A 2-Month-Old Boy with a Pigment Lesion on the Scalp

Abstract

Congenital melanocytic nevi are melanocytic nevi that have their onset at birth or during the first 2 years of life. They are relatively common with an incidence among newborns ranging between 0.2% and 6% (Zayour and Lazova R, Clin Lab Med 31:267–280, 2011). There is a female predominance. Congenital melanocytic nevi initially present as pigmented macules or slightly raised oval papules or plaques. They usually darken over time and become raised or verrucous. Congenital melanocytic can display a wide variety of colors ranging from light brown to black. Hypertrichosis is commonly observed. Congenital melanocytic nevi usually grows proportionally with the child. They are classified according to their estimated adult size as small (<1.5 cm), medium (1.5–20 cm), large or giant (>20 cm) (Navarro-Fernandez and Mahabal, Congenital nevus, 2020). Giant nevi occasionally show satellite smaller lesions. Congenital melanocytic nevi may be associated with melanocyte proliferation in the central nervous system. Large lesions have a higher risk of melanoma development. Congenital melanocytic nevi are usually diagnosed based on the clinical appearance. Dermoscopy or punch biopsy for histopathological examination may be used in cases of diagnostic doubt. Treatment options may be divided into surgical and non-surgical. Non-surgical therapeutic options include dermal abrasion, chemical peels, cryotherapy, electrosurgery, and ablative lasers.