To the Editor.—
The article concerning management of congenital melanocytic nevi (CMN) by Dr Solomon in the September Archives (1980;116:1017) states in the second paragraph, "I believe there is adequate evidence to recommend removal of all CMN." There are certainly two sides to this controversy, and I would like to emphasize several features for consideration. Congenital melanocytic nevi seem to occur in about 1% to 2% of the population, giving a possible number (in the United States alone) of more than 3 million. Accepting the figures stated in the article by Kopf et al1 (that 1.1% of malignant melanomas occurred in CMN) then about 110/3,000,000 (0.0036%) per year become malignant. These figures become even lower when it is realized that many more melanomas occur in giant CMN, thus lowering the number that occur in small CMN.The comment is also made that "melanoma is highly malignant when it occurs
Kirschenbaum MB. Congenital Melanocytic Nevi. Arch Dermatol. 1981;117(7):379–380. doi:10.1001/archderm.1981.01650070003001
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