A giant epidermal nevus of the face treated with a CO2 and dye laser combination: a case report and literature review

Epidermal nevi (EN) are cutaneous hamartomas present at birth, usually occurs in the trunk, the face, or the limbs, appearing as a patch of overgrowing skin. They may be small and localized, but they may interest extensive areas of the body. A 20 years old man came to our attention for an EN interesting all the face. The treatment protocol consisted of a session of CO2 laser in order to vaporize thicker areas, followed by a session of dye laser on the area to prevent scarring. This treatment was performed under local anesthesia and sedation in three surgical sessions spaced 3 months from each other. Two sessions of dye laser spaced apart 6 months were performed during follow-up to further improve the esthetic outcome. The patient was followed for 2 years with no recurrence. Although surgery is still considered the gold standard in EN management, it is not always feasible. This novel combination technique can obtain optimal cosmetic results with no relapse within the period of follow up. Although further trials on a more significant number of patients are required, the combination of CO2 and dye laser promises to become a valid therapeutic alternative when treating giant EN of the face.