Management of congenital nevi at a dermatologic surgical paediatric outpatient clinic: consequences of an audit survey 1990-1997.
BACKGROUND
Since 1987 we have run a Dermatologic Surgical Paediatric Outpatient Clinic (DSPOC) within the Children's Hospital in Bordeaux.


OBJECTIVE
We analyse the consequences of an audit survey concerning the management of patients with congenital nevi (CN) seen at this clinic.


METHODS
We reviewed the cases of 192 children examined and photographed at the DSPOC during the period January 1990-December 1997. Patients were contacted for a reassessment of their status. The management options chosen at the DSPOC were reviewed as well as the satisfaction of the patients or parents of young children.


RESULTS
Of 192 children pre-recruited, 56 girls and 52 boys could be included in the survey. They were mostly European whites and 67% were <6 months of age at the first DSPOC visit. 65/108 (61%) had been operated following the first DSPOC visit. The mean follow-up based on the 1997-1998 survey was 33 months (8 months to 10 years). The size of the nevus, independently of location, influenced decision for early surgery. Another important factor was the estimated disfigurement risk (15% of decisions) mostly related to CN of the face. There was a significant risk of pigmentary recurrence around the scar in children operated before the age of 2, but long-term follow-up indicated a spontaneously regressive course.


CONCLUSIONS
Nevus recurrence in cases operated early suggests a time-dependent phenomenon in nevogenesis. Early counselling is important. Early surgery seems associated with a better scar quality. Explanations concerning risks and outcome are best given with the cooperation of a surgeon and a dermatologist.
Mérigou
Delphine
D
Paediatric Dermatology Unit, National Reference Center for Rare Skin Disorders, Hôpital Pellegrin-Enfants, Place Amélie Raba Léon, Centre Hospitalier et Universitaire de Bordeaux, Bordeaux, France.
Prey
Sorilla
S
Niamba
Pascal
P
Loot
Maya
M
Lepreux
Sébastien
S
Boralevi
Franck
F
Labrèze
Christine
C
Vergnes
Pierre
P
Taïeb
Alain
A
D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D008485:Medical Audit; D009506:Nevus / Q000151:congenital* / Q000473:pathology / Q000601:surgery*; D010045:Outpatients; D017060:Patient Satisfaction; D012878:Skin Neoplasms / Q000151:congenital* / Q000473:pathology / Q000601:surgery*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome