Insight into evolution of a giant congenital nevomelanocytic nevus over 14 years

Abstract

Giant congenital nevomelanocytic nevus (GCNN) is a rare variant of congenital melanocytic nevus measuring >20 cm in size that often has a garment-like distribution. Regular follow up is recommended because of a risk of melanoma transformation of 4.6%. We report a 14-year-old boy with gradual regression of giant congenital melanocytic nevus over the left upper limb, chest, back and axilla, whom we have followed-up since birth. At birth, a hyperpigmented jet-black patch without hair was present over the left side of torso and upper limb including palms and nails. Follow up at the ages of 1, 5, 11 and 14 years showed progressive spontaneous regression of the nevus resulting in shiny atrophic skin, diffuse hypopigmentation, lentigo-like macules, nodules and arthrogryphosis of affected areas. Histopathology of the lesions on follow-up revealed absence of pigmented nevus cells in the regressing areas and thickened sclerotic collagen bundles.

Final congenital melanocytic naevi colour is determined by normal skin colour and unaltered by superficial removal techniques: a longitudinal study

“…This phenomenon could have major implications for cosmetic surgery decisions taken at or near birth. Spontaneous lightening should be distinguished from the very rare cases of actual regression of the naevus . It should also be noted that a small percentage of CMN are tardive, defined as appearing fully or partially after birth.…”

“…Spontaneous lightening should be distinguished from the very rare cases of actual regression of the naevus. [11][12][13][14][15][16][17][18][19][20][21][22] It should also be noted that a small percentage of CMN are tardive, defined as appearing fully or partially after birth. These are the only naevi in our experience that appear to darken after birth, although they are, in fact, only developing their full phenotype.…”

Case report and literature review: Genital leishmaniasis

“…The involvement of the genitals is rare, although there are previous reports of infection of the penis [3] , [4] , [5] , [6] , [7] , [8] , [9] . The ages of those so infected range from infancy to octogenarians [10] , [11] . Generally, though not always, these lesions in areas normally covered by clothing are associated with immunosuppression or attributed to hematogenous spread in the context of multiple cutaneous lesions.…”

Nevi – when to refer

“…(2) Evolution of nevus pigmentation and texture: such changes in CMN often correlate with the patient's Fitzpatrick skin type [15][16][17]. Lesions may become more or less speckled or change in texture or color.…”

“…Lesions may become more or less speckled or change in texture or color. On occasion, proliferative nodules may develop, which are benign growths within a CMN but pose a diagnostic difficulty both visually and histologically with MM [15][16][17]. (3) Pruritis and/or eczematous change: not always an ominous sign and the primary care physician (PCP) may consider treating before referring if there is a low suspicion of malignant transformation otherwise [15,18,19].…”