Secondary reconstruction of a giant congenital lentiginous dermal nevus with serial, large-volume tissue expansion

Giant congenital pigmented nevi pose a substantial reconstructive challenge for the treating physician. Due to the increased risk of malignant transfo rmation in such lesions, complete excision with tissue expansion or skin gr afting is the generally accepted treatment. These modalities can, however, leave the patient with secondary deformities that also require complex reco nstructive procedures. The following case details a patient requiring secon dary reconstruction with large-volume tissue expansion 12 years after excis ion of a giant nevus, and split-thickness skin grafting. This patient illus trates a severe secondary deformity and the usefulness of large-volume seri al expansion in such patients.