“Fried Egg” Nevus That Resembles a Melanoma

A 32-year-old woman complains that an asymptomatic mole on her back looks alarming to her spouse. There is neither a personal nor family history of melanoma, and remainder of her cutaneous examination is unremarkable.

Key point: There are some nevi with odd-appearing morphologies but well-recognized benign courses. One of those is the so-called fried egg nevus, as depicted in this case. No treatment is indicated, especially if removal will result in substantial scar formation.

Treatment: Reassurance was given. Since the lesion was located near the shoulder, a notorious site for scarring following excision, the patient opted for observation.

Note: Eccentric placement of a dark spot in an otherwise bland-appearing nevus is reason for concern, biopsy, or removal. The “fried egg” morphology is invoked only when the dark spot is at or very nearly dead center, much like a “sunny-side up” cooked egg.