title: Dermoscopic evolution of a congenital combined nevus in childhood.
abstract: BACKGROUND
  A combined nevus most commonly consists of a blue nevus in combination with a Clark or Spitz nevus. Dermoscopically, combined nevus can mimic melanoma owing to the presence of dermoscopic features common to both types of lesions. Benign clinical and dermoscopic changes can occur in nevi over time, especially in children and young adults.
  
  
  OBJECTIVE
  To describe the dermoscopic evolution of a congenital combined nevus showing unusual dermoscopic features.
  
  
  METHODS
  Digital dermoscopic analysis was performed at the initial visit and after 8 months. The lesion was surgically excised and histopathologically examined.
  
  
  RESULTS
  An asymptomatic plaque with a central blue area and peripheral brown pigmentation located on the back of a 13-year-old boy was diagnosed dermoscopically as combined nevus. Dermoscopic analysis 8 months later showed color changes from steel blue to gray-blue and black in the central area of the lesion, an increased number of blue-black dots or globules, and peripheral irregular streaks. Histopathology revealed typical features of a congenital combined nevus (blue nevus + compound nevus).
  
  
  CONCLUSIONS
  Over time, congenital combined nevus may show clinical and dermoscopic changes in size, color, and structure. Surgical excision is recommended when clinical and dermoscopic features are equivocal and the diagnosis of melanoma cannot be ruled out.
authors.affiliation: Department of Dermatology, University of L'Aquila, L'Aquila, Italy.
authors.forename: Angela
authors.initials: A
authors.lastname: Ferrari
authors.forename: Gian Piero
authors.initials: GP
authors.lastname: Lozzi
authors.forename: Maria Concetta
authors.initials: MC
authors.lastname: Fargnoli
authors.forename: Ketty
authors.initials: K
authors.lastname: Peris
mesh_terms: D000293:Adolescent; D001415:Back; D046169:Dermoscopy; D003937:Diagnosis, Differential; D006801:Humans; D008297:Male; D008545:Melanoma / Q000175:diagnosis; D018329:Nevus, Blue / Q000151:congenital / Q000175:diagnosis* / Q000601:surgery; D012878:Skin Neoplasms / Q000151:congenital / Q000175:diagnosis* / Q000601:surgery