title: [Indication for early excision of the giant congenital nevus].
abstract: BACKGROUND
  Most of specialists involved in giant congenital nevi (GCN) care, agree that the risk of melanoma is probably not significant enough to warrant the prophylactic removal of all those lesions. However, many patients benefit from very early surgical procedures.
  
  
  METHODS
  In the last 15 years 41 children undergwent surgical removal of their large or giant melanocityc lesions in the first year of life at our institution. Indications for such an early excision were as follows: painful ulceration or bleeding, alarming dermatoscopic changes, location in the scalp being removable with primary closure, concomitant surgical procedures, multiple expected interventions and severe parental psychosocial distress.
  
  
  RESULTS
  All patients had a good cosmetic result. All nevus in the scalp between 3 and 5 cms were removed with a primary closure in order to avoid future need of scalp expansion. Familial psychological distress improved significantly and disturbances related to scholar activities were not noticed.
  
  
  CONCLUSIONS
  Despite the lack of international consensus regarding the appropriate timing for large or giant congenital nevi excision, a selection of patients and their families can benefit from early surgical removal.
authors.affiliation: Servicio de Cirugía Pediátrica, Sección de Cirugía Plástica, Hospital Universitario La Paz, Madrid. queminfantil.hulp@salud.madrid.org
authors.forename: J C
authors.initials: JC
authors.lastname: López Gutiérrez
authors.forename: M
authors.initials: M
authors.lastname: García Palacios
authors.forename: Mercedes
authors.initials: M
authors.lastname: Díaz
authors.forename: C
authors.initials: C
authors.lastname: Soto
authors.forename: Z
authors.initials: Z
authors.lastname: Ros
mesh_terms: D061345:Early Medical Intervention; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D009506:Nevus / Q000151:congenital* / Q000473:pathology / Q000601:surgery*; D012878:Skin Neoplasms / Q000151:congenital* / Q000473:pathology / Q000601:surgery*