Congenital Hairy Nevus Newport Beach
Congenital hairy nevus is a dark-colored, well-circumscribed mole found in infants at birth. This mole often contains hair, and large ones have the malignant potential to transform into melanoma. Because of this malignant potential, the standard of care is surgical excision. If primary closure is not possible due to its large size, three surgical treatment options exist for closing the wound.
The first one is the serial excision of the nevus in two or three stages, allowing some time, usually three months or more, between the surgical excisions for the skin to heal and stretch out again. The advantages of this option include a nice color match and eventual linear closure and scar. The disadvantages to this option are that multiple surgeries under general anesthesia may be needed.
Another option is the complete excision of the nevus and replacement with full thickness skin graft from the abdomen or other donor site. The advantages of this option include the complete excision of the nevus in one stage and the definitive removal of any malignant potential. The main disadvantages of this option include some color mismatch of the skin graft to the primary surgical site and the need for a second surgical site for the skin graft harvest.
A third option is placing tissue expanders, which are like small balloons, into the surrounding tissue to create “extra, new” skin. Advantages of this option include a better color match, as well as providing a viable surgical solution when neither serial excision nor full thickness skin grafting is not possible due to the nevus’s large size or lack of a skin graft donor site, respectively. However, during the expansion process tissue expansion can cause some disfigurement and necessitates either frequent office visits or caregiver education on the expansion technique. Multiple surgeries under general anesthesia would also be needed for this option.