Saturday, June 18, 2011

Kissing Naevus of the Eyelids

A kissing naevus is a type of congenital compound naevus that affects equal portions of the upper and lower eyelid. Because of its extension to the lid margins, the edges of the tumour touch or ‘‘kiss’’ during closure of the lidsAlthough not cancerous, it can cause considerable cosmetic disfigurement to the patient. This woman has had this kissing naevus for life and was very conscious of it. Whenever she went out she cover her left eye with her hair. To remove the blemish, the skin bearing the naevus was excised and reconstructed using a combination of graft and flap as shown below.


Pre-operative appearace of the left kissing naevus.

Pre-operative appearace of the left kissing naevus.
 
The initial plane of closure was marked and the skin
infiltrated with lignocaine and adrenaline.

The kissing naevus was removed leaving a raw area that
 needs to be closed. The lower eyelid defect was closed by
sliding flaps after excising a triangular area of skin.

The triangular skin (arrowed) was kept to be used as skin graft.

The lower eyelid was closed by sliding the skin on
either side of the defect. The triangular skin was
fashioned to closed the remaining raw area.

The appearance of the eye at the completion of
reconstruction.

The appearance of the eye at one-day
post-operative.

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