From: Proceedings 10th World Congress of Cryosurgery
Laser and Cryosurgery for the Treatment of Congenital nevus

November 1998
J.M. Fernandez- Vozediano

The congenital melanocytic nevi are characterized by a wide variety of colors, size, form, surface and presence orabsence of vellus. The can be classified by their size in an arbitrary way in small (up to 5cm). This classification is not based on clinical, histopathological or biological criteria. The most important complication is the development of the malignant melanoma, which is much more frequent in the case of the so called giants. For the treatment of these lesions, it is important to take into account the cosmetic needs. Since these lesions are unpleasant from the aesthetic point of view and could cause serious psychological disorders to people suffering from them, and the vital needs too, due to its potential of degeneration into malignant melanoma. For nevi of small or medium size, the treatment will always be surgical when possible. However, regarding the giant ones, radical surgery could be complicated, very aggressive and in the cases of sistemic malanosis in which we find melanocyle on the fatty tissue, muscular fascia, skeletal muscle, lymph nodes or salivary glands, surgery will not guarantee healing at all. There are some other procedures, but as a rule, the most useful will be the most adequate in every case and moment. The periodical control will be the best procedure in the case of the most light nevi with benign pattern; excision and graft for medium size nevi; the use of expanders depending on the location; dermabrasion will be the most complicated technique; laser-abrasion or laser vaporization technique has come to substitute the dermabrasion, and last, cryosurgery, with a seldom use, it does not seem to be useful as unique treatment. We have had the opportunity to treat a medium size nevus, pigmented and pilous, benign pattern (well limited borders, smooth surface, homogeneus colour and covered of vellus), located on the center of a girl's cheek with cutaneous phototype two. We chose first laser-abrasion, but since it developed a pseudomelanoma (recurrence of melanic pigment) we applied solid cryosurgery with a probe of double cycle fast freezing and slow defrost, achieving the total disappearance of the pigment and a correct healing. As the patient's skin colour is white, we recommended a very strict photoprotection, and we achieved a very good result.


Cryo-Forum Index