Surgical management of pediatric facial Congenital Melanocytic Naevi and use of the novel Patient-Reported Outcome Measure: SCAR-Q to assess outcomes.

Abstract

Congenital Melanocytic Naevi (CMN) are benign proliferations of melanocytes present at birth or shortly thereafter. Surgical management is primarily driven by cosmetic and psychosocial considerations, particularly for facial lesions. This study represents the first application of the SCAR-Q Patient-Reported Outcome Measure (PROMs) to assess the outcomes of excision and reconstruction in patients with facial CMN. Over a 10-year period, 71 patients were included, with 28 (39%) completing the SCAR-Q and Patient & Observer Scar Assessment Scale (POSAS) questionnaires. The mean age at surgery was 6.25 years and mean age at data collection was 15 years. Surgical procedures varied and included excision with primary closure, serial excision, skin grafting, and tissue expansion. Overall, patients expressed high satisfaction with the cosmetic outcomes and minimal psychological impact from scarring. However, no statistically significant correlations were found between gender, lesion location, or surgical technique and PROMs scores. The SCAR-Q is a validated tool that provides a comprehensive assessment of scar appearance, symptoms, and psychosocial impact and should be considered in future evaluations of surgical outcomes for CMN.