Document Detail

Morphologic features and natural history of scalp nevi in children.
MedLine Citation:
PMID:  20479298     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To characterize the clinical changes in clinically distinctive scalp nevi over time in children to help guide management and avoid misdiagnosis as melanoma.
DESIGN: Cohort study.
SETTING: Washington University School of Medicine pediatric dermatology clinics. Patients Of 93 patients younger than 18 years with photographically documented, clinically distinctive scalp nevi, 28 (30%) consented to participate. Minimum follow-up from the initial visit was 1 year. Collectively, these patients had 44 scalp nevi at the initial visit. No patient had a personal diagnosis of melanoma or dysplastic nevus syndrome.
MAIN OUTCOME MEASURES: Clinical changes in scalp nevi as determined using the ABCDE scoring system (ie, asymmetry, border irregularity, color variegation, diameter >6 mm, and evolution/elevation from initial to follow-up images) on initial and follow-up photographs of scalp nevi.
RESULTS: Overall, 77% of the clinically distinctive scalp nevi (34 of 44) showed clinical signs of change during mean follow-up of 2.8 years. Of those with changes, 18 (53%) became more atypical and 16 (47%) became less atypical since the initial examination. None of the changes were concerning for melanoma. The mean total scalp nevus count was 2.6. Scalp nevi represented approximately 6% of total-body nevi. The number of scalp nevi increased with age. Boys had 1.5 times the number of scalp nevi as girls (P = .03).
CONCLUSIONS: Scalp nevi are clinically dynamic in childhood. These changes include an increase or a decrease in atypical features and occur in all age groups. This preliminary study does not support excisional biopsies but does support physician evaluation of scalp nevi evolution and serial photography of clinically distinctive lesions.
Monique Gupta; David R Berk; Cheryl Gray; Lynn A Cornelius; Susan J Bayliss
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Archives of dermatology     Volume:  146     ISSN:  1538-3652     ISO Abbreviation:  Arch Dermatol     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-05-18     Completed Date:  2010-06-07     Revised Date:  2013-07-03    
Medline Journal Info:
Nlm Unique ID:  0372433     Medline TA:  Arch Dermatol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  506-11     Citation Subset:  AIM; IM    
Division of Dermatology, Departments of Internal Medicine and Pediatrics, Washington University School of Medicine, 660 S Euclid Ave, Campus Box 8123, St Louis, MO 63110, USA.
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MeSH Terms
Age Factors
Child, Preschool
Cohort Studies
Dysplastic Nevus Syndrome / diagnosis,  pathology*
Follow-Up Studies
Melanoma / diagnosis,  pathology
Scalp / pathology*
Sex Factors
Skin Neoplasms / diagnosis,  pathology*
Grant Support
P30 CA091842/CA/NCI NIH HHS; P30 CA091842/CA/NCI NIH HHS

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