Congenital Melanocytic Nevus: An Unusual Presentation

Life Sciences -Pathology

Authors

  • Dr. Ketki Wajpeyi Junior Resident, Department of Pathology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Sawangi (M), Wardha, Maharashtra. https://orcid.org/0000-0003-0691-0825
  • Dr. Kishor Hiwale Professor, Department of Pathology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Sawangi (M), Wardha, Maharashtra.
  • Dr. Anil Reddy Junior Resident, Department of Surgery, Acharya Vinoba Bhave Rural Hospital, Datta Meghe Institute of Higher Education and Research, Sawangi (M), Wardha, Maharashtra.

DOI:

https://doi.org/10.22376/ijlpr.2023.13.4.L113-L117

Keywords:

Hairy cell nevus, junctional nevus, skin grafting, nevus, congenital nevus.

Abstract

The overgrowth of melanocytes produces congenital melanocytic nevus. They are commonly present since birth, and the common terms used to describe them are called 'bathing trunk,' 'coat-sleeve,' or 'stocking naevi,' and they are usually found over thighs and back. The giant congenital nevus of size larger than twenty centimeters is highly pigmented and usually hairy. It is more commonly found in females compared to males. It is well recognized that the lesion's displeasing nature might have psychological and social ramifications, negatively affecting the patient's self-esteem, particularly females. Although congenital melanocytic nevus is mostly clinically diagnosed, the histological investigation is required to confirm the diagnosis and rule out malignant changes. The likelihood of transforming the giant nevus to malignant melanoma accounts for approximately five percent; fifty percent of melanomas develop before age two, and eighty percent develop before age seven. The risk of transformation to malignant melanoma is early in giant melanocytic nevus cases and adolescence in small and medium-sized nevi cases. Other complications like transformation to neurocutaneous melanosis consisting of the spread of melanoma to the central nervous system and leptomeninges are also dreadful. Hence, early removal is recommended. Here, we have reported a rare case of a six-year-old patient with a medium-sized nevus on their face with hairy tufts in between. On biopsy, the diagnosis was made as a junctional nevus. After which, the patient was managed with subsequent lesion excision and split skin grafting with an uneventful postoperative period. Our case report aims to report a rare case of congenital melanocytic nevus and to determine the importance of timely diagnosis and intervention. Keywords: , , , ,

References

Walton RG, Jacobs AH, Cox AJ. Pigmented lesions in newborn infants. Br J Dermatol. 1976;95(4):389-96. doi: 10.1111/j.1365-2133.1976.tb00840.x. PMID 974024.

Mackie RM. In: Champion RH, Burton JL, Ebling FJG, editors. Rooks textbook of dermatology. 5th ed. Oxford: Blackwell Scientific Publications; 1993. Melanocytic nevi and malignant melanoma. p. 1525-60.

Arons MS. Management of giant congenital nevi. Plast Reconstr Surg. 2002;110(1):352-53. doi: 10.1097/00006534-200207000-00079, PMID 12087290.

In CW A. Dermatology Moschello SL, Pillshuy DM, HJ, editors. Philadelphia: WB Saunders Company; 1978. Tumors skin; pp. 1323-407.

Imchen S, Ghosh S, Dayal S, Marwah N, Jindal N, Sangal S. Giant congenital melanocytic nevus with developmental dysplasia of the bilateral hip: A rare association. Indian J Dermatol. 2013;58(6):475-7. doi: 10.4103/0019-5154.119963, PMID 24249902.

Krengel S, Hauschild A, Schäfer T. Melanoma risk in congenital melanocytic naevi: a systematic review. Br J Dermatol. 2006;155(1):1-8. doi: 10.1111/j.1365-2133.2006.07218.x, PMID 16792745.

Viana ACL, Gontijo B, Bittencourt FV. Giant congenital melanocytic nevus. A Bras Dermatol. 2013;88(6):863-78. doi: 10.1590/abd1806-4841.20132233, PMID 24474093.

