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PATIENT STORY

A small congenital nevus (Figure 169-1) was noted on this 6-month-old child by his new family physician during a routine examination. The parents acknowledged that it was present from birth and asked if it needed to be removed. They were reassured that nothing needs to be done about it now.

FIGURE 169-1

Small congenital nevus found on the foot of a 6-month-old child. The parents were counseled that this nevus does not need to be excised for the prevention of melanoma. (Reproduced with permission from Richard P. Usatine, MD.)

INTRODUCTION

Congenital melanocytic nevi (CMN) are benign pigmented lesions that have a wide variation in presentation and are composed of melanocytes, the pigment-forming cells in the skin (Figures 169-1, 169-2, 169-3, 169-4, 169-5, 169-6, 169-7).

FIGURE 169-2

Congenital nevus on the breast of a 24-year-old woman. It is verrucous, but entirely benign. (Reproduced with permission from Richard P. Usatine, MD.)

FIGURE 169-3

A benign hairy congenital nevus on the upper buttocks of a 7-year-old boy. The parents requested a consult with plastic surgery to discuss removal. (Reproduced with permission from Richard P. Usatine, MD.)

FIGURE 169-4

A speckled congenital nevus (nevus spilus) on the back of a young woman. (Reproduced with permission from Richard P. Usatine, MD.)

FIGURE 169-5

Large bathing trunk nevus seen on the legs of this older child. (Reproduced with permission from Jack Resneck, Sr., MD.)

FIGURE 169-6

Infant born with large bathing trunk nevus covering most of the back and chest. (Reproduced with permission from Richard P. Usatine, MD.)

FIGURE 169-7

Giant congenital bathing trunk nevus surrounded by satellite nevi in a 7-year-old Hispanic boy. The patient was referred to plastic surgery so that his parents might consider a staged removal of this large nevus. (Reproduced with permission from Richard P. Usatine, MD.)

SYNONYMS

  • Garment nevus, bathing trunk nevus, giant hairy nevus, giant pigmented nevus, pigmented hairy nevus, nevus pigmentosus, nevus pigmentosus et pilosus, and Tierfell nevus.1

  • Tardive congenital nevus refers to a nevus that has similar features to congenital nevi, but appears at age 1 to 2 years.

EPIDEMIOLOGY

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