The Successful Treatment of Eyelid Intradermal Melanocytic Nevi (Nevus of Miescher)With the Dual-Wavelengths Copper Vapor Laser

Introduction: Surgical methods for removing eyelid nevus are associated with a risk of developing such side effects as scarring or loss of eyelashes. Although current laser modalities have shown promising results, eyelid laser surgery may cause skin discoloration and noticeable scarring. This study aims at evaluating the efficacy and safety of the dual-wavelengths copper vapor laser (CVL) treatment of eyelid intradermal nevus of Miescher (NM). Patients and Methods: We present three adult female patients with eyelid intradermal nevus treated with CVL. CVL settings were as follows: the average power of 0.6-0.8 W, under a power ratio of 3:2 at wavelengths of 511 nm and 578 nm, exposure time of 0.3 seconds, the light spot diameter of 1 mm. Results: The dual-wavelength CVL treatment of medium- and large-sized NM provides the complete removal of eyelid dome-like NM after one and two sessions with a month interval correspondingly. The duration of skin healing accounted for two weeks. Conclusion: The complete removal of eyelid NM lesions without side effects demonstrates the safety and efficacy of dual-wavelengths CVL in treating such skin lesions. This laser treatment mode of benign skin neoplasms seems promising for dermatologists and cosmetologists’ clinical practice.

A rare cutis verticis gyrata secondary to cerebriform intradermal nevus: case report and literature review

Background Cutis verticis gyrate (CVG) is a rare morphologic syndrome that presents with hypertrophy and folding of the scalp. CVG can be classified into three forms: primary essential, primary non-essential, and secondary. Cerebriform intradermal nevus (CIN) is a rare cause of secondary CVG. We are here to report a rare case of CVG with an underlying CIN and discuss the clinical course, treatment options, and critical screening guidelines for these patients. Case presentation A 25 year-old male patient presented with a chief complaint of generalized hair loss in the scalp parietaloccipital region for a duration of 1 year and the hair loss area was occasionally accompanied by mild itching. The hair loss started gradually and worsened over time. In addition, he had scalp skin folds resembling the ridge and furrow of the cerebral cortex in the parietaloccipital region since birth. Physical examination revealed hypertrophy and formation of folds in the parietal-occipital area, forming 5 to 6 furrows and ridges. The size of the cerebriform mass was about 12.0 cm × 8.5 cm, without other skin lesions. Diffuse non-scarring hair loss was distributed on the posterior-parietal scalp, mid-parietal scalp and superior-occipital scalp. The diseased tissue of the patient's parietaloccipital area was excised under general anesthesia. The postoperative pathological examination of the tissue excised showed that there were dense intradermal melanocytic nevus, so the patient was diagnosed with secondary CVG caused by CIN. At the 2 year follow-up, there were no obvious changes in the lesions. Conclusions CIN must be differentiated from other conditions that manifest as CVG, including primary essential or non-essential CVG and secondary CVG caused by other reasons. Each CIN patient requires a specific decision of whether to excise the lesion surgically or follow a wait-and-see policy, depending on the patient's will and specific condition. Surgical treatment may be performed when there is an aesthetic demand. However, clinical observation and close follow-up is also a good treatment choice for patients with stable disease or mild symptoms.

Cerebriform intradermal nevus presenting as cutis verticis gyrata: A rarity

Cutis verticis gyrata (CVG) is a rare skin disorder characterized by cerebriform appearance of the scalp with convoluted folds and deep furrows. Cerebriform intradermal nevus (CIDN) is one of the rare causes of CVG. We report a case of CIDN presenting as CVG on the left parietal area of scalp since birth in a 15-year-old girl. She had no neurological or ophthalmologic manifestations or any other cutaneous lesions.

Giant Congenital Blue Nevus Presenting as Cutis Verticis Gyrata: A Case Report and Review of the Literature

Objectives: Cerebriform intradermal nevus and giant congenital blue nevi are rarely reported melanocytic nevi with clinical and histopathologic similarities. Both are known to produce cutis verticis gyrata. We report a significantly large occipital scalp congenital blue nevus with secondary cutis verticis gyrata. The aim of this report is to increase clinical awareness of this entity, highlight histopathologic and mutational features of cerebriform intradermal nevi and giant congenital blue nevi, and stress the importance of clinicopathologic correlation for diagnosis. Methods: Case report and review of the literature. Results: A 20-year-old Asian male presented with a long-standing, large (20 cm × 30 cm), exophytic tumor at the occipital scalp and posterior neck. The skin overlying the lesion was arranged in thick folds resembling the surface of the brain, devoid of hair follicles, and discolored by salt-and-pepper pattern hyperpigmentation. After correlating the clinical and histopathologic findings, we diagnosed giant congenital blue nevus with secondary cutis verticis gyrata. Staged surgical excision was performed with subsequent treatment for hypertrophic scarring and occipital alopecia. Conclusions: Cerebriform intradermal nevus and giant congenital blue nevus have overlapping histologic and clinical features. Head and neck surgeons should be aware that nomenclature of these tumors is subjective and often imprecise. Diagnosis requires correlation of clinical findings, patient history, and histopathology. Surgical excision is advised due to rare malignant transformation potential.

Scalp expansion for giant cutis verticis gyrata secondary to cerebriform intradermal nevus

Cutis verticis gyrata (CVG) is characterized by extensive formation of scalp skin that mirrors the folds of the cerebral gyri. Giant CVG secondary to cerebriform intradermal nevus (CIN) has been rarely reported, and its management mainly involves surgical excision. In certain cases of giant CVG, however, surgical excision is dilemmatic. This case report describes a giant CVG secondary to CIN that was successfully managed with scalp expansion and surgical excision. Previously published studies are also reviewed.

Pitfalls in the diagnosis of lentigo maligna and lentigo maligna melanoma, facts and an opinion

Lentigo maligna/lentigo maligna melanoma (LM/LMM) affects chronically sun-damaged skin of the head and neck with a slow radial growth phase. It is characterised by predominantly lentiginous proliferation of small, but atypical melanocytes with occasional upward scatter in an atrophic epidermis. It is not uncommon for pathologists to receive partial or scouting biopsies to assess for LM. This makes the interpretation of symmetry and circumscription of the lesions challenging. Therefore, both cytologic and architectural criteria should be taken into consideration to render an accurate diagnosis of melanoma. Moreover, pathologists should be vigilant to avoid missing invasion, as this can change the treatment plan and prognosis. Herein, we aim to discuss important pitfalls in the diagnosis of LMM and its invasive component. Some of these caveats are differentiating between true invasion versus adnexal involvement by the in situ component or an incidental intradermal nevus, detection of microinvasion and multifocal invasion, and recognition of desmoplastic/spindle cell melanoma component.

Cutis Verticis Gyrata Secondary to Cerebriform Intradermal Naevus: A rare entity and its Management

Cutis verticis gyrata (CVG) is a rare skin disorder characterised by thick skin folds and grooves, resembling the gyri and sulci of the cerebral cortex. It can be classified as primary essential, primary non-essential and secondary CVG. The rarity of the condition poses a challenge in the diagnosis and ultimately requires good communication between the clinician and the dermatopathologist for diagnosis. Many names have been given to the condition, including Robert-Unna syndrome, cutis verticis plicata, paquidemia verticis gyrata, cutis sulcata, cutis striata or “bulldog” scalp syndrome. To date, the treatment is still limited to plastic surgeons with excision of the folds, scalp reduction and reconstruction. In this article, we are sharing a rare case and the surgical management of a middle age gentleman with cutis verticis gyrata secondary to cerebral intradermal nevus (CIN) over his occipital scalp.