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

ABSTRACT

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.