Shoukr, T., El Anwar, N., Shaker, E. (2020). Evaluation of Split Thickness Skin Graft Followed by Fractional CO2 Laser in Treatment of Facial Congenital Melanocytic Nevus. The Egyptian Journal of Plastic and Reconstructive Surgery, 44(2), 283-288. doi: 10.21608/ejprs.2020.112520
Tarek Shoukr; Noha M. El Anwar; Engy Seif E. Shaker. "Evaluation of Split Thickness Skin Graft Followed by Fractional CO2 Laser in Treatment of Facial Congenital Melanocytic Nevus". The Egyptian Journal of Plastic and Reconstructive Surgery, 44, 2, 2020, 283-288. doi: 10.21608/ejprs.2020.112520
Shoukr, T., El Anwar, N., Shaker, E. (2020). 'Evaluation of Split Thickness Skin Graft Followed by Fractional CO2 Laser in Treatment of Facial Congenital Melanocytic Nevus', The Egyptian Journal of Plastic and Reconstructive Surgery, 44(2), pp. 283-288. doi: 10.21608/ejprs.2020.112520
Shoukr, T., El Anwar, N., Shaker, E. Evaluation of Split Thickness Skin Graft Followed by Fractional CO2 Laser in Treatment of Facial Congenital Melanocytic Nevus. The Egyptian Journal of Plastic and Reconstructive Surgery, 2020; 44(2): 283-288. doi: 10.21608/ejprs.2020.112520
Evaluation of Split Thickness Skin Graft Followed by Fractional CO2 Laser in Treatment of Facial Congenital Melanocytic Nevus
1The Department of Plastic Surgery, Faculty of Medicine, Tanta University
2The Department of Dermatology & Venereology, Faculty of Medicine, Tanta University
Abstract
Background: Congenital melanocytic nevi (CMN) have medical, cosmetic and psychological effects on the cases. Objective: To evaluate the outcome of combined split thickness skin graft (STSG) and fractional CO2 laser in treatment of facial CMN. Material and Methods: This clinical study was carried out on 8 cases with facial hairy CMN. STSG was harvested from the lateral side of the thigh then 5 sessions with 1 mon apart of fractional CO2 laser was performed after healing. Results: Eight cases with facial CMN were included in the study; 6 female cases and 2 male cases. The median age was 5.5y (4-12y). The median follow-up time was 1.5 years (6 month-2y). There was no residual, recurrence nor malignant transformation occurred during the follow-up period. Only one case developed keloid at the site of graft donation and another case developed infection and the healing was delayed. All cases were satisfied. All cases were grade 4 (near total improvement) at the end of the study. Conclusion: STSG can effectively excise the facial CMN reducing the risk of malignant transformation and followed by fractional CO2 laser to enhance the cosmetic appearance with minimal complications.
Viana A.C.L., Gontijo B. and Bittencourt F.V.: Giant congenital melanocytic nevus. An Bras Dermatol., 88: 863-78, 2013. 2- Everett M.A.: Histopathology of congenital pigmented nevi. Am. J. Dermatopathol., 11: 11-2, 1989. 3- Price H.N. and Schaffer J.V.: Congenital melanocytic nevi-when to worry and how to treat: Facts and controversies. Clin. Dermatol., 28: 293-302, 2010. 4- Ruiz-Maldonado R.: Measuring congenital melanocytic nevi. Pediatr. Dermatol., 21: 178-9, 2004. 5- Fahradyan A., Wolfswinkel E.M., Tsuha M., Reinisch J.F., et al.: Cosmetically Challenging Congenital Melanocytic Nevi. Ann. Plast. Surg., 82: S306-s9, 2019. 6- Horner B.M., El-Muttardi N.S. and Mayou B.J.: Treatment of congenital melanocytic naevi with CO2 laser. Ann. Plast. Surg., 55: 276-80, 2005. 7- Sardana K., Chakravarty P. and Goel K.: Optimal management of common acquired melanocytic nevi (moles): Current perspectives. Clin. Cosmet Investig. Dermatol., 7: 89-103, 2014. 8- Bray F.N., Shah V. and Nouri K.: Laser treatment of congenital melanocytic nevi: A review of the literature. Lasers Med. Sci., 31: 197-204, 2016. 9- Omi T. and Numano K.: The Role of the CO2 Laser and Fractional CO2 Laser in Dermatology. Laser Ther., 23: 49-60, 2014. 10- Du F., Yu Y., Zhou Z., Wang L., et al.: Early treatment using fractional CO2 laser before skin suture during scar revision surgery in Asians. J. Cosmet Laser Ther., 20: 102-5, 2018. 11- Majid I. and Imran S.: Efficacy and Safety of Fractional CO2 Laser Resurfacing in Nonhypertrophic Traumatic and Burn Scars. J. Cutan Aesthet. Surg., 8: 159-64, 2015. 12- Choi J.E., Oh G.N., Kim J.Y., Seo S.H., et al.: Ablative fractional laser treatment for hypertrophic scars: Compar- 288 Vol. 44, No. 2 / Treatment of Facial Congenital Melanocytic Nevus ison between Er:YAG and CO2 fractional lasers. J. Dermatolog. Treat., 25: 299-303, 2014. 13- DeBruler D.M., Blackstone B.N., Baumann M.E., McFarland K.L., et al.: Inflammatory responses, matrix remodeling, and re-epithelialization after fractional CO2 laser treatment of scars. Lasers Surg. Med., 49: 675-85, 2017. 14- Shumaker P.R., Kwan J.M., Badiavas E.V., Waibel J., et al.: Rapid healing of scar-associated chronic wounds after ablative fractional resurfacing. Arch. Dermatol., 148: 1289-93, 2012. 15- Goil P., Jain A., Patil A.N., Singh A., et al.: Surgical management of giant congenital melanocytic nevus of face in the adult-outcomes and experience. Eur. J. Plast. Surg., 41: 529-34, 2018. 16- Downs A., Ng S., editors.: CO2 laser treatment for facial congenital melanocytic nevi. J. Am. Acad. Dermatol., Mosby-elsevier 360 Park Avenue South, New York, NY 10010-1710 USA, 2008. 17- Dai T., Zhang S., Ren Y., Liu L., et al.: Clinical effect of full-thickness skin grafts for the treatment of large and giant congenital melanocytic nevus on the face and extremities joints in children. Int. J. Clin. Exp. Med., 9: 5609-15, 2016. 18- El-Sabbagh A.H.: Is there still a place for skin graft in giant congenital melanocytic nevus? Eur. J. Plast. Surg., 41: 177-82, 2018. 19- Kishi K., Okabe K., Ninomiya R., Konno E., et al.: Early serial Q-switched ruby laser therapy for medium-sized to giant congenital melanocytic naevi. Br. J. Dermatol., 161: 345-52, 2009. 20- Hong K.T., Lim J.M. and Lee S.E.: A Treatment of Medium- to-Giant Congenital Melanocytic Nevi with Combined Er: YAG Laser and Long-Pulsed Alexandrite Laser. Medical Lasers, 6: 77-85, 2017. 21- Lee S.E., Choi J.Y., Hong K.T. and Lee K.R.: Treatment of acquired and small congenital melanocytic nevi with combined Er: YAG laser and long-pulsed alexandrite laser in Asian skin. Dermatol. Surg., 41: 473-80, 2015
View on SCiNiTO
Top