An approach to excision of congenital giant pigmented nevi in infancy and early childhood

Complete prophylactic excision of “large” and “giant” congenital nevocellular nevi (CNCN) often involves multiple surgical procedures begun in early infancy and not completed until late adolescence. Timely use of combined modalities of excision and reconstruction, beginning in infancy, and recognizing the benefits and limitations of each technique in each body region may allow completion of the excision of even the most extensive lesions in early childhood. In addition to minimizing the risk of malignant transformation, early complete excision may minimize the late psychologic stress caused by the appearance of the lesion and the late decision to attempt total excision. Tissue expansion and extensive excision and grafting in infancy and early childhood may significantly improve the final cosmetic result following treatment of these extensive lesions.