Treatment of Congenital Hairy Nevus using Superficial Tangential Excision, Laserablation and Dermal Overgraft: Case Report

Even though a variety of treatment modalities for the congenital hairy nevus have been introduced, a standard method that satisfies both aesthetic outcome and complete resection has not yet been established. Due to the malignant potential of congenital hairy nevus, full thickness skin graft or surgery using flaps after complete excision has been widely used. However, in the case of small & medium sized congenital hairy nevi, aesthetic results have greater emphasis due to therir low malignant potential. Three patients who presented with a congenital hairy nevus of 20 cm or less were treated from 1999 to 2001. In order to preserve the function of skin and acquire a more satisfying aesthetic outcome, we performed a tangential excision of the epidermis and papillary dermis under the loupe while preserving the lower dermis as much as possible. Following this procedure, laserablation with CO2 laser was executed to remove remnant nevus cells with dermal over graft. We estimated the postoperative results of pigment disapperance, amount of contracture and skin texture. Satisfying results were obtained during a 6 month to 2 year follow up period. In cases of congenital hairy nevus that can not be covered with full thickness skin graft or flaps after total excision, this procedure seems to be an appropriate alternative treatment modality.

Treatment of the Portwine Stain with Dermabrasion and Dermal Overgraft: A Clinical Experience

Portwine stains(PWSs) are congenital vascular malformations, commonly found in the face, caused by progressively ectactic postcapillary venules of the superficial vascular plexus. They are reported to occur in 0.3% of newborn, and depending on the location and size, they may lead to psychosocial complications. Recently, with the advent of the lasers, ruby, dye, argon and CO2 lasers have been used for the treatment of PWSs. However, the results are variable and unpredictable. We present a case of congenital hemifacial PWS treating with dermabrasion and overgraft with very thin split-thickness skin rather than laser therapy. We achieved good result by using this method.