Melanocytic nevus natural history

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Editors-In-Chief: Martin I. Newman, M.D., FACS, Cleveland Clinic Florida, [1]; Associate Editor(s)-in-Chief: Qurrat-ul-ain Abid, M.D.[2]; Michel C. Samson, M.D., FRCSC, FACS [3]


Vast majority of moles are benign. Nonetheless, the National (U.S.) Cancer Institute reported 59,940 new cases of melanoma by June, 2007, with 8,110 deaths.[1]

Natural history of melanocytic nevi

Natural history of congenital melanocytic nevi

  • CMN grows as the child grows, with an approximate increase in size from infancy to adulthood in different regions of the body as follows:[2][3][4]
    • Head – 1.7-fold
    • Trunk and upper extremities – 2.8-fold
    • Lower extremities – 3.3-fold
  • CMN grows more quickly in early infancy.
  • In addition to changes in size, CMN may change in appearance.
  • Over the course f time CMN may change from flat, evenly pigmented patches to raised moles with a pebbly appearance, verrucous, or cerebriform surface, color may change from tan to darker, lighter, mottled, or uneven pigmentation.

Natural history of acquired melanocytic nevi

  • Common acquired melanocytic nevi start appearing within the first six months of life.[5][6]
  • Common acquired melanocytic nevi begin to appear after the first six months of life, increase in number during childhood and adolescence, reach a peak count in the third decade, and then slowly regress with age.
  • They may increase in number in childhood and adolescence, attaining maximum number in the third decade, and then slowly regress with age.[6][7]
  • Although a change in the appearance of nevus may raise suspicion for melanoma in adults, the ormal natural history of nevi in children and adolescents may include enlargement and elevation of nevi.[8]


Experts say that vast majority of moles are benign. Nonetheless, the National (U.S.) Cancer Institute reported 59,940 new cases of melanoma by June, 2007, with 8,110 deaths.[9]


  2. Marghoob AA, Schoenbach SP, Kopf AW, Orlow SJ, Nossa R, Bart RS (February 1996). "Large congenital melanocytic nevi and the risk for the development of malignant melanoma. A prospective study". Arch Dermatol. 132 (2): 170–5. PMID 8629825.
  3. Rhodes AR, Albert LS, Weinstock MA (January 1996). "Congenital nevomelanocytic nevi: proportionate area expansion during infancy and early childhood". J. Am. Acad. Dermatol. 34 (1): 51–62. PMID 8543695.
  4. Ruiz-Maldonado R, Tamayo L, Laterza AM, Durán C (June 1992). "Giant pigmented nevi: clinical, histopathologic, and therapeutic considerations". J. Pediatr. 120 (6): 906–11. PMID 1593350.
  5. Luther H, Altmeyer P, Garbe C, Ellwanger U, Jahn S, Hoffmann K, Segerling M (December 1996). "Increase of melanocytic nevus counts in children during 5 years of follow-up and analysis of associated factors". Arch Dermatol. 132 (12): 1473–8. PMID 8961877.
  6. 6.0 6.1 Siskind V, Darlington S, Green L, Green A (March 2002). "Evolution of melanocytic nevi on the faces and necks of adolescents: a 4 y longitudinal study". J. Invest. Dermatol. 118 (3): 500–4. doi:10.1046/j.0022-202x.2001.01685.x. PMID 11874490.
  7. Scope A, Dusza SW, Marghoob AA, Satagopan JM, Braga Casagrande Tavoloni J, Psaty EL, Weinstock MA, Oliveria SA, Bishop M, Geller AC, Halpern AC (August 2011). "Clinical and dermoscopic stability and volatility of melanocytic nevi in a population-based cohort of children in Framingham school system". J. Invest. Dermatol. 131 (8): 1615–21. doi:10.1038/jid.2011.107. PMC 3136658. PMID 21562569.
  8. Scope A, Marchetti MA, Marghoob AA, Dusza SW, Geller AC, Satagopan JM, Weinstock MA, Berwick M, Halpern AC (October 2016). "The study of nevi in children: Principles learned and implications for melanoma diagnosis". J. Am. Acad. Dermatol. 75 (4): 813–823. doi:10.1016/j.jaad.2016.03.027. PMC 5030195. PMID 27320410.

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