be excluded.…”

Spontaneous involution of congenital melanocytic nevi of the scalp

“…The best cosmetic results for this technique have been reported when treatment is carried out during the first 2 weeks of life. 16,17 This requires a prompt decision soon after birth, with the resultant pressure on the parents. The cases reported here all showed marked improvement in their appearance after birth, so much so that three of the children had no cosmetic deficit at all in the long term.…”

Final congenital melanocytic naevi colour is determined by normal skin colour and unaltered by superficial removal techniques: a longitudinal study

“…Furthermore, medical complication rates were high, with reported scarring in up to 25%, and wound infection in up to 18% . Several small studies have reported dramatic improvements and high levels of patient satisfaction after superficial removal techniques; however, improvements in colour were judged subjectively and immediately postintervention . Furthermore, several reports and studies still advocate early aggressive intervention in CMN with superficial removal techniques with outcomes reported by direct comparison of results to early postnatal pictures .…”