Congenital pigmented moles (nevi)
Small congenital
pigmented moles (brown birth marks) are present in one percent of all newborn babies,
although most people develop their moles later in childhood or adulthood. Giant congenital moles (larger than 8
inches) are rare, and found in fewer than one in 20,000 newborn infants. Babies with giant congenital moles
clearly have an increased risk of developing
melanomas.
What to expect
The risk of change to
melanoma, a dangerous cancer, of small and medium-sized congenital moles is
slightly increased, but the exact amount of that increased risk is
controversial. There are many
studies being performed currently to try to determine more precisely how much of
a risk there is.
It is important to inspect congenital moles on a regular basis at home. We often
recommend that a dermatologist examine the patient yearly, with serial photographs
being considered for some moles. Signs of early change to melanoma include
the development of irregular borders, changes in color and a change in the
smooth surface of the mole. Any of
these changes should prompt a call to your dermatologist with evaluation shortly
thereafter. A congenital mole
may develop hair growth or uniformly darken (and these are expected changes which
are usually not of concern).
Treatment
Since there is a small risk
of these congenital moles becoming melanoma, we may recommend removal for some
of them. Most often removal can be
performed when the child is older with local anesthesia. Yearly check ups by a
dermatologist are also strongly suggested, as are regular skin self examinations
by older children (and parental examination for younger children). Strict sun protection with sunscreens
and sun avoidance are also strongly encouraged.