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Melanocytic Nevi in Children May Change Over Time

It may be possible to avoid surgical excision in some children

WEDNESDAY, April 26 (HealthDay News) -- Unlike in adults, melanocytic nevi with eccentric foci of hyperpigmentation, or the "Bolognia sign," may change morphologically over time in children, according to a case report in the April issue of the Archives of Dermatology. In some cases, it may be possible to avoid surgical excision of the nevus, the report suggests.

Maria A. Pizzichetta, M.D., from the National Cancer Institute in Aviano, Italy, and colleagues described the case of a 5-year-old girl with a 4-mm brown papule on her upper right arm. The lesion had an eccentric focus of hyperpigmentation that consisted of a blue-gray area associated with irregular brown-black globules or dots.

After 39 months of follow-up with dermoscopy, the lesion underwent morphological changes and an acquired melanocytic nevus was detectable that appeared to be benign clinically and dermoscopically, according to the report. Five other melanocytic nevi developed on the patient, and the nevi had similar characteristics. Two were consistent with a compound type of acquired melanocytic nevus with eccentric foci of hyperpigmentation.

"Dermoscopy allows identification of a morphologic pathway of modifications, probably typical for this type of melanocytic nevus in children, and therefore enables avoidance of surgical excision with attendant hypertrophic scarring in children," Pizzichetta and colleagues conclude. "Conversely, in adults, when dermoscopic follow-up of melanocytic nevi reveals eccentric foci of hyperpigmentation, surgical excision of the lesion is indicated."

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