Congenital melanocytic naevi (CMN) are present at birth in between 1 and 6% of all neonates. They are caused by malformations of the neuroectoderm that are comprised of melanocytes and occasionally neural elements, following dysregulated growth and arrest of melanocytes during migration from the neural crest to the skin. Most commonly they are sub-classified according to size. They are at risk of malignant transformation, but the psychological impact of prominent CMN's is arguably of greater potential concern to the parent and child. Treatment modalities to date have included complete surgical excision with defect reconstruction, as well as less invasive methods such as dermabrasion, curretage, chemical peels and laser therapy. We present an illustrated case of a healthy, term, 4 week-old male neonate with a large CMN on his face. The lesion was dermabraded, and non-cultured epithelial autograft harvested from the right post-auricular area was applied. Dressings were no longer required by the 8th post-operative day, and excellent skin pigmentation and texture was achieved by 5 months post-op.
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