# Proposed treatment options for combined nevi: report of two cases using combination therapy involving surgical excision and laser therapy

## TL;DR

This paper presents a treatment flowchart for combined nevi using surgical excision and laser therapy, based on two successful case studies.

## Contribution

The paper proposes a new treatment flowchart for combined nevi based on histopathological structure and blue nevus background.

## Key findings

- Combination therapy of excision and laser treatment was effective in two cases without complications.
- The proposed flowchart helps select appropriate treatment based on nevus structure.
- No recurrence was observed in the treated cases.

## Abstract

Combined nevi are defined as the presence of 2 or more melanocytic cell groups within one lesion. They now refer to all cases of combinations of benign melanocytic nevus, including nevus cell nevi, Spitz nevi, and other melanocytic tumors, as well as blue nevi. In previous reports, treatment options for combined nevus primarily include surgical excision, laser therapy, cryotherapy, and combination therapy. However, there are no established guidelines for selecting the most appropriate treatment. A treatment for a combined nevus should be selected based on the histopathological structure of the combined nevus. On the other hand, laser therapy for combined nevi affects only blue nevus with melanocytosis and nevus spilus. Considering this background, we devise a treatment flowchart for a combined nevus against a blue nevus background. And we adapted this flowchart to two cases of combined nevus and underwent a combination therapy of excision and laser treatment, and neither case appeared to have any complications(e.g., postoperative hyperpigmentation, ectropion) and didn’t recur. The combination therapy of surgical excision and laser treatment is one of the best treatments for combined nevus, considering the cosmetic aspect. We propose a treatment selection flowchart for combined nevus against a blue nevus background.