Kopf AW, Bart RS, Hennessey P. Congenital endocytic nevi and malignant melanomas. J Am Acad Dermatol. 1979;1(2):123-30. doi: 10.1016/s0190-9622(79)70009-0, PMID 391836.

Kinsler VA, Birley J, Atherton DJ. Great Ormond Street Hospital for Children Registry for congenital melanocytic naevi: prospective study 1988-2007. Part 1-epidemiology, phenotype, and outcomes. Br J Dermatol. 2009;160(1):143-50. doi: 10.1111/j.1365-2133.2008.08849.x, PMID 18811688.

Khashashneh I, Shatnawi M, Tawalbeh A, Alhaji MRM. Giant congenital hairy nevus on the scalp. Sudan J Med Sci. 2008;3:343-7.

Kaplan EN. The risk of malignancy in large congenital nevi. Plast Reconstr Surg. 1974;53(4):421-8. doi: 10.1097/00006534-197404000-00007, PMID 4815697.

Angelucci D, Natali PG, Amerio PL, Ramenghi M, Musiani P. Rapid perinatal growth mimicking malignant transformation in a giant congenital melanocytic nevus. Hum Pathol. 1991;22(3):297-301. doi: 10.1016/0046-8177(91)90165-l, PMID 2004752.

Krengel S, Hauschild A, Schäfer T. Melanoma risk in congenital melanocytic naevi: a systematic review. Br J Dermatol. 2006;155(1):1-8. doi: 10.1111/j.1365-2133.2006.07218.x, PMID 16792745.

Roh MR, Eliades P, Gupta S, Tsao H. Genetics of melanocytic nevi. Pigment Cell Melanoma Res. 2015;28(6):661-72. doi: 10.1111/pcmr.12412, PMID 26300491.

Charbel C, Fontaine RH, Malouf GG, Picard A, Kadlub N, El-Murr N, et al. NRAS mutation is the sole recurrent somatic mutation in large congenital melanocytic nevi. J Invest Dermatol. 2014;134(4):1067-74. doi: 10.1038/jid.2013.429, PMID 24129063.

Mancianti ML, Clark WH, Hayes FA, Herlyn M. Malignant melanoma simulants arising in congenital melanocytic nevi do not show experimental evidence for a malignant phenotype. Am J Pathol. 1990;136(4):817-29. PMID 2327470.

Koot HM, de Waard-van der Spek F, Peer CD, Mulder PG, Oranje AP. Psychosocial sequelae in 29 children with giant congenital melanocytic naevi. Clin Exp Dermatol. 2000;25(8):589-93. doi: 10.1046/j.1365-2230.2000.00712.x, PMID 11167967.

Gowda VK, Basude A, Srinivas SM, Bhat M. Giant melanocytic nevi with neurocutaneous melanosis masquerading as neurofibromas. J Pediatr Neurosci. 2016;11(3):258-60. doi: 10.4103/1817-1745.193357, PMID 27857802.

Newton Bishop JA. Chapter 54. Lentigos, melanocytic naevi, and melanoma. In: Burns T, Breathnach S, Cox N, Griffiths C, editors. Rook's textbook of dermatology. 8th ed. Oxford: Blackwell Publishing Science; 2010. p. 1-57.

Price HN. Congenital melanocytic nevi: update in genetics and management. Curr Opin Pediatr. 2016;28(4):476-82. doi: 10.1097/MOP.0000000000000384, PMID 27307047.

Published

2023-07-01

How to Cite

Wajpeyi, D. K. ., Hiwale, D. K. ., & Reddy, D. A. . (2023). Congenital Melanocytic Nevus: An Unusual Presentation: Life Sciences -Pathology. International Journal of Life Science and Pharma Research, 13(4), L113-L117. https://doi.org/10.22376/ijlpr.2023.13.4.L113-L117

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Section

Case Study