Great Ormond Street Hospital surgeon operates on huge birthmark in Colombia

Viewers of Channel 4’s Body Shock programme Turtle Boy last night saw Great Ormond Street Hospital plastic surgeon, Mr Neil Bulstrode, travel to Colombia to help remove a huge birthmark from a six-year-old boy, Didier.Didier was born with an extreme case of congenital melanocytic nevus (CMN). His birthmark was so big it amassed to approximately 40 per cent of his body weight.

Two doctors from Great Ormond Street Hospital, Clinician Dr Veronica Kinsler and Plastic Surgeon Mr Neil Bulstrode, are experts in diagnosing and managing this rare type of birthmark and featured in the documentary as leading players in the field.
Dr Veronica Kinsler said: "CMN are moles that are present at birth. They can vary in size and number and the incidence of larger or multiple lesions is approximately 1 in 20,000 new births per year. 
"We think there are likely to be around 3,000 severely affected individuals at the moment in the UK, with lots more who are mildly affected.
"When babies are born, their parents can get understandably very worried until they know what the marks are. In the weekly clinics we run we are able to give a diagnosis, check that the moles themselves are safe and whether the skin appearance is telling us what other things might need to be checked.
"In around 25 per cent of patients with severe CMN, there may be related neurological problems. We therefore regularly check children's development to see whether there are any neurological signs and carry out an MRI scan of the brain to see if there are any abnormalities." 
Some patients choose to have surgery to remove some of the more prominent or impacting birthmarks, often when the CMN are on the face, and surgeon Neil Bulstrode carries out between 30 and 40 removals each year. 
Mr Neil Bulstrode explains: "The majority of patients do not have surgery, because they do not need to be removed for medical reasons, and removing them leaves scars. Sometimes the CMN lighten spontaneously so they become less noticable, so we often advise patients and their families to wait and see what happens naturally.
"On the other hand, with Didier, the boy featured in the Channel 4 documentary, the case for removing the birthmark was incredibly strong. It was so bulky and widespread it was significantly impacting upon his quality of life. Being able to take my extensive experience of birthmark removals at Great Ormond Street Hospital over to Colombia and join the local team in Bogota was amazing. 
"It was complex surgery, involving the removal of the birthmark in its entirety and then carrying out a complicated series of skin drafts over several stages. It’s fantastic that Didier is now back home in his village and doing well."
If a member of your family has CMN, you could contact the support group Caring Matters Now www.caringmattersnow.co.uk. This is a support group for families set up by families, many of whom are Great Ormond Street Hospital patients.