Results of the early use of tissue expansion for giant congenital melanocytic naevi on the scalp and face.
OBJECTIVE
Giant congenital melanocytic naevi (GCMN) are uncommon, have a significant morbidity and require extensive treatment. This paper presents results after complete excision of GCMN on the scalp, forehead or periorbita after early tissue expansion. Based on 15 years of experience, we want to show that performing tissue expansion at a young age is advisable.


METHODS
We included 17 consecutive patients in whom 38 tissue expanders were used. Early and late complications were noted. Patients were seen for a clinical follow up in which scars and re-pigmentation were evaluated with a validated scar scale (POSAS).


RESULTS
All GCMN could be excised completely with early tissue expansion. The age at treatment ranged from 4 months to 2 years of age. With a mean follow-up period of 8.7 years, mild re-pigmentation was seen in only three patients and none of the patients developed a malignant melanoma. Complication rates are comparable with the literature.


CONCLUSIONS
Tissue expansion is a good method for removing GCMN located at the scalp or face with good cosmetic and oncological results. Performing tissue expansion at a young age is advisable.
Department of Plastic, Reconstructive and Hand Surgery, Isala Klinieken of Zwolle, Amsterdam, The Netherlands. zaal@nvpc.nl
Laura H
LH
Zaal
Chantal M
CM
van der Horst
D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004954:Esthetics; D005153:Facial Neoplasms / Q000151:congenital / Q000601:surgery*; D005260:Female; D006258:Head and Neck Neoplasms / Q000151:congenital / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D009508:Nevus, Pigmented / Q000151:congenital / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods; D012535:Scalp / Q000601:surgery*; D012878:Skin Neoplasms / Q000151:congenital / Q000601:surgery*; D015626:Tissue Expansion / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome