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Medicine (Baltimore). 2018 Jan;97(4):e9725. doi: 10.1097/MD.0000000000009725.

An alternative strategy treated giant congenital melanocytic nevi with epidermis and superficial dermis of the lesions.

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Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.


Giant congenital melanocytic nevi (GCMN) are defined as rare pigmented lesions that are believed to form between weeks 9 and 20 of gestation. It is difficult to reconstruct large defects after the removal of the lesions and it has posed a great challenge to the plastic surgeon and dermatologist.Given all those difficulty reconstructing the defects, we try to explore an alternative way to resurfacing the defect after removal of GCMN.Patients with GCMN received single-stage excision. Following the subcutaneous tissue and deep dermis were discarded, epidermis and superficial dermis were harvested as graft substitutes to reconstruct the defects in situ.All of the grafted tissue survived well and skin color in the surgical area gradually became lighter. During the periodicity of follow-up, neither hypertrophic scars nor recurrence were observed. Furthermore, histopathology examination demonstrated that there are no distinct melanocytes gathered in the postoperation lesions.For those GCMN which is difficult to reconstruct with traditional methods, resection of the lesion followed by reconstruction with epidermis skin and superficial dermis from the lesions in situ may be a feasible and alternative therapy method.

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