Is Laser Therapy an Adequate Treatment for Giant Congenital Melanocytic Nevi?

Abstract

Summary Treatment of congenital and acquired nevi nevocellulares is still controversial because of the possibility of incomplete destruction of deeper situated nevi cells and the possibility of masking a melanoma. Giant congenital melanocytic nevi (GCMN) are rare disfiguring potentially malignant lesions. The approach towards these patients is based on two main considerations: attempt to minimize the risk of malignancy, and obtain an acceptable cosmetic result. Sometimes they are too large to be removed by multiple surgical excision or by use of osmotic expander. The objective of the treatment of giant congenital nevi is to obtain ablation without side effects and aesthetic after-effects. At this time, however, such treatment does not exist. Treatment of GCMN with laser is not an alternative to surgery. Lasers should only be regarded as a treatment option for GCMN that cannot be surgically excised. For the moment laser therapy of GCMN should be restricted to well controlled studies or to individual patients in whom surgical procedure is not possible or where unacceptable scarring would otherwise result. Today ultrashort high energy pulsed CO2 laser and the normal mode ruby laser are the two lasers available. But their results are too unforeseeable, and painful. The combined use of different lasers cannot give us a better solution. In the future new picosecond Q-switched laser can perhaps provide us with another form of treatment, with less pain, and no scars.