Treatment of Congenital lid Nevus

About the disease

Congenital lid nevus, also known as kissing nevus, is a growth on the eyelid, which is usually present when the child is born. It is characterized by a large nevus (a mole or raised birthmark) on or around the eye. In most cases, this condition develops where the upper and lower eyelids connect. Congenital lid nevus is rare and was first described at the beginning of the 20th century.

The size of the nevus depends on each individual case. The color of the nevus also varies from light to dark brown, depending on the patient’s skin type. In rare cases, it can start to grow once the child is already born. In general, congenital lid nevus grows very slowly and will eventually stop growing by itself.

It is believed that congenital lid nevus forms during the fetal development period (6-24 weeks), when the baby’s eyelids first appear, fuse together and then separate. This is why the eye often appears to be covered by one large nevus when the eye is closed. The condition develops in melanoblasts (the precursor to melanocytes, which produce melonin in skin). This could be due to a genetic predisposition or gene mutation.

Congenital lid nevus does not affect the child’s ability to see and they will still be able to close their eyes properly. Nonetheless, this condition is a cosmetic defect and many people may wish to have it removed.

Symptoms

• Nevus on the eyelid, which can be present at birth or appear later
• The nevus grows very slowly and stops growing on its own, sooner or later.
• The child’s ability to see is usually unaffected.

Diagnosis

• A diagnosis of congenital lid nevus is usually made by a pediatrician during a general examination at the time of the child’s birth.
• Parents may also notice a nevus growing on their child’s eyelid that was not there when the baby was born.

Treatment

• Surgical resection of congenital lid nevus is the most effective way of removing congenital lid nevus.
• Doctors advise that surgery be performed early in the child’s life, in order to prevent problems, such as occlusion or malignancy, in the future.
• A full thickness excision is performed in most cases, in order to remove all nevus cells from the deeper layers of the skin and to prevent congenital lid nevus from growing back. This is followed by a skin graft, which may leave minimal scarring. 

Authors: Dr. Nadezhda Ivanisova, Dr. Farrukh Ahmed