Most dermatologists evaluate children and adolescents who have changing moles. Moreover, most of those patients are evaluated by general rather than pediatric dermatologists. Yet, Menzies et al1 show that the percentage of innocent moles that change, as seen via short-term sequential dermoscopic imaging, is dramatically greater in children and adolescents compared with middle-aged adults, and these changes are more likely to be innocent in the former group than in the latter. As a consequence, using change as a criterion for excising pigmented nevi results in many unnecessary procedures in children and adolescents.
Cohen B. To Biopsy or Not to Biopsy Changing Moles in Children and Adolescents: Are We Removing Too Many Pigmented Nevi in This Age Group?Comment on “Variables Predicting Change in Benign Melanocytic Nevi Undergoing Short-term Dermoscopic Imaging”. Arch Dermatol. 2011;147(6):659-660. doi:10.1001/archdermatol.2011.154