Congenital agminated melanocytic nevus - case report
A nine-year-old male patient, phototype V, student, was referred to the dermatology\nclinic for evaluation of multiple pigmented lesions on his left thigh. He was\naccompanied by his father, who informed that the child had had a cluster of melanocytic\nlesions since birth. The cluster increased in size following the growth of the patient\nand the minor lesions became somewhat closer together over the years. The family\nbackground of skin cancer was negative. The father has a history of congenital nevi on\nthe face and left lumbar region. The patient presented epilepsy and was in treatment\nwith carbamazepine, imipramine and risperidone.\nOn physical examination, the patient had a cluster of approximately 20 maculopapular,\nlightly palpable blackened lesions of different sizes on the anterior part of his left\nthigh, forming a cluster of nevi ( and\n). The diameter of the total lesion was 9.2cm\nx 7.6cm. The largest isolated lesion measured 2.6 cm x 1.3cm. Dermoscopy revealed\npredominantly homogeneous pattern with diffuse brownish areas, regular network at the\nperiphery and numerous regularly distributed small dots (). No background pigmentation was noted on clinical or dermoscopic\nexamination between lesions.\nA single lesion was excised for histological evaluation with a 2 mm border of normal\nskin. The histopathological findings revealed an intradermal melanocytic nevus without\nhistological melanocytic hyperplasia or hyperpigmentation in clinically normal\nperipheral skin ( and ).\nConsidering the clinical and histopathological diagnosis of the lesion and treatment\nlimitations due to the size of the total lesion, it was decided to keep dermoscopic\nmonitoring of the patient every 4 months. It has enhanced to the family the importance\nof sun protection and guidance for the observation of changes such as modification of\ncolor, palpation (such as nodularity), shape and rapid growth.