Efficacy of Cultured Epithelial Autograft after Curettage for Giant Melanocytic Nevus of the Head

Maeda, Tamami; Morimoto, Naoki; Kakudo, Natsuko; Kusumoto, Kenji

doi:10.1097/gox.0000000000001827

Cited by 5 publications

(5 citation statements)

References 10 publications

(22 reference statements)

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“…There are few reports of GCMN cases treated with CEA transplantation. 7 , 8 Previously reported cases of CEA transplantation resulted in lower engraftment rates than split-thickness skin grafts and severe scar contractures in the transplanted area. 9 In addition, no studies have been conducted on how to remove nevus tissue before CEA transplantation.…”

Section: Introductionmentioning

confidence: 99%

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

Takaya

Kato

Ishii

et al. 2021

Plastic and Reconstructive Surgery - Global Open

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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.

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Section: Introductionmentioning

confidence: 99%

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

Takaya

Kato

Ishii

et al. 2021

Plastic and Reconstructive Surgery - Global Open

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“…The wound surface after curettage of GCMN is an ideal recipient site for CEA application because the dermis component remains and infection or contamination is absent. Although few case reports have shown the effectiveness of CEA application for GCMN treatment [ 16 , 17 ], neither long-term follow-up nor histopathological evaluation after CEA application has been performed. Therefore, herein, we report the evaluation of our cases treated with CEA application along with the analysis of their long-term follow-up and histopathological evaluation.…”

Section: Introductionmentioning

confidence: 99%

Treatment of giant congenital melanocytic nevi with cultured epithelial autografts: Clinical and histopathological analysis

Shoji-Pietraszkiewicz

Sakamoto

Katsube

et al. 2021

Regenerative Therapy

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Introduction Curettage and dermabrasion are effective in the treatment of giant congenital melanocytic nevi (GCMN); however, local infection and hypertrophic scar formation are major issues. Thus, we applied cultured epithelial autografts (CEA) on skin defects after curettage or abrasion of GCMN and assessed the postoperative outcomes. Methods Seven nevi lesions of five patients (aged 3 months to 24 years) were treated with CEA after curettage or abrasion with a dermatome or a surgical bar, respectively. We assessed the postoperative outcomes, including CEA take ratio, erosion and/or ulcer formation in the acute phase, hospitalization days, Vancouver scar scale, and color improvement one year after the operation. In addition, a histological evaluation of a skin biopsy was performed over one year after the operation. Results The CEAs took well on the wound, and the wound surface was mostly epithelized by postoperative day 7 in all cases. While hypertrophic scar formation and slight pigmentation were observed in some lesions, the color was improved in all of the treated lesions. Histopathological examination revealed that the regenerated epidermis had stratified keratinocytes with rete ridges, and the dermal layer without nevus cells regenerated above the remaining dermis layer. Conclusions In this study, we found that early epithelialization and regeneration of the dermal layer was achieved after the application of CEA, suggesting that CEA could be an effective option after curettage or abrasion of GCMN.

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“…In Japan, cultured epidermal autograft (CEA; JACE®; Japan Tissue Engineering Co., Ltd., Gamagori, Japan), which is prepared using Green's technique and have been used to treat severe burn patients around the world, were approved and covered by public health insurance for the treatment of large-to-giant CMN in 2016 [ 16 , 17 ]. Since then, we have applied CEA proactively for the treatment of CMN, especially after curettage and partial-thickness removal of CMN.…”

Section: Introductionmentioning

confidence: 99%

Cultured epithelial autografts for the treatment of large-to-giant congenital melanocytic nevus in 31 patients

Morimoto

Mitsui

Katayama

et al. 2021

Regenerative Therapy

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Introduction Giant congenital melanocytic nevus (GCMN) is a large melanocytic nevus, and its full-thickness removal is usually difficult due to the lack of skin available for reconstruction. Curettage is an alternative approach in cases of GCMN to remove the superficial dermis above the cleavage plane with a curette in the neonatal period, and its major complications include repigmentation, retarded epithelization, and hypertrophic scar formation. In Japan, the JACE® cultured epidermal autograft (CEA) was approved and covered by public healthcare insurance for the treatment of congenital melanocytic nevus (CMN) that is difficult to treat with conventional methods in 2016. We have used CEA for wounds after curettage in the neonatal period or following ablation after the neonatal period in combination with laser therapies to reduce the above-mentioned complications. Methods In this study, we summarized all consecutive CMN patients treated using CEA from December 2016 to April 2019 and evaluated the duration required for epithelialization, incidence of hypertrophic scar, and color change in the target nevus by comparing the L∗ values one year later between the Curettage group, the non-Curettage group with initial treatment or the subsequent group. Results No significant differences were seen in the epithelization period or incidence of hypertrophic scars among the groups, but the color of the target nevus was improved significantly in the Curettage group (p < 0.01) and non-Curettage group with initial treatment (p < 0.01). Conclusions In conclusion, CEA seems to accelerate epithelization after curettage or ablation of CMN, and this treatment could improve the color of CMN when applied initially.

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Efficacy of Cultured Epithelial Autograft after Curettage for Giant Melanocytic Nevus of the Head

Abstract: Supplemental Digital Content is available in the text.

Cited by 5 publications

References 10 publications

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

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

Treatment of giant congenital melanocytic nevi with cultured epithelial autografts: Clinical and histopathological analysis

Cultured epithelial autografts for the treatment of large-to-giant congenital melanocytic nevus in 31 patients

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