Choroidal nevus is one of the most common benign melanocytic tumor. The prevalence rate of choroidal nevi is 0.15% - 10.00%, which is high among whites and low among colored people, and is obvious higher in male than that in female. Secondary changes in the surrounding retina of the benign tumor, such as subretinal fluid and choroidal neovascularization, may result in vision loss. This benign tumor carries risks for transformation into malignant melanoma. The factors predictive of transformation into melanoma included greater thickness, subretinal fluid, visual symptoms, orange lipofuscin pigment, tumor location (tumor margin near optic disc), ultrasonography hollowness and absence of halo. Early identification of the related features which impair visual acuity is important for early treatment and better prognosis, and it is especially important to monitor the tendency of malignant transformation. Optical coherence tomography (OCT) could provide detailed information which aid in diagnosing, differentiating and monitoring of choroidal nevi. OCT and optical coherence tomography angiography are emerging as excellent techniques to investigate choroidal melanocytic lesions. The treatment modalities, such as laser photocoagulation, photodynamic therapy and intravitreal anti-vascular endothelium growth factor, have been proved to be effective for choroidal nevi with secondary changes. In the future, the relevant researches should be imposed to provide more detailed information in order to explore the nature and characteristics of this disease.
【摘要】 目的 总结皮肤扩张器用于巨痣整形的护理措施。 方法 2008年4月-2009年11月对28例皮肤扩张器置入治疗巨痣整形的护理措施进行总结和分析，重点加强了心理护理、健康教育及注水期间的护理。 结果 术后患者皮肤色泽正常，外观满意出院。随诊1年，效果佳。 结论 加强心理护理，有针对性的健康教育，重视注水期间护理措施的实施，对皮肤扩张器置入术用于巨痣整形患者至关重要。【Abstract】Objective To summarize the nursing interventions of skin expander plasty of giant nevus. Methods From April 2008 to November 2009, 28 cases of giant nevus were admitted for skin expander surgery.The nursing interventions，especially the mental nursing, health education and nursing care during the infusion period were summarized and analyzed. Results The results were satisfactory including the color and the appearance by one-year follow-up. Conclusion It is important to emphasize the mental nursing, health education and nursing care during the infusion period for the patient undergoing giant nevus plasty treated with skin expander.
Objective To observe the effectiveness of skin graft combined with thorax wire fastening for repairing postoperative coloboma after resection of chest back giant nevus. Methods Between June 2007 and October 2010, 17 cases of chest back giant nevus were treated. There were 7 males and 10 females, aged from 3 years and 6 months to 15 years(mean, 8 years). The size of giant nevus was 20 cm × 12 cm to 60 cm × 50 cm. Two cases of them were ever treated by laser, while the others were never treated. The check before operation showed ulcer of the skin and effusion in 2 cases, hard skin in 3 cases, hair growth in 7 cases, and normal in 5 cases. Five cases had serious itch. After giant nevus was cut off, thorax wire was fastened to reduce the wound area, and then the intermediate spl it thickness skin graft of thigh was used to repair the wound. Comprehensive anti-scar treatment was given postoperatively. Results The wound size was (2 110.74 ± 725.69) cm2 after resection of giant nevus, and was (1 624.94 ± 560.57) cm2 after thorax wire fastening, showing significant difference (t=9.006, P=0.001). All the grafting skin survived; the incision and wound at donor site healed by first intention. The patients were followed up 6 months to 2 years (mean, 13 months). No scar prol iferation or contracture occurred. The skin color and elasticity were similar to the normal skin; the nipple, navel, and other local apparatus were not shifted after operation. Conclusion It can reduce donor site of skin and postoperative scar, and achieve satisfactory appearance to cover the wound by skin graft combined with thorax wire fastening after chest back giant nevus was cut off .
ObjectiveTo investigate the effectiveness of modified kite flap in repair of soft tissue defect after divided nevus of lateral canthus excision.MethodsBetween October 2010 and April 2018, 20 children (20 eyes) with divided nevus of lateral canthus were admitted. There were 13 boys and 7 girls, with an average age of 7.9 years (mean, 4-14 years). There were 11 cases of moderate range lesions (maximum diameter, 1.5-2.0 cm) and 9 cases of small range lesions (maximum diameter, <1.5 cm). After excising the divided nevus of lateral canthus, the area of soft tissue defect ranged from 0.72 to 3.23 cm2. The modified kite flap was used to reconstruct the structure and shape of lateral canthus.ResultsThere were 16 cases of mixed nevus and 4 cases of intradermal nevus. The flaps survived and the incisions healed by the first intention. The patients were followed up 12-22 months (mean, 13.6 months). There was no malformation, valgus, exposure keratitis, or obvious scar. No malignant transformation occurred or nevus recurred during follow-up. At last follow-up, the effectiveness was rated as excellent in 16 cases, good in 3 cases, and poor in 1 case.ConclusionThe modified kite flap can repair the soft tissue defect after excising the divided nevus of lateral canthus, and obtain the good appearance and function of lateral canthus.