title: Giant congenital melanocytic nevus localized in the axillary area: serial excisions as optimal treatment option.
abstract: Congenital melanocytic nevi are relatively rare lesions (1-6%). Their size and location can cause cosmetic and functional disorders of varying degrees of severity, but in addition they can also undergo transformation to malignant melanoma. Different types of treatments have been described as being effective for these lesions, the choice of the most appropriate method depending on the size and the location of the nevi as well as the patients age. While locally destructive methods for superficial treatment could successfully reduce the pigmentation, recurrences are not rare and incomplete elimination of the melanocytic nevus would not exclude the possible development of subsequent malignancy. Surgical excision is the only reliable method allowing for complete removal of the lesion and the provision of material for subsequent histological examination. Complete surgical excision is a good option for prevention of future malignant transformation, but it is not always possible to carry out, especially in the case of large melanocytic nevi. In such cases, serial or staged surgical excisions represent an optimal therapeutic approach with the greatest assurance of total removal of the lesion, even large. We present the case of a female patient with a congenital melanocytic nevus located in the axillary area that had increased significantly in size during her pregnancy. The lesion was successfully treated through a series of surgical excisions with excellent aesthetic results in Onkoderma-Policlinic for Dermatology and Dermatologic Surgery, Sofia, Bulgaria.
authors.affiliation: Onkoderma- Policlinic for Dermatology, Venereology and Dermatologic Surgery, Sofia, Bulgaria.
authors.forename: A A
authors.initials: AA
authors.lastname: Chokoeva
authors.affiliation: Onkoderma- Policlinic for Dermatology, Venereology and Dermatologic Surgery, Sofia, Bulgaria.
authors.forename: G
authors.initials: G
authors.lastname: Tchernev
authors.affiliation: Onkoderma- Policlinic for Dermatology, Venereology and Dermatologic Surgery, Sofia, Bulgaria.
authors.forename: E
authors.initials: E
authors.lastname: Trayanova
authors.affiliation: Department of Pathology and Dermatology, University of Virginia Health System, Charlottesville, VA, USA.
authors.forename: J W
authors.initials: JW
authors.lastname: Patterson
authors.affiliation: Professor and Chair of Dermatology, University of Rome "G. Marconi", Rome, Italy.
authors.forename: T
authors.initials: T
authors.lastname: Lotti
authors.affiliation: Department of Dermatology and Allergology Hospital Dresden-Friedrichstadt, Academic Teaching Hospital of the Technical University of Dresden, Dresden, Germany.
authors.forename: U
authors.initials: U
authors.lastname: Wollina