Allah K C, Yéo S, Kossoko H, Assi Djè Bi Djè V, Richard Kadio M
Service de Chirurgie Plastique Reconstructrice et Esthétique, Chirurgie de la main et Brûlologie, Centre Hospitalier Universitaire de Treichville, 01 BP V 3 Abidjan 01, Côte d'Ivoire.
Rev Stomatol Chir Maxillofac. 2012 Nov;113(5):353-7. doi: 10.1016/j.stomax.2012.07.002. Epub 2012 Sep 25.
Giant congenital pigmented nevi are benign melanocytic tumors. The lesion transformation to a malignant melanoma is a rare but severe condition. Treatment is complex and often difficult. The purpose of this study was to analyze the results and discuss the contribution of expansion technique in the treatment of giant nevi of the cephalic extremity.
Six giant nevi (five children and one adult) were treated by skin expansion between 1993 and 2010.
The nevus had a fronto-temporal region and vertex location (one case), and hemifacial in five cases. Subtotal resection of the nevus was performed in every case. The defect was filled by a double rotation flap of expanded scalp (one case), and an expanded total skin graft (five cases). Two complications were observed: a depression of the frontal bone in a 6-year-old child who had received a total prosthesis volume of 2000 mL; and migration of the valve under a prosthesis, which required repositioning. These complications did not alter the final results.
The risk of evolution to a malignant melanoma is considerably decreased after exeresis of congenital nevi. Tissue expansion is a true skin bank. It allows treating giant congenital nevi of the scalp and face, with good esthetic results and less morbidity.
巨大先天性色素痣是良性黑素细胞肿瘤。该病变转变为恶性黑色素瘤虽罕见但情况严重。治疗复杂且往往困难。本研究的目的是分析结果并探讨扩张技术在治疗头面部巨大痣中的作用。
1993年至2010年间，对6例巨大痣（5例儿童和1例成人）采用皮肤扩张术进行治疗。
痣位于额颞部和头顶（1例），半面部5例。所有病例均行痣的次全切除。缺损分别采用扩张头皮双旋转皮瓣修复（1例）和扩张全厚皮片移植修复（5例）。观察到2例并发症：1例6岁儿童接受总量2000 mL假体后额骨凹陷；1例假体下瓣膜移位，需重新定位。这些并发症未影响最终结果。
先天性痣切除后演变为恶性黑色素瘤的风险显著降低。组织扩张是一个真正的皮肤库。它能够治疗头皮和面部的巨大先天性痣，美学效果良好且并发症较少。
