I thank Dr Kirschenbaum for his interest in my recently published comment on the management of CMN. I have no disagreement with his estimates of the incidence of melanoma in CMN. I do differ in viewing the incidence as an unacceptably high risk, whereas he apparently disagrees. The study by Kaplan1 was cited in my article as the source that described the potentially early fatal outcome of melanoma arising in the lesions. A second study cited in my article2 did the same. Dr Kirschenbaum's letter elegantly supports the contention that the word "giant" is relied on too often and too imprecisely, since he describes other studies where most of the lesions would have to be called "small," yet resulted in malignant degeneration. I agree with him that follow-up in the studies cited by him was inadequate to draw any conclusion concerning the fate of the patients.
Solomon LM. Congenital Melanocytic Nevi-Reply. Arch Dermatol. 1981;117(7):380. doi:10.1001/archderm.1981.01650070003002
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