One stage reconstruction of the upper eyelid after excision of an extensive blue nevus—case report

Excerpt

Congenital melanocytic nevi of the eyelid and periorbital region are unusual. Although the risk of malignant transformation of congenital melanocytic nevi is not quantified in the literature, large sized ones are regarded as premalignant conditions having a melanoma risk between 0% and 42%. Thus, many authors suggest complete resection when possible [1]. Besides the melanoma risk, there are concomitant symptoms and a profound psychological impact. The patients then seek consultation for aesthetic improvement. Concomitant symptoms are epiphora, ptosis, visual field impairment, ectropion, entropion and chronic corneal irritation or secondary corneal abrasion. Epiphora develops when the medial canthal area with the lacrimal puncti involved or when the eyelids are pushed away from the cornea [2]. Large masses lead to ptosis and visual field impairment of the upper lid and to ectropion or entropion at the lower lid. Entropion or ciliary growth disturbances can cause chronic corneal irritation. Because this can lead to secondary corneal abrasion, it demands urgent treatment [3]. …