Divided naevus of the eyelid, seven cases
ABSTRACT Divided naevus of the upper and lower lids is an infrequent congenital naevus of the human eyelids. It is also known as kissing naevus or split ocular naevus. The histological types of divided naevi may be melanocytic, cellular or compound. Until now about 30 such cases have been reported in the literature. In our clinic, in the last 20 years we have seen seven patients with divided naevus, four female and three male. Three patients, two children of 10 and 11 years and a 77-year-old nun, did not accept any treatment. The remaining four patients, three female and one male, accepted surgical treatment. None of them had received any treatment in the past. Three of these divided naevi were cellular and one was melanocytic. Treatment included a two stage reconstruction in three cases and a single stage procedure in one case. The lower eyelid was usually treated first, and upper eyelid full thickness grafts were mostly used. Lid shortening was common, particularly in the cellular naevi. The results were aesthetically and functionally good. No major complications were observed.
[Show abstract] [Hide abstract]
ABSTRACT: To describe a method for staged partial resection of congenital divided eyelid nevus. The rationale, technique, and outcomes for this approach are described. Retrospective chart review of a case series. Clinical records of 12 patients with divided eyelid nevus were reviewed with attention to presenting features, surgical management, histopathology, and follow-up course. Surgical approach involved the use of bipolar and thermal cautery to ablate the eyelid margin component, skin excision for cutaneous lesions, and then repair with advancement flaps or skin grafting. Eight patients with divided nevus were treated with a staged surgical approach: 5 primarily and 3 as revision cases. Average age was 16.3 years at primary presentation (range, 2-36 years), 16.5 years at initial surgery (range 2-36 years), and 36.0 years at presentation for revision (range, 12-72 years). Primary patients required 1 (n = 3) or 2 (n = 2) surgeries. Revision patients required 2 (n = 1) or 3 (n = 2) procedures in addition to those they had already undergone. Anterior lamellar repair was by granulation (n = 2), local skin flaps (n = 3), or skin grafts (n = 3). Average follow-up was 21.6 months (range, 0-98 months). No adverse effects or malignant transformations were seen. Patients with divided eyelid nevi often present for surgical management because of cosmetic and functional concerns. Because small-to-medium congenital nevi have a low risk of malignant transformation, total excision may not be necessary. A staged surgical approach with cautery ablation and contouring of the eyelid margin component and surgical resection of the anterior lamellar portion may be a reasonable treatment strategy for these patients.American Journal of Ophthalmology 07/2013; DOI:10.1016/j.ajo.2013.05.032 · 4.02 Impact Factor
Dermatologic Surgery 07/2013; 40(1). DOI:10.1111/dsu.12289 · 1.56 Impact Factor
[Show abstract] [Hide abstract]
ABSTRACT: Congenital panda nevus or the divided nevus of the eyelids is a rare form of melanocytic nevus involving both upper and lower eyelids with the risk of future malignant transformation along with the patients' complaints about the cosmetic appearance. Delicate anatomic features of the eyelids and the limited skin re-dundancy of the periorbital region make the surgical removal and reconstruction difficult, even in mild cases with partial involvement of the eyelids. A case of congenital panda nevus involving upper and lower eyelids, the eyebrow, and part of the malar eminence and the nasal dorsum is presented. A multistaged surgical management of the lesion with staged excision and reconstruction with preexpanded forehead flaps, temporal island flap, and skin grafts is discussed. Key Words: Panda nevus, divided nevus of the eyelid, eyebrow, forehead flaps, tissue expander (J Craniofac Surg 2012;23: 00Y00) C ongenital panda nevus is a rare form of melanocytic nevus in-volving both upper and lower eyelids. It has been first described by Fuchs in 1919 1 and called it ''divided nevus of the eyelids.'' Until now, about 40 such cases have been reported in the literature. 2 This condition is also known as kissing nevus or split ocular nevus 3 owing to its distinctive periorbital pigmentation pattern. 4 The rarely encountered complications of the lesion are ectropion, epiphora, ptosis, or amblyopia. 3,5 Although the most important risk is the possible malignant change of the lesion, 6 the main complaint of the patients is usually the aesthetic appearance. Surgical excision of the lesion is the only rational treatment modality. The delicate anatomic features of the eyelids and the limited skin redundancy of the periorbital region, especially in children and young adults make the surgical removal and reconstruction difficult. 7