Risk of melanoma in medium-sized congenital melanocytic nevi: a follow-up study.
BACKGROUND
The risk of the occurrence of malignant melanoma (MM) in medium-sized (1.5 to 19.9 cm in diameter) congenital melanocytic nevi (CMN) is the subject of controversy. Universally accepted recommendations regarding the management of such lesions have not been made.


OBJECTIVE
Our purpose was to assess the risk of MM arising in medium-sized CMN.


METHODS
The study included 230 medium-sized CMN in 227 patients, first seen in a private dermatology practice from 1955 to 1996, who were followed up for MM arising within their CMNs. Criteria for entry into the study included (1) a clinically diagnosed medium-sized CMN, (2) minimum follow-up period of 1 year, and (3) a photograph of the lesion in the patient's medical record.


RESULTS
No MM occurred in a medium-sized CMN during an average follow-up of 6.7 years (median, 5.8 years) to an average age of 25.5 years (median, 19.1 years).


CONCLUSIONS
The results of this short-term follow-up study do not support the view that there is a clinically significantly increased risk for MM arising in banal-appearing medium-sized CMN or that prophylactic excision of all such lesions is mandatory. Lifelong medical observation seems a reasonable alternative for many medium-sized CMN.
Sahin
S
S
Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, USA.
Levin
L
L
Kopf
A W
AW
Rao
B K
BK
Triola
M
M
Koenig
K
K
Huang
C
C
Bart
R
R
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008545:Melanoma / Q000453:epidemiology*; D008875:Middle Aged; D009508:Nevus, Pigmented / Q000151:congenital* / Q000453:epidemiology; D018570:Risk Assessment; D012878:Skin Neoplasms / Q000151:congenital / Q000453:epidemiology*; D013997:Time Factors