doi: 10.18282/jsd.v2.i1.74 Copyright © 2017 Alkahtani MM, et al. This is an Open Access article distributed under the terms of the Creative Commons Attribution-Non Com- mercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/), permitting all non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. 46 CASE REPORT Giant congenital melanocytic nevus - Reconstruction using multiple modalities: A case report Mohammed Mesfer Alkahtani * , Loujin Asad, Arwa Sindi Department of Plastic, Reconstructive and Burns Surgery, King Abdulaziz Medical City, Jeddah, Saudi Arabia Abstract: Congenital melanocytic naevi are neuroectodermal lesions that are mainly composed of melanocytes. They are present in 1% to 6% of all newborns. These lesions carry the risk of transforming into melanomas; however, the psychological effect of such disfiguring naevi is potentially of greater concern to both the child and parent. Several classifications for congenital melanocytic naevi have been proposed, the most common of which is the sub-classification according to their size as this affects the choice of treatment. Many treatment modalities have been utilized including surgical excision followed by reconstruction, curettage, dermabrasion, laser therapy and chemical peels. In this report, we present a case of an otherwise healthy eight-year-old girl with a giant congenital melanocytic naevus on the central face. The lesion was mostly excised with remaining satellite lesions dermabraded. The defect was then reconstructed with a full thickness skin graft harvested from the expanded supraclavicular skin, in addition to the ReCell (non-cultured epithelial autograft) technique. Within six months post-operation, excellent skin pigmentation and texture was achieved. Keywords: Congenital facial naevi; ReCell; dermabrasion; tissue expander; melanoma Citation: Alkahtani MM, Asad L, Sindi A. Giant congenital melanocytic nevus-Reconstruction using multiple modali- ties: A case report. J Surg Dermatol 2017; 2(1): 46–49; http://dx.doi.org/10.18282/jsd. v2.i1.74. *Correspondence to: Mohammed Mesfer Alkahtani, King Abdulaziz Medical City, Jeddah, Saudi Arabia, drhababi@gmail.com. Received: 9 th September 2016; Accepted: 7 th December 2016; Published Online: 16 th January 2017 Introduction Congenital melanocytic naevi (CMN) are neu- ro-ectodermal lesions that are evident at birth. These lesions develop between the 5 th and 25 th weeks of gesta- tion. They are present in 1% to 6% of all newborns with an incidence of 1:20,000 [1,2] . Several classifications of congenital melanocytic naevi have been proposed in literature; the most common of which is the sub-classification according to their an- ticipated surface diameter in adulthood: small lesions are those less than 1.5 cm in diameter, medium lesions are 1.5 cm to 20 cm in diameter, and large lesions are more than 20 cm in diameter [3] . This has been modified to de- fine large lesions as those that are 11 cm to 20 cm in di- ameter, and naevi larger than 20 cm are considered as giant lesions [4] . As there is a risk of malignant degeneration associated with large and giant CMN (reported to reach up to 12 percent) [5,6] , it is common practice to completely excise such lesions. It is also thought that surgical excision may reduce the risk of malignant degeneration. However, this remains a topic of controversy throughout literature. There is no doubt that surgical excision must be taken into consideration, as such a disfigurement can be detri- mental to a child’s psychological development [3,7-10] . When considering surgical excision, the size and site of the naevus is of tremendous importance in determin- ing the plan of management [9,11] . This is a much complex task when an aesthetically important area such as the