Lim Jung Min, Oh Yeongjoo, Lee Si-Hyung, Cho Mi Yeon, Chung Kee Yang, Roh Mi Ryung
Department of Dermatology, Gangnam Severance Hospital, Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seoul, Korea.
Department of Dermatology, Severance Hospital, Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seoul, Korea.
Lasers Surg Med. 2019 Jan;51(1):62-67. doi: 10.1002/lsm.23030. Epub 2018 Oct 30.
For small to medium sized congenital melanocytic nevi (CMN), the treatment of choice is staged surgical excision. Ablative lasers or pigment-specific lasers have also been recommended for lesions difficult for surgical removal or to avoid surgery. In this study, we retrospectively analyzed the results of several treatment options for CMN to find out the optimal treatment method.
Patients with small to medium sized CMN were retrospectively reviewed. Treatment options were categorized into four groups: (i) Excision only; (ii) Excision followed by scar laser; (iii) Excision followed by pigment-specific laser; and (iv) Laser only. Treatment response was assessed by investigator's global assessment (IGA) score on a seven-point scale.
A total of 119 cases were included. Lesions were most commonly located on the face (59/119, 49.6%), measured 2 ∼ 10 cm in size (72/119, 60.5%), and treated with excision only (50/119, 42.0%). Among treatment options, excision followed by scar laser showed the highest IGA score of 6.38. Options including surgical methods showed higher IGA scores compared to laser-only treatment (P < 0.01). Staged excisions and single excisions showed no difference in IGA scores. Patient satisfaction scores increased after scar laser treatment of the staged excision scar.
For the treatment of small to medium sized CMN, treatment strategies including surgical methods are cosmetically superior to laser-only treatment. Also, the combination of surgical excision with scar laser has the potential for better clinical outcomes and patient satisfaction. Lasers Surg. Med. 51:62-67, 2019. © 2018 Wiley Periodicals, Inc.
对于中小型先天性黑素细胞痣（CMN），首选的治疗方法是分期手术切除。对于难以手术切除或避免手术的病变，也推荐使用消融激光或色素特异性激光。在本研究中，我们回顾性分析了几种CMN治疗方案的结果，以找出最佳治疗方法。
对中小型CMN患者进行回顾性研究。治疗方案分为四组：（i）仅切除；（ii）切除后联合瘢痕激光治疗；（iii）切除后联合色素特异性激光治疗；（iv）仅激光治疗。治疗反应通过研究者整体评估（IGA）评分进行评估，评分采用七点量表。
共纳入119例病例。病变最常见于面部（59/119，49.6%），大小为2至10厘米（72/119，60.5%），仅接受切除治疗的有50例（50/119，42.0%）。在各种治疗方案中，切除后联合瘢痕激光治疗的IGA评分最高，为6.38。与仅激光治疗相比，包括手术方法的治疗方案IGA评分更高（P<0.01）。分期切除和单次切除的IGA评分无差异。分期切除瘢痕经瘢痕激光治疗后患者满意度评分提高。
对于中小型CMN的治疗，包括手术方法的治疗策略在美容效果上优于仅激光治疗。此外，手术切除联合瘢痕激光治疗有可能获得更好的临床效果和患者满意度。《激光外科与医学》51:62 - 67，2019年。©2018威利期刊公司
