Dermatologic surgery in children: an update on indication, anesthesia, analgesia and potential perioperative complications

Dermatologic surgery in children: an update on indication, anesthesia, analgesia and potential... IntroductionDermatologic surgery in infants and children is becoming more frequent, mainly because skin lesions increase in size proportionally with age and skin growth, leading to considerably larger excision wounds; their early removal therefore leads to very good cosmetic results due to increased skin elasticity and excellent tissue regeneration . The most frequently excised lesions in children are congenital and sebaceous nevi, Spitz nevi, acquired melanocytic nevi and dermoid or epidermal cysts . Pediatricians and dermatologists should be aware of the indications for surgery or laser therapy in infants as well as the optimal timing of these procedures (Table ).Summary of the most common skin lesions that require surgery or laser therapy in childhoodDermatologic conditionsRisk of malignancy developmentTherapeutic approachCongenital nevi– giant congenital nevi: (> 20 cm) 2 % risk of melanoma development; (> 60 cm) 12 % risk– highest risk of melanoma development during childhood – clinical monitoring of congenital melanocytic nevi– excisional biopsy of new nodules within the nevus– monitoring of central nervous system involvement– small/medium congenital nevi: step‐excision, tissue expanders, flaps, skin grafting– large congenital nevi: dermabrasion, curettageSpitz nevi– benign melanocytic neoplasms in children, sharing histologic features with melanoma; difficult diagnosis– complete excision with 5 mm margins regardless of age Nevus sebaceus– benign hamartoma showing http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Journal Der Deutschen Dermatologischen Gesellschaft Wiley

Dermatologic surgery in children: an update on indication, anesthesia, analgesia and potential perioperative complications

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Publisher
Wiley Subscription Services, Inc., A Wiley Company
Copyright
© 2018 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd.
ISSN
1610-0379
eISSN
1610-0387
D.O.I.
10.1111/ddg.13451
Publisher site
See Article on Publisher Site

Abstract

IntroductionDermatologic surgery in infants and children is becoming more frequent, mainly because skin lesions increase in size proportionally with age and skin growth, leading to considerably larger excision wounds; their early removal therefore leads to very good cosmetic results due to increased skin elasticity and excellent tissue regeneration . The most frequently excised lesions in children are congenital and sebaceous nevi, Spitz nevi, acquired melanocytic nevi and dermoid or epidermal cysts . Pediatricians and dermatologists should be aware of the indications for surgery or laser therapy in infants as well as the optimal timing of these procedures (Table ).Summary of the most common skin lesions that require surgery or laser therapy in childhoodDermatologic conditionsRisk of malignancy developmentTherapeutic approachCongenital nevi– giant congenital nevi: (> 20 cm) 2 % risk of melanoma development; (> 60 cm) 12 % risk– highest risk of melanoma development during childhood – clinical monitoring of congenital melanocytic nevi– excisional biopsy of new nodules within the nevus– monitoring of central nervous system involvement– small/medium congenital nevi: step‐excision, tissue expanders, flaps, skin grafting– large congenital nevi: dermabrasion, curettageSpitz nevi– benign melanocytic neoplasms in children, sharing histologic features with melanoma; difficult diagnosis– complete excision with 5 mm margins regardless of age Nevus sebaceus– benign hamartoma showing

Journal

Journal Der Deutschen Dermatologischen GesellschaftWiley

Published: Jan 1, 2018

References

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