Dermoscopy for Congenital Melanocytic Nevi

A practical review of dermoscopy for pediatric dermatology part I: Melanocytic growths

The value of dermoscopy in the detection of skin cancer is well established. Less is published on the utility of dermoscopy in the evaluation of pediatric skin disease. Our review (in two parts) aims to serve as an update on pediatric dermoscopy and to provide readers with a practical application for the use of dermoscopy in pediatric dermatology clinics. In part I, we propose a dermoscopy algorithm for pediatric skin disease and melanocytic growths, and in part II, we address vascular growths, common skin infections, and inflammatory conditions for which dermoscopy is valuable.

Unusual clinical presentation of regression in a congenital melanocytic nevus

BACKGROUND

Regression of congenital melanocytic nevi is usually accompanied by the halo phenomenon and is considered a rare event.

OBJECTIVE

A 15-year-old woman presented for the evaluation of multiple halo nevi. She had on her trunk a figure-of-eight pigmentary lesion, which had been developed after the coalescence of two distinct congenital melanocytic nevi. Close to the indentation between the two portions of the lesion, there was an achromic rounded area, extending from the perinevic skin to the nevus, causing its partial regression.

METHODS AND MATERIALS

Dermoscopic examination disclosed a globular and homogeneous pattern, which was irregularly present at the edge of the achromic area. The histopathologic diagnosis was compound congenital melanocytic nevus with an eccentric area of regression.

CONCLUSIONS

In our case, the presence of a regression area in the surrounding skin and the association with multiple halo nevi suggest a similarity with halo phenomenon, despite the atypical "halo," which was discontinuous and eccentric.

Dermoscopy of an acral congenital melanocytic nevus

Congenital melanocytic nevi carry a risk for malignant transformation into melanoma, therefore early detection of suspicious features is crucial to reduce mortality rates. Dermoscopy improves the early detection of melanoma while reducing the number of unnecessary excisions of benign pigmented skin lesions. Dermoscopically, congenital melanocytic nevi are often characterized by the presence of a cobblestone pattern, but to date, little is known about the dermoscopic features of acral congenital melanocytic nevi. We report an acral congenital melanocytic nevus typified by the presence of three different dermoscopic patterns that are commonly seen in acquired melanocytic nevi of palms and soles.