Management of Small and Intermediate Congenital Nevi: A Nationwide Survey in Italy

Abstract

Objective: Small- and intermediate-sized congenital nevi (SCN and ICN) undergo periodic clinical monitoring or surgical excision. We analyzed the management of SCN and ICN in the Italian hospital network. Methods: A nationwide survey of a representative sample of centers was conducted. Data were analyzed grouping centers by melanoma incidence into high-volume (>25 diagnoses per year) and low-volume (≤25 diagnoses per year). Results: In the pediatric population, 11% of SCN and 22% of ICN are excised, the remainder undergoing clinical monitoring at intervals of 6 months to 2 years (SCN) and of 6 months to 1 year (ICN). In adults, 24% of SCN and 41% of ICN are excised. Clinical monitoring of SCN varies from 6-monthly (most common among low-volume hospitals) to every 2 years; preferred strategies for ICN are follow-up at 1 year (51%) or follow-up at 6 months (42%). For prophylactic surgery, complete excision is preferred. Conclusions: The Italian hospital network values management and treatment of SCN and ICN. In most cases natural evolution prompts prophylactic excision. Clinical examination is an important monitoring tool, though follow-up frequency depends on the clinician's experience and practice.

Divided or kissing nevus of the penis: A new case with dermoscopic findings

“…Therefore, aesthetics and functionality are primary considerations in the management of these patients . Clinical features and benign dermoscopic findings are reassuring and alleviate the need for a biopsy, although the rare possibility of malignant transformation warrants close follow‐up, so we advise clinical and dermoscopic examination every 6 to 12 months—depending on the characteristics of the divided nevus—as is usually done with other congenital nevi …”

“…1,3,14,15 Clinical features and benign dermoscopic findings are reassuring and alleviate the need for a biopsy, 1-3 although the rare possibility of malignant transformation warrants close follow-up, 9,15 so we advise clinical and dermoscopic examination every 6 to 12 months-depending on the characteristics of the divided nevus-as is usually done with other congenital nevi. 17 Early dermoscopic signs of a melanoma of the mucosa could include structureless parts and gray color. 18 Multiple patterns and blue or white colors may be observed in more-advanced lesions.…”

The outcome of using different surgical modalities and laser therapy in the treatment of small‐ and medium‐sized congenital melanocytic nevi: a systematic review

“…Another study based on a nationwide survey (including multiple representative centers around the country) was done in Italy . The main objective of the study was to analyze the treatment of small and intermediate CMN which undergo periodic clinical monitoring or surgical excision.…”

“…Overall, congenital nevi could have a malignant transformation risk, but the risk of malignant transformation is more evident among the large‐sized congenital nevi. Clinically, congenital nevi can be divided into three types based on its size: small‐sized (SCN, ≤1.5 cm), intermediate‐sized (ICN, 1.5–20 cm), and large‐/giant‐sized (>20 cm) . There are various modalities used in the treatment of CMN.…”

Surgical Site Infection After Skin Excisions in Children: Is Field Sterility Sufficient?

“…The excision of skin lesions is one of the most common pediatric procedures . Depending on a number of factors such as age, patient cooperation, and surgeon comfort, these operations may be performed in the clinic setting using local anesthesia and field sterility or in the operating room under general anesthesia.…”