PR31 A LITTLE GIRL WITH A GIANT NAEVUS. A CASE REPORT

Purpose  The treatment of congenital giant hairy naevi remains controversial and it can present a challenge for the reconstructive surgeon. Recent publications promote the use of curettage and laser treatment, however they show incomplete clearance. In this atmosphere we present a case of surgical resection involving serial excision, skin grafts and tissue expansion with early good cosmetic results. Methodology  Now aged 2 year old girl was born with extensive congenital melanocytic naevi of her face, involving lower forehead, glabella, medial eyelids, nasal bridge and medial cheeks bilaterally. Lower back and right calf were also involved. No associated anomalies were recorded. At one week of age she had curettage of the facial naevus, when the surface naevus containing most of pigment and naevus cells was removed in London. She was left with the left eye ectropion due to a small scar. She moved to NZ and underwent further treatment. There was no role for laser treatment so surgical excision at the age of 12 months was performed, followed by insertion of tissue expanders, bilateral cheek and forehead advancement and full thickness graft to defects post serial excisions. A literature review was performed and our findings compared with historical results from other centres. Results  Multiple treatment techniques have been used over the last few decades. Surgical approach provides stable long term results in terms of cosmesis and function and early good results are shown in our case. We will continue further reconstructions in the future to achieve the best appearance and function.