Controversial issues in congenital nevi

Abstract

Congenital melanocytic nevi are very common lesions that nevertheless pose many controversial questions. A systematic review of the literature suggests that the risk of developing melanoma on giant congenital melanocytic nevi (GCMN) is lower than previously thought given that, in the most recent series of GCMN, only 2% of patients developed melanoma and most did so before the age of 5 years. Therefore, prophylactic surgery should be considered on an individual basis according to the degree of clinical suspicion of melanoma and the esthetic and functional consequences. In extensive reviews of series of biopsies of melanoma, small congenital melanocytic nevi have been associated with 7% to 8% of cases. Many authors believe that these might represent a significant risk of malignant conversion from 10 years onwards and so recommend regular control visits during infancy and prophylactic exeresis in puberty.