Large Pigmented Nevi Research Articles

Ten-year experience in face and neck unit reconstruction using tissue expanders

BackgroundTissue expansion allows optimal aesthetic reconstruction by the use of a similar adjacent tissue to reconstruct a defect without creation of significant donor site morbidity, especially in the face and upper neck area. MethodsA total of 78 patients underwent facial reconstruction by insertion of a tissue expander (TE) in the cheek or the neck due to burn scar, traumatic scar, leschmaniasis or large pigmented nevi. ResultsAll reconstructions were completed satisfactorily; complications were: complete extrusion (2.6%), incomplete extrusion (3.8%), partial necrosis (14.1%), haematoma (6.4%), wide scar (33.3%), hypertrophic scar (17.9%), lower lid ectropion (1.3%), post-expansion atrophy (2.6%), permanent decrement in sensation (1.3%), sagging (14.1%) and infection (2.6%). ConclusionsThe lateral facial areas and neck contain essentially the same type of skin; hence, tissue expansion allows optimal aesthetic reconstruction by the use of a similar adjacent tissue and expanding either the lower face or the neck interchangeably without creation of major donor site morbidity; even when we use free flaps for coverage, although we achieved good contour and sufficient bulk, but due to poor colour match, reconstruction with expanded skin of the upper neck is needed for better result.

Neurocutaneous Melanosis: Report of Three Cases and Up-to-date Review

Neurocutaneous melanosis is a rare noninherited embryonic neuroectodermal dysplasia, which is observed sporadically and never affects the entire integument. The hallmark of neurocutaneous melanosis in the neonatal period is the presence of a large bilateral hairy dark nevus with satellite nevi over the trunk and neck. The diagnosis should be considered in neonates with large pigmented nevi and in those with more than 3 hairy dark nevi regardless of their size. Neonates with neurocutaneous melanosis are at risk of developing neurological problems. The most common neurological complications are hydrocephalus, seizures, cranial nerve dysfunction, and signs of spinal cord and root involvement. The authors report 3 cases of histologically confirmed neurocutaneous melanosis and describe the course of neurological symptoms and clinical findings including cognitive tests and neuroimaging. The case reports are complemented by an up-to date review on this clinical entity.

An Exploratory Analysis of the Occupational Correlates of Large Pigmented Nevi at Lawrence Livermore National Laboratory

To examine the association between exposure to occupational factors and the presence on the body of large pigmented nevi greater than 5 mm, data were collected from 110 employees of Lawrence Livermore National Laboratory employed between 1969 and 1980. In this exploratory prevalent case-control study analysis, 38 employees reported having at least one large pigmented nevus and 72 reported none. Occupational factors associated with the presence of large pigmented nevi (adjusted for age and the number of sunburns per year under age 21) were being an engineer (prevalence odds ratio [POR] = 3.20, 95% confidence interval [CI] = 1.0,10.6) or an electrical engineer (POR = 2.56, 95% CI = 0.3,20.3), being hired at Lawrence Livermore National Laboratory before 1962 (POR = 3.07, 95% CI = 1.2,7.7), and having one's skin exposed to rare earth metals (POR = 3.78, 95% CI = 0.9,15.1).