Clinical Resolution of a Neonatally Eroded Giant Congenital Melanocytic Nevus

Gass, Julia; Grant, J. W.; Hall, Per; Atherton, D.J.; Burrows, Nigel

doi:10.1111/j.1525-1470.2006.00311.x

Cited by 11 publications

(14 citation statements)

References 15 publications

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“…7,14,89 Some authors observed an initial tendency to darkening of the lesions through adolescence, followed by a significant lightening, associated to an increase in surface roughness, appearance of nodules and hypertrichosis 24,46,90 Generally, lesions tend to become thicker over time. 17,44-46 The appearance of nodules in the nevus usually corresponds to the proliferation of neuroid tissue elements.…”

Section: Evolutionmentioning

confidence: 99%

Giant congenital melanocytic nevus

Viana

Gontijo

Bittencourt

2013

An. Bras. Dermatol.

135

164

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Giant congenital melanocytic nevus is usually defined as a melanocytic lesion present at birth that will reach a diameter ≥ 20 cm in adulthood. Its incidence is estimated in <1:20,000 newborns. Despite its rarity, this lesion is important because it may associate with severe complications such as malignant melanoma, affect the central nervous system (neurocutaneous melanosis), and have major psychosocial impact on the patient and his family due to its unsightly appearance. Giant congenital melanocytic nevus generally presents as a brown lesion, with flat or mammilated surface, well-demarcated borders and hypertrichosis. Congenital melanocytic nevus is primarily a clinical diagnosis. However, congenital nevi are histologically distinguished from acquired nevi mainly by their larger size, the spread of the nevus cells to the deep layers of the skin and by their more varied architecture and morphology. Although giant congenital melanocytic nevus is recognized as a risk factor for the development of melanoma, the precise magnitude of this risk is still controversial. The estimated lifetime risk of developing melanoma varies from 5 to 10%. On account of these uncertainties and the size of the lesions, the management of giant congenital melanocytic nevus needs individualization. Treatment may include surgical and non-surgical procedures, psychological intervention and/or clinical follow-up, with special attention to changes in color, texture or on the surface of the lesion. The only absolute indication for surgery in giant congenital melanocytic nevus is the development of a malignant neoplasm on the lesion.

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Section: Evolutionmentioning

confidence: 99%

Giant congenital melanocytic nevus

Viana

Gontijo

Bittencourt

2013

An. Bras. Dermatol.

135

164

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“…[4] Halo phenomenon may be due to loss of melanin synthesis and/or apoptosis of melanocytes. [1,2] Loss of melanin synthesis may be a more plausible explanation as the number of dermal nevus cells may not reduce much, they rather become amelanotic. [2] The induction of host immune response could actually become a therapeutic option in congenital melanocytic nevi.…”

Section: Discussionmentioning

confidence: 98%

“…[1,2] Loss of melanin synthesis may be a more plausible explanation as the number of dermal nevus cells may not reduce much, they rather become amelanotic. [2] The induction of host immune response could actually become a therapeutic option in congenital melanocytic nevi. [6] Spontaneously resolving CMN with leukoderma and vitiligo-like depigmentation at a distant site as was noted in our case was a rare occurrence.…”

Section: Discussionmentioning

confidence: 98%

“…[1] There are, however, few reports of melanocytic nevi, including some giant nevi, which have involuted without an associated halo or vitiligo. [1,2] Ulceration in congenital melanocytic nevus (CMN) in the neonatal period has also been reported to be associated with almost complete pigmentary regression in early childhood. [2] We hereby report a rare case of spontaneous regression in a CMN which was also associated with depigmentation in the lesion, and discuss the histopathology and immunohistochemistry study of biopsy specimens taken from different sites of the regressing lesion.…”

Section: Nevus Introductionmentioning

confidence: 98%

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Spontaneous regression of a congenital melanocytic nevus

Nath¹,

Thappa²,

Ganesh³

2011

Indian J Dermatol Venereol Leprol

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Congenital melanocytic nevus (CMN) may rarely regress which may also be associated with a halo or vitiligo. We describe a 10-year-old girl who presented with CMN on the left leg since birth, which recently started to regress spontaneously with associated depigmentation in the lesion and at a distant site. Dermoscopy performed at different sites of the regressing lesion demonstrated loss of epidermal pigments first followed by loss of dermal pigments. Histopathology and Masson-Fontana stain demonstrated lymphocytic infiltration and loss of pigment production in the regressing area. Immunohistochemistry staining (S100 and HMB-45), however, showed that nevus cells were present in the regressing areas.

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“…Persistence of nevus cells was described in a case of involution of a neonatal eroded giant CMN with desmoplastic reaction (Fig. 27.9a-c ) [ 46 ]. CMN rarely affect the scalp in the form of a giant cerebriform nevus; the skin is thrown into folds resembling the undulation of the cortical surface of the brain [ 30 ].…”

Section: Clinical Presentationmentioning

confidence: 99%

Congenital Melanocytic Nevi

Boente¹

2015

Pediatric Skin of Color

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Pigmentary nevi are the most common skin neoplasm found in humans with an incidence of 3 % in whites and 16 % in black infants at birth. The incidence of melanocytic nevi increases throughout infancy and adulthood, as well as at puberty, during pregnancy and with hormonal therapy. Congenital melanocytic nevi (CMN) are defi ned as neural crest derived benign nevomelanocytic proliferations that are present at birth or in the few weeks of life. They are genetically determined and persist throughout life. Prevalence of CMN is 1-2.4 % of newborns; African and Japanese decent have higher incidence than Hispanics or whites and the incidence is 1:500,000. Prevalence of CMN is 1-2.4 % of newborns; African and Japanese decent have a higher incidence than Hispanics or whites and the incidence is 1:500,000. A new classifi cation for determining risks of adverse events in CMN includes the following criteria: satellite nevus count, anatomic localization, color heterogeneity, surface, rugosity, hypertrichosis, and dermal or subcutaneous nodules. They are more frequent on the trunk and extremities, brown-black in color, with small nodules and coarse hair, with a regular smooth and well demarcated border. Satellite melanocytic nevi are common. Proliferative nodules may appear within the nevus, which usually represent benign neurotization of the lesion.By dermatoscopy, the main pattern seen in congenital nevi is the so-called cobblestone pattern, constituted of large, angulated globules, resembling cobblestones. Excision of CMN before the development of malignant melanoma (MM) should be considered to reduce the chances of malignant melanoma development and cosmetic reasons, although it is technically diffi cult, and complete removal is often impossible.

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Clinical Resolution of a Neonatally Eroded Giant Congenital Melanocytic Nevus

Cited by 11 publications

References 15 publications

Giant congenital melanocytic nevus

Giant congenital melanocytic nevus

Spontaneous regression of a congenital melanocytic nevus

Congenital Melanocytic Nevi

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