Hair growth in a skin graft from a glabrous donor site in a child

Abstract

An 8-year-old girl with brown hair presented with a large (8×10 cm) congenital hairy naevus involving her left cheek and temple. Due to the size of the lesion, excision was planned in two stages, in combination with tissue expansion of her left groin skin for Wolfe grafting. The lesion was excised in its inferomedial portion and a fullthickness skin graft applied. Care had been taken to harvest the graft lateral to the normal growth area of secondary sexual hair. Two weeks later, it was noted that a few small areas of the graft had not taken. These areas underwent necrosis and healing by secondary intention (Fig. 1). The patient found these areas to be extremely painful and complained of hypersensitivity. Then, upon review at 3 months, hair was seen on the graft (Fig. 2), whereas the naevus hair had been thick and dark, the stimulated hair was fine and depigmented. No hair was noted in the donor groin region (Fig. 3). The patient was referred for laser depilation treatment; however, this was unsuccessful due to the lack of hair pigmentation. Despite this, the patient and her family were pleased with the improvement in her appearance.