Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

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Images in Medicine
Year : 2009 | Month : August | Volume : 3 | Issue : 4 | Page : 1704 - 1705

Giant Congenital Melanocytic Naevus

K SHREEDHARA AVABRATHA*, DAMBALKAR G **, AGNIDEVI L**

*Asso. Prof.,** P.G.Student, Dept. of Pediatrics, Fr. Muller Medical College, Kankanady, Mangalore – 575002

Correspondence Address :
Dr. K. Shreedhara Avabratha,Asso. Prof.,
Dept. of Pediatrics,Fr. Muller Medical College,
Kankanady, Mangalore-575002,Karnataka, India.
Ph:(0824)2238000,09448027147.E mail: shreedharkdr@gmail.com

How to cite this article :

K SHREEDHARA AVABRATHA, DAMBALKAR G, AGNIDEVI L. GIANT CONGENITAL MELANOCYTIC NAEVUS . Journal of Clinical and Diagnostic Research [serial online] 2009 August [cited: 2017 Nov 24 ]; 3:1704-1705. Available from
http://www.jcdr.net/back_issues.asp?issn=0973-709x&year=2009&month=August&volume=3&issue=4&page=1704-1705&id=551

Term female baby born by normal vaginal delivery to a second gravida mother with uneventful antenatal history was noted to have large hyper pigmented patches over the anterior abdomen, back and proximal parts of both thighs covering up to 30% of body surface area. Diameter of the largest naevus was 25 cm in its long axis (Table/Fig 1). Many satellite lesions were also found scattered over the body (Table/Fig 2). All lesions were blackish in colour and were well defined. Though most lesions had a smooth surface, few over the back were noted to have a rough surface with hairy outgrowths.

Congenital pigmented naevi have been arbitrarily divided into 3 size ranges depending on their maximum diameter as small, being less than 1.5 cm, medium, being 1.5-20cm and large or giant, being over 20cm 1, 2. The incidence ranges from 1in 20,000 to 1in 50,00003. Other synonyms for a giant congenital naevus (GCMN) are bathing trunk naevus or garment type naevus. GCMN is extremely rare, occurring one in 500,000 newborns4. Giant congenital naevi carry the potential for malignant change. The risk is well documented in lesions involving over 5 percent of the body surface5. Large axial lesions with many satellite lesions may be associated with neurocutaneous melanosis which may be detected by the brain MRI scan6.

This type of giant garment or bathing trunk naevi is very distressing to the parents and poses a difficult surgical challenge. Many centers recommend deep curettage or shaving in the early neonatal period, with the objective of removing as many melanocytic naevus cells as possible7. Autologous grafts are then used for resurfacing. Alternative approaches of treatment are dermabrasion, laser therapy and curettage, but carry a greater risk of leaving behind naevus cells. Regardless of the method of choice, lifelong periodic cutaneous examination is indicated, especially in those lesions which are not excised6.

References

1.
Mackie RM. Disorders of the cutaneous melanocytes, In: Rook’s textbook of dermatology 7th ed. Oxford UK Blackwal publishing, 2004; 38:1-39.
2.
Mahajan BB, Pall A, Gupta RR. Congenital melanocytic nevus studded with strawberry hemangioma on the scalp, Indian J Dermatol Venerol Leprol 2003; 69:40-1.
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Rhodes AR. Melanocytic precursors of cutaneous melanoma. Estimated risks and guidelines for management, Med Clin North Am 1986;70(1):3-37
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Grichnik JM, Rhodes AR, Sober AJ. Benign hyperplasias and neoplasias of melanocytes, In: Fitzpatrick’s Dermatology in General Medicine 6th ed. New York, USA MCGraw-Hill publisher, 2003:881-905
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Swerdlow AJ, English JSC, Qiao Z. The risk of melanoma in patients with congenital naevi. A cohort study. J Am Acad Dermatol 1995; 32: 595-99
6.
James WD, Berger TG, Elston DM, Melanocytic nevi and neoplasms, In: Andrews diseases of skin, clinical dermatology 10th ed. UK, Saunders Elsevier, 2000: 685-701.
7.
Zaal LH, Mooi WJ, Sillevis SJH, Vander Horst CM. Classification of congenital melanocytic nevi and malignant transformation: a review of literature,British Journal of plastic surgery 2004; 57:707-19.

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