Nevi are pigmented lesions (colored “birthmarks,” “moles”) that may be congenital (present at birth) or acquired (appearing some time after birth). There are many different types of nevi, and nevi may occur anywhere from head to toe.
Does the nevus cause my child any pain?
Usually nevi are not painful. However, some nevi may become ulcerated or irritated, causing discomfort. These nevi are typically removed surgically.
What are the different types of nevi?
As noted above, there are many different types of nevi. They may be congenital or acquired. Certain types of nevi are more commonly treated with surgical biopsy or excision. These include the giant congenital nevi (“giant hairy nevi”) and the nevus sebaceous of Jadassohn. There is an increased risk of melanoma forming within a giant congenital nevus, although this risk is still small. There is about a 10-15% risk of basal cell skin cancer occurring in the nevus sebaceous after puberty; therefore, excision of these nevi is recommended before that time.
Who gets nevi?
Nevi can occur in any child. There are some inherited conditions in which nevi are present. Also, nevi are associated with sun exposure.
What causes nevi?
Nevi are caused by an overgrowth of specific types of skin cells. As noted above, heredity and sun exposure can play a role in the formation of nevi.
What are the main issues related to nevi?
The primary issue with a nevus is whether or not it will become a skin cancer of some sort. Most nevi are not worrisome at all and will never cause a problem. However, other types of nevi are more concerning, such as the giant congenital nevus and nevus sebaceous of Jadassohn mentioned above. While a plastic surgeon or dermatologist can usually be quite confident about whether or not a particular nevus is concerning, the definitive diagnosis can only be determined after the nevus is excised and sent to a pathologist for study.
Are there other problems that occur commonly with nevi?
Nevi on the face or large nevi on other parts of the body can be unsightly and be a source of psychosocial stress for the child.
When giant congenital nevi occur on the head or over the spine, there is a small risk of neurocutaneous melanosis, or involvement of the central nervous system (brain and spinal cord) with melanoma or melanoma precursors. In addition, giant congenital nevi that involve the full circumference of an arm or leg can sometimes restrict the growth of the affected limb.
What is the treatment for babies and children with nevi?
Nevi can be observed with regular examinations or surgically excised. For small nevi, such surgical treatment can be done as a minor outpatient procedure. Giant congenital nevi may require multiple complex surgical procedures for excision, depending upon the size and location of the nevus. If surgery is appropriate, your surgeon will design a surgical treatment plan specifically for your child after discussing all of the options with you.