Discussion
GCMN is a large hyperpigmented lesions commonly present since birth, these patches are trend to malignant transformation in the first 3 to 5 years of patients’ life 5,6. The GCMN is occurred 1 in 20000 to 1 in 50000 births 2. Due to its tendency to the malignant transformation, increased risk of neurological abnormalities and cosmetic reasons the timely treatment is essential7,8. Laser therapy, Skin grafting, the curettage of the nevus tissue in newborns, and the cultured epidermal autograft (CEA) are reported for GCMN treatment 7.The treatment options mostly recommended in the early ages of the patients9.
To our knowledge, there is no published data from the Ministry of Public Health (MoPH) of Afghanistan on the prevalence of the CMN in the country. Less knowledge of the people, limited access of rural residents to health settings, and poverty let the patients to delay in their visit to the central clinics. Meanwhile for those who present their illness it’s difficult to accept the clinicians’ prescriptions particularly who need to cost and surgery 10. In the reality the primary indication for such giant nevus, with high-risk phenotypical features, large size and axial location and multiple satellite lesions of the trunk, the serial excision of the lesion was recommended but unfortunately the patient was lost to follow up.