[Diagnosis and operative treatment of nevi and hemangiomas in the area of the head and neck].

This paper is divided into four sections. In the first section we attempted to emphasise for the plastic surgeon some practical aspects of clinical diagnosis of moles. Taking into account the pathologic and dermatologic nomenclature we classified moles (naevi) as a) melanocytic naevi, b) vascular naevi, c) epithelial naevi. The second section deals with the indication for surgical treatment. Distinction is made between relative and absolute indications. We considered the cosmetic reason only as a relative indication for surgery. On the other hand we based the absolute indication on three reasons: a) Psychosocial aspects observed in patients with moles on the face. b) Risk of malignancy: there is a high risk of melanoma associated with congenital melanocytic naevi, dysplastic naevi and blue naevi; carcinomas can develop to a sebaceous naevus; basaliomas have been described in linear verrucous epidermal naevus (Schimmelpennig-Feuerstein-Mims Syndrome). c) Complications associated with location and/or the size of a mole: amblyopia results if a haemangioma on eyelid remains untreated. Kasabach-Merrit-Syndrome develops in children with large haemangiomas. In the third section we explain our reasons for not performing incisional biopsies on pigmented skin lesions and we also describe basic surgical techniques such as simple excision with primary wound closure according to RSTL, regional flaps and free grafts (full thickness graft, split thickness graft, mesh graft, composite graft). The fourth section is a short review of special techniques in the treatment of haemangiomas: electrocoagulation, cryosurgery, magnesium seeds, systemic corticosteroids, sclerosing methods and radiotherapy.