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CORRESPONDENCE COLUMN |
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| Year : 2006 | Volume
: 51
| Issue : 2 | Page : 153 |
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| Melanocytic nevi in children: A clinical study |
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Kalyan Banerjee
Asansol, West-Bengal, 120 Apcar Gardens, Asansol WB, India
Correspondence Address:
Kalyan Banerjee
Asansol, West-Bengal, 120 Apcar Gardens, Asansol WB
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/0019-5154.26946
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How to cite this article:
Banerjee K. Melanocytic nevi in children: A clinical study. Indian J Dermatol 2006;51:153 |
Melanocytic Nevi are challenging propositions for the clinician, diagnostically as well as therapeutically. The potential for malignant changes remains a cause for concern together with the chance occurrence of systemic anomalies like neurocutaneuos melanosis and spinal dysraphism. The diagnosis of malignant transformation and melanoma in the pediatric age group,though rare, is often very difficult with debatable histological changes in similar lesions like that of the Spitz nevi. The study of melanocytic nevi in children in JIPMER provides an excellent review of these challenging clinical conditions including their incidence pattern.[1] Role of parental assistance and examination are very important in clinical assessment and further follow -up. Digital photography and dermoscopic images of the area with the nevi is vital for diagnosis and further assessment.[2]
History of headache, irritability, lethargy, photophobia, recurrent vomiting, loss of developmental milestones, seizures, disproportionate growth of head circumference and focal neurologic signs are potential markers for neurocutaneous melanosis which should not be ignored and often may require scanning for confirmation of diagnosis. Large congenital melanocytic nevi on the head, neck and posterial central axis and satellitosis having greater than 3 small congenital nevi without a concomitant large congenital melanocytic nevus are good clinical markers that distinguish children who are most likely to develop neuro cutaneous melanosis.[3]
In cases where we encounter a Spitz nevi and melanocytic tumours of uncertain malignant potential (MELTUMPs), among all the diagnostic procedures, a sentinel lymph node biopsy should be considered specially in the pediatric subject. Experience of the London School of Hygiene and New York University of Pigmented Lesion Group has revealed that the risk of malignant transformation in medium sized congenital melanocytic nevus is low similar to that of the small congenital melanocytic nevi. Melanoma, although a rare pediatric malignancy, comprises 1-3% of all pediatric cancers.[4] At birth, focal or multifocal lesions may frighten the parents and the clinician alike. They are mostly benign proliferative nodules which heal continuously with conservative care.
An increase in patient registries, long term follow-up and multi disciplinary collaborations will slowly unfurl the mystery of complex clinical problems surrounding the melanocytic nevi.
 References | |  |
| 1. | Senthikumar M, Thappa DM. Melanocytic nevi in children. A clinical study. Indian J Dermatol 2006;51:26-9.  |
| 2. | LaVigne EA, Oliveria SA, Dusza SW, Geller AC, Halpern AC, Marghoob AA. Clinical and Dermoscopic Changes in Common Melanocytic Nevi in School Children: The Framingham School Nevus Study. Dermatology 2005;211:234-9. [PUBMED] [FULLTEXT] |
| 3. | Kadonaga JN, Frieden IJ. Neurocutaneous melanosis: Definition and review on the literature. J Am Acad Dermatol 1991;24:747-55. [PUBMED] |
| 4. | Kopf AW, Bart RS, Hennessey P. Congenital nevocytic nevi and malignant melanomas. J Am Acad Dermatol 1979;1:123-30. [PUBMED] |
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