Nevomelanocitic congenital nevu

Nevomelanocitic congenital nevus known as congenital hairy nevus is a pigmented surface lesion present at birth. Nevomelanocitele melanoblastelor and forms are derivatives of the cancer cell group. Multiple definitions have been used to classify non-living in small, medium and giant. These include the diameter, total body surface area and the possibility of intervention in a single excised nevus.
Giant congenital nevi potential to become malignant is significant and an important consideration in treatment and control of this clinical entity. Multiple studies have attempted to elucidate the cumulative risk of developing cutaneous melanoma in patients with congenital nevi. Have recent study showed that cumulative risk of melanoma is 5 to 5 years, 7% for people with large or giant congenital nevi. For small nevi risk was assessed at 0. 8% and 5%. Malignancy should be suspected in increasing length of a nevus, pain, bleeding, or itching significant pigmentation.
Treatment of patients with congenital nevi depends on lesion size, location and propensity for malignant transformation. Aesthetic considerations are important. Surgery for giant congenital nevi is shown at the age of 6 months. The procedures used in the surgical treatment include serial excision and reconstruction with skin grafts, tissue expansion, local flaps and free tissue transfer. Adjuvant treatments include chemical peeling, dermoabraziunea, laser. Surgical excision remains the treatment of adjuvant therapy mainly because the cells do not completely remove nevice. Control of small lesions include photographic documentation and monitoring by surgical excision.
Pathogenesis
Nevomelanocite congenital nevi were arranged in clusters in the epidermis and dermis or well ordered in the form of nests or cords. This nevomelanocitelor in the lower third of the dermis is typical of congenital nevi. Nevomelanocitele may extend into subcutaneous tissue. They tend to be associated with the nerves and blood vessels.
Congenital nevi increase the child grows. The risk of melanoma is proportional to the size nevus. For 50% of malignant giant nevi were developed at three years old, 60% and 70% in infancy to puberty. Approximately 40% of malignant melanomas seen in children occur in large congenital nevi. When a large congenital nevus involving the head or neck or middle line of the trunk can be seen associated meningeal melanocitoze occasionally complicated by seizures, focal neurologic defects, hidrocefalus obstruction or malignant changes.