Spontaneous involution of congenital melanocytic nevi of the scalp

Strauss, R.M.; Newton-Bishop, Julia

doi:10.1016/j.jaad.2006.05.076

Cited by 56 publications

(27 citation statements)

References 20 publications

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“…19 Second, evidence for improved scarring has been demonstrated in fetuses 28 but not in newborns or infants. Third, while it may be true that surgery in early infancy allows for resection and primary closure of more skin than in older children, the resulting scars may stretch more in dimensions 29 and there may also be a restrictive impact on growth. Fourth, some lesions may have the potential of changing within the first years of life 12,30 ; early excision may lead to overexcision of lesions that could potentially lighten over time, or it may result in underexcision of lesions that could continue to evolve in surrounding skin.…”

Section: Timing Of Surgerymentioning

confidence: 99%

“…Fourth, some lesions may have the potential of changing within the first years of life 12,30 ; early excision may lead to overexcision of lesions that could potentially lighten over time, or it may result in underexcision of lesions that could continue to evolve in surrounding skin. 29 Last, new evidence suggests that general anesthesia in infants and young children may increase the risk for cardiac arrest 31 and adversely affect neurological development. 32,33 …”

Section: Timing Of Surgerymentioning

confidence: 99%

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The Shifting Paradigm in the Management of Giant Congenital Melanocytic Nevi

Arad

Zuker²

2014

Plastic and Reconstructive Surgery

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Congenital melanocytic nevi remain a subject of controversy with respect to risk of malignant transformation and recommended management. Recent studies indicate a lower malignant risk (0.7 to 2.9 percent) than had previously been estimated. Surgery has not been proven to reduce malignant risk or improve quality of life, and may result in undesirable aesthetic and functional outcomes. In this article, the authors review key controversial issues in the management of congenital melanocytic nevi and re-evaluate indications for surgical treatment. An updated review of controversial topics in the management of congenital melanocytic nevi is presented, and clinical applications are demonstrated through clinical cases. Updates regarding the risks and outcomes of congenital melanocytic nevi patients open a renewed debate with respect to the indications for surgery as well as the extent of surgery that may be suitable. Treatment should be tailored to achieve optimal aesthetic results whereby complete nevus excision is not the goal. As such, nonsurgical management and incomplete nevus excision should be integrated as legitimate parts of any treatment algorithm.

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Section: Timing Of Surgerymentioning

confidence: 99%

Section: Timing Of Surgerymentioning

confidence: 99%

The Shifting Paradigm in the Management of Giant Congenital Melanocytic Nevi

Arad

Zuker²

2014

Plastic and Reconstructive Surgery

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“…The latter is further supported by a recent series of spontaneous involution of scalp CMN in childhood. 25 Thus, removal of scalp lesions by tissue expansion is no longer advised, given the significant surgical intervention required and notable associated complication rate (e.g. alopecia).…”

Section: Surgical Management Of Cmnmentioning

confidence: 99%

Congenital melanocytic naevi

Cugno

Kinsler

Bulstrode

2015

Plastic and Reconstructive Surgery

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Congenital melanocytic naevi (CMN) are present at birth, or very occasionally, arise in the first 2 years of life (tardive CMN). These lesions grow commensurate with the child, but tardive lesions can appear to grow more rapidly as the full extent of the CMN is often not initially apparent. The incidence ranges from 1 to 2% if all sizes are considered to approximately 1 in 20 000 for naevi projected to be greater than 20 cm in diameter in adulthood. 1 CMN are commonly classified according to maximum projected adult size and the total number of lesions at birth. The most recently proposed classification of size is small (CMN with an estimated diameter in adulthood of less than 1.5 cm), medium (M1, 1.5-10 cm and M2, 10-20 cm), large (L1, 20-30 cm, L2, 30-40 cm) and giant (G1, 40-60 cm, G2, >60 cm). 2 However, the authors prefer not to employ the term giant as it is often unacceptable to patients and families.The estimates of projected adult size are determined in a variety of ways, none of which are decidedly accurate, but remain the most reliable methods currently available. Some clinicians use a scaling factor applied to the CMN diameter at birth. More specifically, a CMN on the head is predicted to enlarge by a factor of 1.7, on the trunk and upper extremity by a factor of 2.8 and on the lower extremity by a factor of 3.3. 3 This approach is not without fault, as CMN often affect more than one region of the body and it does not account for significant differences in growth between the sexes. Other clinicians therefore estimate the projected adult size by drawing the child's CMN onto an adult body map, and estimating the longest non-circumferential diameter.CMN can present as isolated singular lesions or can be accompanied by a variable number of smaller discrete so-called satellite lesions. These lesions should be counted or estimated as each satellite lesion represents an additional CMN.

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“…Wenn sich kongenitale melanozytä-re Nävi (KMN) am behaarten Kopf manifestieren, ist die hiermit einhergehende Bedeckung mit kräftigen, stark pigmentierten Haaren oft auffälliger als der eigentliche Nävus. Offenbar neigen KMN in dieser Lokalisation mehr als an anderen Stellen zu einer partiellen Regression mit deutlicher Aufhellung, gelegentlich sogar zur vollständigen klinischen Rückbildung [24]. Dies sollte vor Exzisionen mit aufwendiger Defektdeckung, z.…”

Section: Melanozytäre Näviunclassified

Fehlbildungen und Nävi des behaarten Kopfes

Behle

Hamm

2014

Hautarzt

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Unusual congenital or early-onset skin lesions on the scalp often pose a diagnostic challenge particularly as the clinical evaluation may be hampered by dense hair growth. Thus, this paper provides a concise review on developmental abnormalities and nevi with exclusive or predominant scalp localization. Aplasia cutis congenita occurs as an isolated finding, in association with genetic syndromes, nevi and anomalies or as a consequence of intrauterine trauma and teratogens. A hairless area with a narrow surrounding rim of hypertrichosis (hair collar sign) may point to occult cranial dysraphism, especially if accompanied by further suggestive signs as port-wine stains, large hemangiomas, dimples, congenital dermoid cysts, and sinuses. Many diverse entities may hide behind cutis verticis gyrata with the primary essential form being rare and representing a diagnosis of exclusion. In contrast to former belief, benign adnexal tumors arise in a nevus sebaceus considerably more often than basal cell carcinomas and other malignant epithelial tumors. Provided that tumor development is not suspected, excision of a nevus sebaceus nevus is indicated primarily for aesthetic-psychosocial reasons. However, surgical treatment is considerably easier in small children. Nevus sebaceus may be a cutaneous marker for several complex syndromes whereas nevus psiloliparus presents almost always in connection with encephalocraniocutaneous lipomatosis. Congenital melanocytic nevi of the scalp tend toward clinical regression, so that surgical intervention in large lesions should be carefully considered. In contrast, the threshold for excision of blue nevi and other conspicuous melanocytic nevi on the scalp should be low, especially since they are difficult to monitor.

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Spontaneous involution of congenital melanocytic nevi of the scalp

Cited by 56 publications

References 20 publications

The Shifting Paradigm in the Management of Giant Congenital Melanocytic Nevi

The Shifting Paradigm in the Management of Giant Congenital Melanocytic Nevi

Congenital melanocytic naevi

Fehlbildungen und Nävi des behaarten Kopfes

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