Benign Congenital Nevus

An 8-year-old boy presented with a solitary, nearly circular, asymptomatic pigmented lesion of the right anterior temple. His mother asserted that the lesion was both enlarging and becoming darker with time. There was no family history of melanoma.

Key point: The lesion, although dark, was relatively uniform in color and smooth in outline. Examination of the lesion with a dermatoscope did not disclose any features suggestive of malignancy.

Treatment: Despite the examination results, because of the history of recent change and the anxiety level of the patient’s parents, the lesion was excised with narrow (2 mm) margins. Histology disclosed a benign congenital nevus.

Note: Melanoma in pre-adolescent children is extremely rare, but not totally unknown. Therefore, family history and lesional factors must be taken into account when making therapeutic decisions.