doi: 10.1503/cmaj.240037 A 69-year-old woman presented to our dermatology clinic with a the Breslow thickness should be determined as it is the strongest single congenital melanocytic nevus on her right lower back, predictor of metastasis and mortality.2 measuring 7 × 3 cm, with new-onset pruritus and hyperpigmenta- Most melanomas that arise in congenital melanocytic nevi are of tion for 1 month (. [...] We performed dermoscopy and identi- the superficial spreading subtype and occur after puberty (in lesions fied findings concerning for malignancy (i.e., atypical network, < 20 cm) or before the age of 5 years (in lesions ≥ 20 cm).3 Prophylac- irregular pigment dots or globules, irregular blotches, and blue- tic excision of smaller congenital melanocytic nevi (< 20 cm) solely white veil), compared. [...] Given the malignant infiltration detected tical with increased size and does not eliminate melanoma risk else- within the papillary dermis without epidermal ulceration, a sur- where.1 For early identification and treatment of the development of gical oncologist performed a wide local excision of the congenital melanoma, annual full body skin assessments, mole mapping, and melanocytic nevus and bio. [...] The dermoscopy, ideally by a dermatologist, are encouraged for patients absence of metastasis indicated localized invasive melanoma with a congenital melanocytic nevus of 20 cm or wider in a truncal (stage T1a N0 M0 in the tumour, node, metastasis staging sys- location, those with multiple nevi (congenital melanocytic nevi or tem). [...] Content licence: This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY-NC-ND 4.0) licence, which permits use, distribution and reproduction in any medium, provided that the original publication is properly cited, the use is non- commercial (i.e., research or educational use), and no modifications or adaptations are made.
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