Abstract

Volume.124 Number.2

Original article : Case report

Eyelid Reconstruction with a Skin Graft from Eyelid after Excision of Divided Nevus
Mami Kawamura1,2, Miwa Aikawa1,2, Tomoyuki Kashima1,2
1 Oculofacial Clinic Tokyo
2 Shinmaebashi Kashima Oculoplastic Clinic

Background: The divided nevus across the upper and lower eyelids is congenital melanocytic abnormality that occurs during the fetal eyelid development stage, where the eyelids must be fused. This dermatological abnormality, which covers a wide area ranging from the upper and lower eyelid margins to the eyelid skin, may cause facial disfiguration or eyelid dysfunction. To treat the patients with these impairments, excision over a wide area of lesion is needed, which in turn, requires eyelid reconstruction with skin grafts or skin flaps. We report a case of eyelid reconstruction with an excised skin for dog ear correction after excision of the divided nevus.
Case: A 14-year-old woman presented with divided nevus of the right eye since birth. The nevus covered the area from the upper and lower eyelid margins to the eye skin. The nevus was 1×1.2 cm and 1×0.8 cm in size on the upper and lower eyelids, respectively. The nevus was excised along the lid margin keeping the root of eyelashes. The skin was excised in a spindle shape along the skin secant line for dog ear correction. The excised skin was grafted to the main skin defect, and the lid margin was exposed. At month 3 after the surgery, successful engraftment was confirmed with no deformity and dysfunction of eyelids. The texture and color of the graft well matched to the surrounding skin.
Conclusions: Skin defects formed by the excision of eyelid tumor can be reconstructed using remote skin grafts and skin flaps; however, skin grafts from eyelids provide the best texture and color matching. Reconstruction with eyelid skin after the excision of the divided nevus showed good results in terms of facial appearance and function, although the applicable tumor diameter was limited.
Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc) 124: 70-76, 2020.

Key words
Divided nevus, Skin graft, Eyelid skin, Texture, Color matching
Reprint requests to
Mami Kawamura, M. D. Oculofacial Clinic Tokyo. 8F, Ginza1-chome Bldg, 1-15-4 Ginza, Chuo-ku, Tokyo 104-0061, Japan