The management of congenital melanocytic nevi (CMN) has become a controversial subject. Since the studies of Greeley et al,1 it has become apparent that patients with giant ("bathing trunk" and others) nevi have a relatively increased incidence of malignant melanoma developing in their lesions. Now the subject of debate has been enlarged to include all CMN. I stress the term "congenital" because CMN occur at a much earlier time in development than nevi appearing after birth. The presence of such lesions on the upper and lower eyelids (the "wink" nevus) suggests that they may be formed between 50 and 53 days of embryologic age. Furthermore, some dermatopathologists2 believe CMN are histologically distinct from lesions developing after birth. At least two issues remain to be resolved. Can CMN be classified by size (or any other way) into those that should be removed and those that may be safely left
Solomon LM. The Management of Congenital Melanocytic Nevi. Arch Dermatol. 1980;116(9):1017. doi:10.1001/archderm.1980.01640330055011
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