Optimization of curative techniques with laser light in congenital giant pigmented nevi in children

Abstract

BACKGROUND: Congenital giant pigmented nevi (CGPN) occur in 1:20 000 to 1:500 000 newborns. They are small (1.5 to 5 sq. cm), medium (5 to 50 sq. cm) and a truly gigantic (more than 50 sq. cm) types of pigmented nevi. CGPN create a psychological problem in children, due to aesthetic discomfort. Various techniques for their removal are not always effective and may cause complications: relapse (6–41%), skin scarring (6%), malignancy is possible in adults (10%). The question of CGPN effective removal remains open. This stimulates search for the optimization of applied curative options; and one of the ways is to use laser light for CGPN removal in children. Previously, individual researchers used infrared radiation (λ 10.6 microns) generated by pulsed periodic CO₂ laser for this purpose; some experimental work on "blue" (λ 0.45) light generated by diode laser was done too. Experimental studies on the skin of laboratory animals could define features of exposure and promising modes of these types of laser radiation for surgical application in CGPN removal.

AIM: To improve outcomes of treatment of various CGPN forms in children with optimized laser techniques.

METHODS: The CGPN removal was done with "blue" laser light (λ 0.45 micron) using Lasermed 10-03 device manufactured by Russian Engineering Club LLC (Tula) and laser light (λ 10.6 microns) generated by pulsed periodic CO₂ laser device ALDAN (manufacturer IOF RAS, Moscow, Russia). 35 children with various CGPN forms were treated in the Clinical and Research Institute of Emergency Pediatric Surgery and Trauma. Among them: 18 patients with a small form, 11 children with an average form, and 6 with a true gigantic form. Children’s age ranged from 6 to 18 years. In 13 children, CGPN located on the face, in 6 — on the anterior surface of the chest, in 8 — on the lower and upper extremities, in 4 — on the abdominal wall and in 4 — on the back.

RESULTS: The final good clinical and aesthetic outcome was registered in 29 children with small and medium CGPN forms. In 6 patients with true gigantic forms, good clinical and satisfactory aesthetic results were registered preliminary, at the treatment stage. No unsatisfactory results were seen.

CONCLUSION: Our experience with optimized techniques using mentioned types of laser light for the removal of various CGPN forms in children has confirmed their clinical and aesthetic effectiveness and outlined the prospect of their application in pediatric surgery.

Keywords

congenital giant pigmented nevus / "blue" laser radiation with a wavelength of 0.45 microns / infrared radiation with a wavelength of 10.6 microns / pulsed periodic CO2 laser / clinical study

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[39] Patent RUS № 2820879/ 14.07.2023. Gorbatova NE, Podurar SA, Platonova AD, et al. Method for Treating Congenital Giant Pigmented Nevi (CGPN) in Children. Available from: https://i.moscow/patents/ru2820879c1_20240611

[40] Патент РФ на изобретение № 2820879/ 14.07.2023. Горбатова Н.Е., Подурар С.А., Платонова А.Д., и др. Способ лечения врождённых гигантских пигментных невусов (ВГПН) у детей. Режим доступа: https://i.moscow/patents/ru2820879c1_20240611

RIGHTS & PERMISSIONS

Podurar S.A., Gorbatova N.E., Bryantsev A.V., Duvansky V.A., Tertychnyy A.S., Varev G.A., Nikiforov S.M., Simanovsky Y.O.