Congenital Nevi in Infants: Should They Be Treated? - Dermatology

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Congenital nevi, or congenital moles, are pigmented lesions present at birth. They can vary in size, shape, and color, and while most congenital nevi are benign, there are important considerations regarding their management and potential risks.


Should Congenital Nevi Be Treated?
The decision to treat a congenital nevus largely depends on several factors, including its size, location, and characteristics. In your case, the nevus on your son's thigh measures approximately 1x1 cm, which is relatively small. Generally, small congenital nevi (less than 1.5 cm in diameter) have a lower risk of becoming malignant compared to larger ones. However, larger congenital nevi (greater than 20 cm) are associated with a higher risk of melanoma, particularly if they exhibit atypical features.


Risk of Malignancy
The risk of a congenital nevus transforming into melanoma is influenced by its size and other characteristics. Studies suggest that the risk of melanoma in small congenital nevi is quite low, but it is essential to monitor them for any changes over time. Signs that may indicate a need for further evaluation include:
- Changes in size, shape, or color
- Irregular borders
- Itching, bleeding, or crusting
- New symptoms such as pain
For your son, if the nevus remains stable and does not exhibit any concerning features, it may not require immediate treatment. However, regular dermatological check-ups are advisable to monitor the nevus for any changes.


Treatment Options
If treatment is deemed necessary, options include:
1. Observation: Regular monitoring by a dermatologist, especially during growth spurts in childhood.

2. Surgical Excision: If the nevus shows concerning changes or if there is a cosmetic concern, surgical removal may be recommended. This is typically done under local anesthesia in children, and the excised tissue can be sent for histopathological examination to rule out malignancy.


Psychological and Cosmetic Considerations
Beyond the medical aspects, the psychological impact of having a visible nevus should also be considered. As children grow, they may become self-conscious about their appearance. If the nevus is in a location that is easily visible and could lead to teasing or bullying, parents may opt for removal for cosmetic reasons.


Follow-Up and Monitoring
Regardless of the decision made, it is crucial to maintain regular follow-up appointments with a dermatologist. They can provide guidance on monitoring the nevus and assessing any changes that may occur over time.


Conclusion
In summary, while the congenital nevus on your son’s thigh is likely benign, it is essential to monitor it for any changes and consult with a dermatologist for personalized advice. Regular check-ups will help ensure that any potential issues are addressed promptly. If you have concerns about the nevus or its appearance, discussing these with a healthcare professional can provide clarity and peace of mind.