Congenital Melanocytic Naevus — SCE Dermatology MCQ

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ModeratePaediatric DermatologyCongenital Melanocytic NaevusSCE Dermatology

A 4-year-old girl presents with a 4 cm flat, brown, uniformly pigmented patch on her trunk that has been present since birth. It is homogeneous in colour with regular borders. What is the recommended management?

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Correct answer: E — Annual photographic monitoring

Congenital melanocytic naevi (CMN) require risk assessment based on size. A 4 cm CMN in a child is classified as medium-sized (1.5-20 cm projected adult size). The lifetime melanoma risk for medium-sized CMN is estimated at <1%. BAD guidelines recommend baseline documentation (photography), regular monitoring by parents with education about changes to look for, and annual clinical review. Prophylactic excision is not routinely recommended for medium CMN unless there are clinical concerns. Giant CMN (>20 cm) carries a higher melanoma risk.

Reference: BAD 2010 Guidelines for management of CMN