Congenital melanocytic nevi
Congenital melanocytic nevi are present in 1% of newborns.
Unlike cafe-au-lait macules, these lesions are raised.
Clinically they range from small bland melanocytic nevi to large hairy bathing trunk nevi, to large hamartomatous lesions. The large, often exophytic hamartomatous lesions may show evidence of multiple malignant appearing processes in the neonate.
The giant congenital nevus has an estimated lifetime risk of melanoma of 6%. Risk of smaller lesions has not been well defined.
- There is, at present, no consensus on the management of congenital nevi.
- Extremely atypical hamartomatous lesions should probably be excised during the first year of life.
- Others should be removed, if possible, or followed for potential malignant change.